Actions and Next Steps (ACCESS)

You will often receive telephone contacts requesting to speak to a named worker or a particular service. However, this may or may not be the best person for them to speak to.

When the person/carer making the contact requests specifically to speak to or be contacted by a particular team or practitioner you should establish as quickly as possible whether the contact should be forwarded to that practitioner/team.

You should check available systems to establish whether:

1. The person/carer is allocated to the practitioner they have requested to speak to; or
2. The service/team is responsible for either the assessment or review of the person/carers needs.

You should not transfer a telephone call to a named worker if it is clear that the worker is not allocated to the person/carer. This will not be helpful to the worker or to the person/carer as they will not be speaking to the right person to resolve the contact.

If the practitioner is not available

If the practitioner is not available you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a member of the service/team they are based in.

If you know when the practitioner is likely to become available you should:

1. Inform the person/carer of this;
2. Leave the practitioner a message alerting them to the contact, any action undertaken and confirming the information given to the person about when to expect a call back;
3. Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required should the practitioner be unavailable for more than a few hours;
4. Agree with the person/carer what they should do if the practitioner does not make contact at the expected time; and
5. Make a proportionate record of all the above.

If it is not clear when the practitioner will become available you should:

1. Inform the person/carer of this;
2. Leave the practitioner a message alerting them to the contact, any action undertaken and what information has been given to the person/carer;
3. Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required; and
4. Agree with the person/carer what they should do if the practitioner does not make contact within an agreed timeframe; and
5. Make a proportionate record of all the above.

When a written contact is addressed to a named worker you should establish as quickly as possible whether the contact should be forwarded to that practitioner.

You should check available systems to establish whether the person/carer is allocated to the practitioner that the written contact is addressed to.

You should not transfer a written contact to a named worker if it is clear that the worker is not allocated to the person/carer. This will not be helpful to the worker or to the person/carer as they will not be dealing with the right person to resolve the contact.

Before transferring the contact you should:

1. Confirm that the practitioner the written communication is being transferred to is available within a reasonable timeframe for the action indicated by the contact, or that there is a mechanism in place for the written contact to be received and managed by the service in which they work;
2. Where the communication is a letter or an e-mail, whether the practitioner wishes to receive the original contact (if not this should be filed securely); and
3. Where a written response confirming the contact has been received is required or requested, agree who will provide this.

The most secure way to transfer a written contact is to send a message to the practitioner alerting them to the contact and where it can be found on the recording system.

Any original copies of e-mails must be sent via internal secure e-mail systems only and any original letters must be sent via internal postal services or secure delivery only.

If the practitioner is not available

If the practitioner is not available you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a member of the service/team they are based in.

If the practitioner is not available within a reasonable timeframe for the action indicated by the contact you should:

1. Leave the practitioner a message alerting them to the contact, where it can be found on the recording system and any action undertaken, including what has been agreed with the person/carer if contact has been made with them;
2. Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required and writing any acknowledgement letter to confirm arrival of the contact;
3. When the practitioner is not available within any timeframes indicted in the written contact or for more than a few days inform the person/carer making the contact of this;
4. Agree with the person/carer what they should do if the practitioner does not make contact within an agreed timeframe; and
5. Make a proportionate record of all the above.

If a person/carer is not ordinarily resident, an assessment by the Local Authority that will not be responsible for meeting their eligible needs may not be in their interests or give them an assessment. Information and advice should be provided to support the person/carer (or the referrer) to understand ordinary residency and the benefits of having their needs assessed by the Local Authority in which they are ordinarily resident:

1. That the Local Authority in which they are ordinarily resident will have a duty to meet their eligible needs (as opposed to no duty to do so in this authority);
2. That the Local Authority in which they are ordinarily resident will have a duty to carry out Care and Support/Support planning with the person/carer to determine the best way to meet eligible needs (as opposed to no duty to do so in this authority); and
3. That the Local Authority in which they are ordinarily resident will have a duty to review and monitor the effectiveness of the support provided to meet eligible needs (as opposed to no duty to do so in this authority).

Wherever possible, the person/carer (or referrer) should be provided with signposting information as required to enable them to contact the Local Authority in which they are ordinarily resident. If they are likely to experience difficulty doing so then, with their consent (or in their best interests if they lack capacity), this can be done on their behalf.

If the person/carer insists that an assessment is carried out by this Local Authority, if they have an appearance of need, the assessment should be completed. In this instance, if the person/carer is subsequently found to have eligible needs, information gathered during the assessment should be shared with the Local Authority in which they are ordinarily resident so that they can decide with the person/carer how best to meet their needs moving forwards.

If the Local Authority in which the person/carer is ordinarily resident disputes ordinary residence, declines to carry out an assessment or declines to meet eligible needs following an assessment, legal advice should be sought. In all cases, the process of meeting eligible needs must not be delayed.

Time should not be spent debating whether or not a person/carer is ordinarily resident in the area if this is not clear. The person/carer is entitled to an assessment of need based on an appearance of need, and not whether they are ordinarily resident. To delay the process of meeting eligible needs whilst establishing ordinary residence would be unlawful. The assessment should therefore be completed and the question of ordinary residence resolved afterwards.

If the information gathered during a telephone contact suggests the person/carer would benefit from further assessment or intervention a referral should be taken so long as:

1. The person/carer the referral relates to is making the referral;
2. The person/carer the referral relates to has given their consent to the referral; or
3. The person/carer that the referral relates to lacks mental capacity to make a referral and a decision has been made under Best Interests that a referral should be made; or
4. The person that the referral relates to is at risk of harm from abuse or neglect.

The following information should be included in a referral:

1. All personal details, including the persons/carers full name (and also preferred name or previous surname), address and preferred contact details, date of birth, national insurance number and NHS number;
2. The name, relationship and contact details of the person making the referral (if not the person/carer themselves);
3. When and how the person/carer consented to the referral;
4. If the person has not consented to the referral, was a mental capacity assessment carried out and is the referral being made under Best Interests;
5. What the presenting issue is from the person's/carer's perspective and what they would like to happen;
6. What the presenting issue is from the referrer's point of view (if the referrer is not the person/carer) and what action they may recommend;
7. What options have been considered with the person/carer to resolve the issue so far, including what support the person/carer has had from family and community networks;
8. What information and advice has been provided to the person or what information and advice may be required;
9. What prevention services have been used, considered or may be of benefit;
10. Any specific communication needs of the person/carer that need to be considered so they can understand and be involved in any adult Care and Support process;
11. Whether the person/carer is likely to have substantial difficulty in any adult Care and Support process, and if so whether an independent advocate has been considered;
12. Details of any previous or current Care and Support/Support services (whether the Local Authority is providing them or not);
13. With the person's/carer's consent the name and contact details of anyone involved in their life who should be involved in any assessment (family member, friend or professional); and
14. Any other information deemed relevant by the person/carer or referrer (if the referrer is not the person/carer).

Sometimes it is clear which service in the Local Authority should receive the referral that has been made. Where this is clear local processes should be followed to transfer the referral to that service.

Sometimes it is less clear which service should receive a referral. For example, if the person/carer's needs could potentially be met by more than one team.

Decision making in this instance should be as simple and consistent as possible. It should involve the person/carer and the potential services with the aim of reaching a shared agreement. Any delays should not negatively impact the person/carer or put them at risk through the delay of any Care and Support/Support needs being met.

Though not a requirement, it would be prudent to apply the same criteria that the Care Act requires to be applied when deciding the most appropriate worker:

1. The views and wishes of the person/carer about which service/team would best support them must be regarded;
2. The service/team must possess the skills, knowledge and competence to carry out the anticipated Care and Support functions; and
3. The service/team must possess the skills, knowledge and competence required to work with the particular person/carer in question.

tri.x as developed a tool that can be used a required to support consistent decision making about team suitability.

See: Team Suitability Decision Support Tool.

The service area or team receiving the referral should make effective use of the information gathered thus far and not make the person/ carer (or anyone else previously consulted) repeat information unnecessarily.

Whenever the outcome of a contact or referral is that the person/carer will be involved in any adult Care and Support process (including any assessment, review, reassessment or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person/carer when:

1. There is no appropriate other person to support and represent them; and
2. They feel that the person/carer would experience substantial difficulty being fully involved in the Care and Support process without support.

Decisions about the need for advocacy should be made as early as possible because advocacy must be provided before the Care and Support function to be carried out can begin. As such if you know that advocacy will be likely you should discuss this with the person and make a referral at the same time as you transfer the request for a review or reassessment.

See Using Independent Advocacy, which includes guidance on how to establish whether a person needs an advocate, the different advocates that are available and how to make a referral.

The Local Authority has a duty to provide good information around finances at an early stage. This provides people with an understanding from the beginning about how they may be expected to contribute financially towards the cost of any Care and Support/Support they receive so that they can start thinking about and planning how they could use their financial resources flexibly to fund a range of potential care options. You should take any opportunity to provide this information, and should particularly make sure that it has been provided whenever a transfer is made to another service that may result in an assessment, review or reassessment.

See: Specific Requirements on the Provision of the Information and Advice around Finances for guidance on the requirements of the Care Act.

See the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment.

Whenever the outcome of a contact or referral is that the person/carer will be involved in any adult Care and Support process (including any assessment, review, reassessment or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person/carer when:

1. There is no appropriate other person to support and represent them; and
2. They feel that the person/carer would experience substantial difficulty being fully involved in the Care and Support process without support.

Decisions about the need for advocacy should be made as early as possible because advocacy must be provided before the Care and Support function to be carried out can begin. As such if you know that advocacy will be likely you should discuss this with the person and make a referral at the same time as you transfer the request for a review or reassessment.

See Using Independent Advocacy, which includes guidance on how to establish whether a person needs an advocate, the different advocates that are available and how to make a referral.

The Local Authority has a duty to provide good information around finances at an early stage. This provides people with an understanding from the beginning about how they may be expected to contribute financially towards the cost of any Care and Support/Support they receive so that they can start thinking about and planning how they could use their financial resources flexibly to fund a range of potential care options. You should take any opportunity to provide this information, and should particularly make sure that it has been provided whenever a transfer is made to another service that may result in an assessment, review or reassessment.

See: Specific Requirements on the Provision of the Information and Advice around Finances for guidance on the requirements of the Care Act.

See the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment.

In addition to our own services, information and advice is available from community and partner organisations. Information about these can be found in the Adult Services section of the Council website which also contains the Adult Social Care Directory.

See: Adult Social Care Hub

Sometimes it is helpful to contact a well known national organisation with a dedicated information and advice service or help-line. See: National Organisations with Information and Advice Helplines for details of some national organisations offering this service.

Some national organisations do not have dedicated information and advice services but can still provide such support upon request. See: National Contacts for Adult Care and Support for a wider range of useful national contacts for adult Care and Support.

You can also see the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment, including questions relating to Disabled Facilities Grants (DFG).

NOTE: This FAQ is based on statutory duties and powers and does not represent Milton Keynes local policy.

When providing information and advice on local charging policy, always refer to the relevant policy. This will be found in the Local Resources section.

There is also information about charging on our Council website.

See: Paying for your Care and Support

Information and advice must be provided in an accessible way so that the person/carer for whom it is intended can best understand and make use of it.

If you feel the person/carer for whom the information and advice is intended will need support to understand it then you should:

1. Consider whether the person/carer has anyone appropriate who can help them to understand it;
2. Consider any steps that you can take to support them to understand it (for example talking through the information over the telephone or summarising it in a simpler format); and
3. Consider the benefit of independent advocacy.

Information about preventative services provided by our Adult Services can be found in the Local Resources section.

This includes, but is not limited to:

• Community Alarm;
• Community Occupational Therapy;
• Rehabilitation.

In addition to our own services, preventative support is also available from community and partner organisations. Information about these can be found in the Adult Services section of the Council website.

See: Adult Social Care Hub