Ensuring you have your say on the Care Plan
Anyone who has been through the Adult Social Care or Continuing Health Care assessment knows that putting a care plan in place is essential to ensuring your needs under health and care are met.
We have all heard that the plan should be centred around the person and that the views of the person and others including carers and family members are to be taken into consideration (sec 10 19 and 10.20 stat guidance Care Act). Unfortunately, due to years of austerity this is the area where most people feel let down regardless of legislation, guidance, case law through the courts, or Ombudsman decisions from the PHSO and LGO (parliamentary deal with health and local government deal with social care). Peoples views, wishes and even fundamental needs or health domains as defined by legislation seem to be put aside in the name of cost saving. This makes a mockery of the systems and fundamental rights and goes against even the ethos of the services who provide them.
Most plans will include lengthy meetings sometimes even multiple meetings where every little detail is argued. Locally it is even down to how many wipes are needed to clean a person by day multiplied and worked out by the penny. This is costly and hugely unnecessary creating additional burden for staff and people who need the services.
We have even received information on a number of cases where assessors have told people that if the plan (that the authority) has written without regard of people's views or wishes are ignored, that if people do not sign them they will not get their money.
The advocacy I provide has had to come with solutions and advice to help get round this minefield of a situation which seems to have been created unnecessarily. The sooner people seek independent advocacy the better, and I do not mean when going through the process, but almost before you ring the services to get help. The guidance does suggest and allows for this.
The system itself I believe leads to many people being told that they are not eligible without even knowing the eligibility criteria. Most initial calls, which according to the guidance is when the process actually starts and not when they visit you, will nowadays be handled by a contact centre. Even other agencies who support such services know what needs are to be met. The amount of people who come to me for advice on the basis of having a disability or age thinking that is the gateway, are surprised to hear that the Care Act does not even mention these words in relation to assessment or needs.
I am not going into the specific needs or domains for these in this blog, as I have covered these before; they can be found here: https://haloabletec.blogspot.
Once you know what your needs are (see above link). The next thing a person needs to do is to be specific. The questions asked at assessments often mislead, questions such as ‘can you go to the toilet?’ are common. When in fact what you need to point is how difficult it is to get to the toilet and complete the task.
One of the main issues is that you are often thrown paperwork before (if you are lucky) or just ask on the day. No-one can remember everything on the day, and often things get missed.
I advise that a person should keep a diary for at least a week listing things based on the needs. Anything you have difficulty with in your day to day life, write it down. Once you have these notes you will be more prepared for the meeting and will be more informed as to the help you need (most people tend to underestimate, or wont give the full story, no one likes to really say they need help.
A copy of this should be sent to the assessor and more importantly ask for the copy to be attached to your assessment. This is then your proof of the items needed and requested. Even if they say they cannot do that or that they need to use their forms, you will have an email and a copy that you can use to show what you think your needs are. Sec 10.37 of the guidance makes it clear that the forms should not be static and that plans should be in a format that works for the person.
If the assessors say it is not allowed remind them the statutory guidance (10.32) does not say it is 50/50 split but individuals can take a greater share of the planning involved.
Even after all this, if a person is asked to sign a copy of the plan that they are not happy with next to the signature when signing say so. I always do on mine and say that an actual copy of my needs and plan has already been sent to them and that I am only signing the copy as requested to do so. Take a photo or scan of this before sending. Any subsequent arguments at least you will have the documentation to stand your ground and to ensure your rights are being met.
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