Initial contact - First contact
It is not always clear what counts as the first contact between customer and the council, and what should be done.
There are a variety of 'routes in' to council systems and processes; it is important to establish what they are because keeping records of first contact means data can be shared and support provided.
Statutory duties related to first contact
There are no statutory duties related to a 'first contact' process, nor performance targets regarding the time between first contact and other stages of the customer journey. From a Care Act perspective, what matters is that the necessary decisions are made before formal assessment is completed.
Local authorities must undertake an assessment with any adult with an appearance of care and support need, and a financial assessment, regardless of whether the local authority thinks the individual has eligible needs. Local authorities must also carry out a carer's assessment for any individual who provides or intends to provide care for an adult and appears to show signs of their own support needs.
People need to understand their rights to advocacy, which are dependent upon whether an appropriate informal person who can help exists and is willing to undertake this role
- What sort of assessment is needed and how much depth it needs to go into
- The ability of the individual to take part in supported self-assessment
- Whether the individual's mental capacity is likely to be an issue
- What to do if someone refuses assessment
- Dealing with any safeguarding concerns
What are the outcomes we want to achieve?
- The person has a good understanding of the process ahead and knows where to get further information and advice or support
- The person knows who will be in touch and when
- The person has received a range of information and advice that can help maintain their independence and resilience: improved personal skills knowledge and abilities, better circle of support and greater involvement in the local community
- The person has an understanding of the financial assessment process and charging policy
- Potential mental capacity issues have been identified, for appropriate support and processes to be put in place
- Easy access to a range of universal services
What tools and resources do we need to do a good job? What are the steps we have to go through?
- Information and advice on the local offer of care and support, how the system works, how to access services and how to raise concerns
- Financial information and advice including financial assessments and charging policy
- Direct payments information
- Universal services available e.g. equipment and telecare
- All resources, information in preferred format
- Simple initial assessment, combined with carer as required
- Copy of the detailed assessment and questions for preparation
- Copy of previous assessments including information from other organisations/ professionals
- Independent advocacy
- Virtual access to enable self-service, e.g. web-portal (with self-assessment, self-referral), email, social media (including Skype)
- Physical access where needed or preferred, e.g. supported access, face to face meetings, drop-in clinics
- Integrated care record/ system
- Information sharing protocol
- Motivational/ interview skills for staff and awareness of asset or strength-based approaches to social care
- Follow up call
What are the products we will have at the end of this process?
- Triaging and more information gathered about the person
- Decision on next steps and need for further support / assessment
- Record of outcome of first contact, including:
- Record of interaction
- Preferred ongoing contact arrangements
- Information and advice provided about local universal services available e.g. culture, leisure, and environmental opportunities in the person's local community, equipment, Telecare availability
- Signposting to local peer support networks and information and advice services / local community organisations
- Provision of information and advice about intervention and preventative services including referral onwards
- Referral for assessment
- Name of contact/ care coordinator who will lead on assessment
- Follow up call diarized to check how person is getting on and making use of the information and advice provided
When does this process start and end and within what timescales should this process be completed?
- Starts when the council or another organisation begins to collect information
- Completed at the point of referral or signposting to other services including referral for detailed/ further assessment
- Local commitment to minimum standard, e.g. all queries answered within 2 hours
- Initial review at 6 weeks
Who needs to be involved and what is their role? Who is taking the lead?
- Customer service advisor (Public Access team/ single point of access)
- Third sector advice agencies
- Care navigator
- Family or carer
- Independent advocate where pre-appointed or chosen representative
Each council has different internal and partnership arrangements, so first contact points vary significantly from any one locality to another. Similarly, recording of this first contact can simultaneously be an important way of getting support, prevention and early intervention to an individual or a family, but it can also become a burdensome process. Getting this balance right is both challenging and important.
Case study 1: Leicestershire First Contact Service (pdf - 107Kb)
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The First Contact Service is a multi-agency scheme run by Leicestershire Council in partnership with the District councils, police, fire and rescue and voluntary sectors groups. It is based on a single checklist that any of the partner agencies can complete when they meet someone who would benefit from the service.
This case study demonstrates how that single checklist can:
- reduce duplication between agencies
- trigger a wide range of preventative information and resources
- promote independence and well being
The Leicestershire First Contact Service is also helping the Council to meet its responsibilities under the Care Act to promote well being and provide universal and targeted information.
- 95 % of people using First Contact are not known to Adult Social Care
- On average 1 checklist results in a referral on into at least 3 partner agencies
A recent development has been to integrate the checklist into GP clinical systems so that a GP can complete on screen with the patient and promptly send on to the First Contact service. 27 GP surgeries are now actively using the First Contact Service.
- Case study 1 additional information: Scheme starter pack Leicestershire (pdf - 397Kb) (opens new window)
- Case study 1 additional information: Leicestershire Health Partner Referral (pdf - 143Kb) (opens new window)
Case study 2: Nottinghamshire - Carers Telephone Assessments at the Customer Services Centre (pdf - 103Kb)
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Nottinghamshire has established a Carers Support Service within its Customer Services Centre.
The service enables older carers to:
- be assessed over the telephone ( where appropriate) and have reduced waiting times, with cases being assessed within an average of a 7 day period
- receive accurate information and immediate support to enable them to continue caring longer and avoid crises
- have emergency respite arranged quickly and appropriately
- be referred for a carers' break provided by the NHS when appropriate
- be referred and signposted to relevant organisations supporting prevention
- be promptly assessed regarding a carers' personal budget
The service has been evaluated by Public Health and carers have given positive feedback. In particular, they say that the telephone assessment is far less intrusive and time-consuming than a home visit and does not negatively affect the person they are caring for.The Service has very significantly reduced the number of carer assessments being completed in older adult's teams freeing qualified social worker time to complete other work.
Case study 3: Nottinghamshire County Council Customer Services Centre (pdf - 108Kb)
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Nottinghamshire has restructured its Customer Services Centre so that over 75 % of its social care enquiries are now resolved at the front door significantly reducing work flow into operational teams and providing the customer with a more timely and targeted response.
It has done this by establishing a "triage" process, the key elements of which are:
- Identified Customer Services Advisors ( level 2 ) who respond to all social care enquiries
- A multi disciplinary Adult Access Service who deal with more complex referrals and undertake a range of assessments previously completed within operational teams
From March 2105 they will be further reducing process through a "self serve" option on the Council's website which will offer:
- A more comprehensive "on line" directory of universal and preventative resources
- "On line" contact assessments which will provide a quicker indication of care and support needs and eligibility for funded support
- an "Information Prescription" and signposting to relevant information and advice for those with ineligible needs
Future web developments are planned which will enable users to complete e-forms, make appointments and payments online