Archived decisions

REPORT OF THE

EXECUTIVE MEMBER

ADULT SOCIAL CARE

PART II

    CHANGE TO THE ELIGIBILITY CRITERIA UNDER WHICH COMMUNITY CARE SERVICES ARE DELIVERED

    1. The Executive Member has agreed to the information and consultation process to move eligibility criteria to critical only.

    2. The process will last for three months and will be designed to inform

      organisations and individuals of the Department's proposal to adopt eligibility criteria at "critical" only for community care assessments and will consult on this proposal, its implications and issues surrounding implementation. The consultation process will seek views from people affected by the proposal which will include:

      Organisations of users and carers; private sector providers; voluntary sector providers; voluntary organisations; the NHS; District Councils, staff and organisations representing black and minority ethnic groups and the Social Care PRC.

    3. The Government's Fair Access to Care advice recommends that a consultation process commences on the proposal only to provide services to users whose care needs are assessed as falling within the critical category of the eligibility criteria.' The proposals form part of the Department's budget recovery programme to ensure that the amount of care provided is consistent with the budget allocation. While this is a proposal, public law indicates that there must be a consultation process and at the same time views will be sought on implementation.

    4. Under the Fair Access to Care Guidance there are four categories of eligibility

    these are set out as follows:

    Critical: Someone's need for help is `critical' if one or more of the following

    circumstances apply:

          _ life is, or will be threatened

          _ significant health problems have developed, or will develop

          _ there is, or will be, little or no choice and control over vital aspects of the immediate environment

          _ serious abuse or neglect has occurred, or will occur

          _ there is or will be, an inability to carry out vital personal care or domestic routines

          _ vital involvement in work, education or learning cannot, or will not be, sustained

          _ vital family and other social roles and responsibilities cannot, or will not be, undertaken

    Substantial: Someone's need for help is `substantial' if one or more of the

    following circumstances apply:

          _ there is, or will be, only partial choice and control over the immediate environment

          _ abuse or neglect has occurred, or will occur

          _ there is, or will be, an inability to carry out the majority of personal care or domestic routines

          _ involvement in many aspects of work, education or learning cannot, or will not, be sustained

          _ the majority of social support systems and relationships cannot, or will not, be sustained

          _ the majority of family and other social roles and responsibilities cannot, or will not, be undertaken.

            Moderate: Someone's need for help is `moderate' if :

          _ inability to carry our several personal care or domestic routines

          _ involvement in several aspects of work cannot be sustained

          _ several social support systems, relationships, family and other social roles cannot be sustained

          _ several family and other social roles and responsibilities cannot, or will not, be undertaken

            Low: As above, but to a lesser degree, i.e. they can sustain most roles.

    5. Since these criteria were introduced, Hampshire's policy has been to provide services to people in the top two categories of critical and substantial. The eligibility criteria for Hampshire County Council Adult Social Care services were set to include the Critical and Substantial categories of the Department of Health framework for Fair Access to Care from April 2003. HThere are still some people in the lower two categories who were receiving care prior to the introduction of the Fair Access to Care guidelines who will be assessed to establish whether it would be appropriate to remove them from service if they do not meet the current categories of critical or substantial.

    6. The budget pressures on the Adult Services Department are well documented elsewhere. The Department provided in excess of £11m more care than it was funded for in 05/06. That pressure continues into this financial year and it is essential that the amount of care provided meets the available budget level insofar as is reasonable and lawful. The Department is providing care to more people than it can afford and care packages have been increasing in size and cost. One part of the financial recovery programme is to review the application of eligibility criteria. This will have implications across the whole system and family, friends and voluntary organisations will need to be more engaged in support for individuals in need.

    7. While action will be taken to review all people in the two lower categories of the eligibility criteria with a view to re-categorising them or removing service, the Department will also be taking steps to ensure that services are not provided for those clients whose needs are such that they should be receiving NHS funded continuing care. This is as important for the Department as it is for users, as NHS funded care is free at the point of delivery. This work will be carried out in conjunction with health partners, and will be informed by Department of Health guidance on the issue as well as legal advice.

                    PATRICIA BANKS

                    Executive Member for Adult Social Care