ISF module 3 - eligibility and creative support planning

1. Module 3: Care Act Eligibility
& Creative Support Planning

2. Welcome and
Introductions
Jacqui Hendra
Self Directed Futures and Fellow of the
Centre for Welfare Reform

3. Recap from module 2: Person
Centred Planning and PATH
• Using PATH to work with the person and the people important to
them to identify their hopes and dreams for the future.
• From this the Social Worker will then identify both eligible and non-
eligible needs/goals. Those that will be funded by the local authority
and those that will need to be achieved through different means.
• The how and when will then be determined by the person with
support from their Provider and those in their support network.

4. Care Act Eligibility & creative support planning
Learning Outcomes
Be able to carry out asset/
strength-based person
centred support planning
& work with individuals to
think of creative ways to
meet their needs and
improve outcomes
Demonstrate the skills
needed to research assets
in the local community,
that meet the individuals
needs and interests and
help them to make best
use of them
Understand how the use
of all resources, including
assistive technologies,
community groups and
voluntary organisations
can be utilised to achieve
the best possible
outcomes for people
Know how to broker and
pool budgets between
individuals and other
service providers
Understand that meeting
eligible needs criteria
results in resource
allocation from different
funding sources
Understand positive risk
taking and how you can
support people to take
positive risks in the
context of your role

5. What we would love to see
• We want people to have support that is focused and working towards their outcomes.
Those that are eligible outcomes and those that aren’t eligible but have been identified
by the individual as important to them.
• We want to encourage creativity – don’t be worried about putting ideas forward
• We want to be looking at what resources people already have available to them, what’s
in the local community and the use of assistive technology
• We want to shift thinking from time and task to achieving outcomes

6. Discussion:
What is your understanding of Care
Act eligibility and how it relates to
your role?

7. Care Act Guidance
The core purpose of adult care and
support is to help people to
achieve the outcomes that matter
to them in their life. (1.1)
https://www.gov.uk/government/publications/care-act-
statutory-guidance/care-and-support-statutory-guidance

8. Different types of outcomes/goals
Maintenance Change Prevention
Where the person might be
seeking to hold on to skills.
For example Maintenance
goals focus on:
Hygiene is maintained.
Social contact continues.
Staying safe and secure.
Maintaining tenancy or any other
occupancy agreements.
Living in a clean and tidy
environment.
Where the person may be
looking to develop skills in new
areas.
For example Change goals
focus on:
Changes in symptoms and
behaviour.
Improving morale/mood state
Increased physical.
ability/functioning e.g. mobility
Increased confidence.
More social contact.
Where the person may be
looking to prevent something
from happening.
For example Prevention goals
focus on:
Risk of falls is reduced/removed.
Episodes of mental ill health/low
mood are prevented.
Skin breakdown is prevented.
Prevent readmission to hospital.

9. Why is it
important to
understand
eligibility?
• It is a key element of the Care Act
Assessment process
• To understand what can be funded by social
care and what can’t
• To help the discussion about how those
goals that won’t be funded by ASC can be
met
• To develop a shared understanding and
language between providers and social
work teams
• To ensure that support is focussed and has
direction to meet a person’s eligible
outcomes

10. Social work perspective
The great advantage of Individual service funds is the flexibility they give the
person to use the money in imaginative ways – as long as they are doing so to
meet their agreed eligible outcomes. This is why for both the person and the
Local authority the plan needs to be as clear as possible as regards the purpose
of the payment (as distinct from their personal funds and any benefits they
receive).
This way, the person can confidently use the funds in creative ways (as long as
they fit with the plan’s intentions), and the care manager can support them with
this, as well as identify and deal with issues such as potential misspends.

11. Providers are key in working towards goals
Social workers may have written some great goals with the person, but without
the ongoing involvement and support of the provider of the services, (e.g.
Domiciliary Care), those goals will be hard to achieve. Having clear goals set in
the Care and Support plan and communicating these to the provider of services
will support them in delivering the service, to progress that person’s
independence.
If the goals are unclear or too restrictive, we can make the mistake of building in
care and support that continues with no definite direction or aim, which creates,
rather than reduces dependency on services.

12. Care Act Guidance –
relationship with other
services & avoiding
duplication
• 10.23 …….they make clear that
local authorities must not meet
needs by providing or
arranging any health service or
facility which is required to be
provided by the NHS, or doing
anything under the Housing
Act 1996.

16. Exercise – Discuss the 3 scenarios below and decide if they would be classed as
an Eligible or Non-Eligible need and what considerations would need to be
made?
2) Joe lives in his own
home and has a
physical disability. The
lift that accesses his flat
is not in operation and
there is a £100 call out
charge to repair it.
1) Sarah lives in her own
home and receives 40
hours of support per week,
including daily support
with her medication and
personal care. She wants
to go on a 3 day short
break to Butlins and
requires support with this.
3) Hannah lives in her
own home and receives
daily support. She
wishes to attend a
catering course and has
ambitions to achieve
employment.

17. Care Act Guidance
The maximum flexibility should be
incorporated to allow adjustment and
creativity, for example by allowing people
to include personal elements into their
plan which are important to them (but
which the local authority is not under a
duty to meet). (10.37)
https://www.gov.uk/government/publications/care-act-
statutory-guidance/care-and-support-statutory-guidance

18. Balancing the important to and important for

19. Doing things
differently

20. Care Act Guidance –
ISFs and flexible
support
• …… the person may have fluctuating
needs, in which case the plan should
make comprehensive provisions to
accommodate for this, as well as indicate
what contingencies are in place in the
event of a sudden change or emergency.
This should be an integral part of the care
and support planning process, and not
something decided when someone
reaches a crisis point. (10.44)
• https://www.gov.uk/government/public
ations/care-act-statutory-guidance/care-
and-support-statutory-guidance

21. A parent’s perspective
“The fixed rota when James had to return to us for three nights has now
become a thing of the past. We are able to choose between ourselves when
and the duration of these visits. Sometimes one night sometimes several not
as previously fixed.
All these small adjustments have made us as a family so much more relaxed
knowing that any emergency and where possible all activities can be
supported, leading to a far happier family without all the stresses and strains
and restrictions we previously experienced. This flexibility has enabled James
to diversify his activities to include , amongst others, using FaceTime, taking
part in online cookery lessons, online shopping and art which he desperately
loves. All facilitated by the support that he receives.”

22. Flexible Support Planning
The goals you would like
to achieve
Eligibility Actions to achieve this Time to achieve
You want to access the
cafes and shops in town
on your own.
Community Care staff will work with
you to gain confidence
and travel further
distances into town, they
will be there but at a
distance until you feel safe
on your own.
1-8 week
You want to heat up meals
in the oven or microwave
on your own and transfer
them out onto a kitchen
table and then eat them.
Nutrition Care staff will work with
you to gain confidence
and supervise you to do
this every day until you
feel able to do this on
your own.
1-8 week

23. Flexible Support Planning
The goals you would like
to achieve
Eligibility Actions to achieve this Time to achieve
You want support to
transfer out of bed, onto
the shower chair, and into
the shower every
morning.
Home safety Care staff will work with
you to support you to do
what you can, and check
with you daily.
Ongoing
You want to be able to
wash most of your body
yourself, whilst in the
shower. Clean your own
teeth and wash your hair.
Hygiene Care staff will continue to
work with you to meet
your own personal care
needs. You know what
you can do and will ask
for support in areas you
need ongoing support
Ongoing

24. Care Act Guidance – it’s
not just about services
The concept of ‘meeting needs’ is
intended to be broader than a duty to
provide or arrange a particular service
……… The intention behind the legislation
is to encourage this diversity, rather than
point to a service or solution that may be
neither what is best nor what the person
wants. (10.10)
https://www.gov.uk/government/publications/care-act-
statutory-guidance/care-and-support-statutory-guidance

25. Moving from support provider to support
broker

26. Creative
Support
Brokering
© Self Directed Futures

27. Activity: Thinking creatively to meet outcomes
• Taster sail-ability
• Swim with dolphins in Florida
• Horse riding
• Keep my flat clean
• Find a paid job
• Control my anger
• Manage my money
• Support someone to be more
independent in the community

28. Discussion
Which goals would be eligible for social care funding?
Which goals wouldn’t be eligible for social care funding?
What is the best way to meet the goals?
What if something is too expensive?

29. Creative support planning – things to
remember
• 70% of the information you need about a person will come from the PATH
session but 30% will need to come from elsewhere. e.g. through 1:1s
and/or as part of the preparation for the PATH ‘thinking about the here and
now’ people can share information about their personal health and care
needs at this stage
• Consider all the assets available:
• what can that person do for themselves
• what’s available in the community
• what can family and friends offer
• How can equipment or technology help
• other sources of income
© Self Directed Futures

30. Discussion: How
much do you
know about
personalised
technology?

31. Simple
solutions
For years Janice had her medication
administered (15 minutes every AM
& PM). Now introduced a
medication dispenser, her support
worker has spent time working
with her to see that she can use it
and has now increased her
independence.

32. Care Act Guidance
• 10.48 It is important that people are
allowed to be very flexible to choose
innovative forms of care and support,
from a diverse range of sources,
including quality providers but also
‘non-service’ options such as
Information and Communication
Technologies (ICT) equipment, club
membership, and massage.

33. Discussion
Marcus lives alone
and wants to keep in
touch with relatives in
Australia and build a
relationship with
them using video call.
A tablet would be
good for this but who
should pay?

34. Pooling personal budgets
(joint purchasing)
Mark and Chris live together and have 1:1
support, they have their own interests
but sometimes enjoy going out for a
Sunday roast. Sometimes Mark might not
be in the mood to go out but his support
team will know this from his behaviours.
But on the days he does, Mark and Chris
will pool their budget and with support
from just one member of the team they
will go out for a meal.
Sarah and Claire have started to attend a
fitness class. Normally they would have
1:1 support but as their friendship has
grown they will walk together with one
support worker and then go to the class

35. Pooling personal budgets (joint
purchasing)
Monica chose not to go back to Day
Centre but rather than increase the
budget as daily support required
Monica with her circle of support
explored alternatives with £87 budget.
Monica decided to share 10 support
hours with a friend and now they will
go out into the community once a
week to try different activities that
they choose with one member of
support staff.
Janet and Jude both like to go
swimming and so they jointly pay for a
taxi to travel together

36. The art of the possible
Josh has a learning disability; he
has been attending a yoga class
and during the pandemic has
decided that he would like to
deliver a class online with his
teacher for others to attend.

37. Managing risk when purchasing support on
behalf of the person
Example: someone wants to try trampolining
Starting place - how can we make this happen and
how can we make it safe
Things to think about, to check and evidence:
• Does the person have the necessary qualifications?
• Do they have insurance?
• Where will it happen?
• What is being offered and what will be learnt?
• How will it be delivered?
• Monitor progress – is it working well?

38. Managing risk
Providers might be concerned that the risk is too high or feel
uncomfortable.
Speak with the LA and risk assess together – might need a
Multi Disciplinary Team meeting or to consider the Mental
Capacity Act but it might be manageable
Confidence will grow the more you do it and positive risk
taking will form part of the way you work

39. Reminder: Mental Capacity Act and making
decisions
The core principles of the MCA 2005 are set out in s.1. They are:
• A person must be assumed to have capacity unless it is established that
they lack capacity;
• A person must not to be treated as unable to make a decision unless all
practicable steps to help him to do so have been taken without success;
• A person is not to be treated as unable to make a decision merely
because he makes an unwise decision;
• An act done, or decision made, under this Act for or on behalf of a
person who lacks capacity must be done, or made, in his best interests;
and
• Before the act is done, or the decision is made, regard must be had to
whether the purpose for which it is needed can be as effectively
achieved in a way that is less restrictive of the person’s rights and
freedom of action.
https://1f2ca7mxjow42e65q49871m1-wpengine.netdna-ssl.com/wp-content/uploads/2020/12/Mental-Capacity-Guidance-Note-Capacity-
Assessment-January-2021.pdf

40. Next session: Monitoring and Review
Please can you complete the feedback form when it
gets emailed following the session, we appreciate
hearing your thoughts