Initial contact - Proportional approaches

What does a proportionate approach mean in practice?

Overview

The Care Act and its Guidance promotes the principle of 'proportionality'. Often proportionate approaches can be difficult to employ. For example, in the case of proportionate assessments, a simple assessment can uncover hidden complexity, whilst apparent complex cases can be relatively straightforward.

However, where it is clear that a simple assessment is possible, the Guidance enables a slimmed down assessment to be undertaken. It is important to note that an assessment must end in a decision about eligibility if the person wants one, it is suggested, and must therefore have explored the necessary minimum to provide an evidence basis for that conclusion.

The principle of proportionality can be applied to other social care processes, including first contact, planning stages and also during monitoring and review.

Features

What does it mean? ...at first contact

  • Information on what to expect at each part of the process and what to do if things change
  • People receive a range of information and advice that can help them plan how to maintain their independence and resilience
  • Potential mental capacity issues are identified early, for appropriate support and processes to be put in place (including face to face assessment)
  • Early information and signposting to online tools for financial charging
  • Early information and signposting to online tools for support planning
  • Early information and signposting to support and advice on direct payments
  • Choice of time, location and medium for first contact

What does it mean? ...at assessment

  • Choice of time, location and medium for how the assessment and planning activity is carried out
  • Impact of assessment on the person/ carer taken into account
  • A scaled process which fits individual circumstances and acknowledges what the person wants from the process
  • People's mental capacity to make decisions about their own care and support is properly considered, and formally assessed where it is in doubt
  • If it is thought people may lack mental capacity, they get appropriate help to participate in the assessment
  • An understanding of the urgency and complexity of need and how needs may fluctuate
  • Signposting to other sources of information advice and support

What does it mean? ...at planning stage

  • A range of DIY support planning tools enabling people to plan for themselves
  • A summary support plan
  • A short term care and support plan
  • If it is thought people may lack mental capacity to make decisions about their own care and support, they get appropriate help to participate in the planning
  • If people are assessed as lacking mental capacity, decisions are made in their best interests in line with the Mental Capacity Act
  • Choice of time, location and format

What does it mean? ...for monitoring and review

  • A light touch review process which enables people who are managing well to self-review and provides scalable support as required including the option of peer-led review
  • A scalable review tool that is proportionate to the level of need and personal budget amount
  • Improved resilience and focus on building informal networks
  • Choice of time, location and format
  • A light touch approach to monitoring direct payments which focuses on whether outcomes are being met and within budget rather than on the detail of what has been purchased
  • A scaled approach to managing disputes by exception so that people are supported to get back on track if they are struggling to manage or make a mistake by purchasing something prohibited
  • A fallback option so that people can switch from direct payments to managed support if things are not working and support is not enough to get circumstances back on track

Problem

Proportionality is about conducting the processes in a manner that is both consistent and appropriate to the needs which must be met. For example, it would not be sensible to sanction lengthy planning, personal budget development and panel sign off for a relatively simple case where the adult and council have agreed on how to meet needs at an early stage. Proportionality should be seen as a layered process that does not omit parts of the Care Act.

Solutions

  • Case study: Doncaster Council - Proportional approaches (pdf - 143Kb) (opens new window)

    Doncaster Council has produced a leaner model to capture the process from social care assessment, to eligibility, to resource allocation, outcomes statement and thereafter, to support planning. The approach captures the Wellbeing principles of the Care Act 2014, is asset based and works with the person who uses the service to co-produce the outcomes important to them. It enables the Council to move to an 'assets first, services last' approach drawing on a range of resources available to the person in their own network and communities.

Comments

Posted on by Old Site User

The Care Act 2014 places an obligation on people making eligibility decisions to take the fluctuation nature of a person's needs into account, for example in the case of someone living with multiple sclerosis (MS) or Parkinson's. I wonder if there are examples of effective application of such assessment out there and would be grateful for any pointers, links etc. to examples of good practice.

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