Policy approved by: / Adults, Health & Community Wellbeing Management Team
Date Policy approved: / 21st August 2008
Implementation Date: / September 2008
Review Date: / July 2009
Status: / Final / Version no: / 2.0
Adults, Health & Community wellbeing
Document Control Sheet
Title of Policy: / Putting People First: Validation of Support Plans and Personal BudgetsPurpose of Policy: / To provide the policy framework for confirmation of the content of support plans drawn up under self directed support and for validation of the personal budget.
Target Audience: / Adult Social Care Practitioners and Managers, especially those involved in supporting individuals to draw up support plans, administration of the resource allocation system or authorisation of support plans or personal budgets.
Implementation Date: / September 2008
Action required: / Adoption of this policy as the framework for confirmation and validation of support plans in relation to self-directed support within Adult Social Care.
This policy supersedes: / Adult Social Care Purchasing Guidance in relation to support plans drawn up under self directed support and personal budgets.
This policy should be read alongside: / Adult Social Care Purchasing Guidance
SDS Strategic Overarching Policy
SDS Support Planning Policy
SDS Resource Allocation System Policy
SDS Risk Enablement Policy
Lead Director: / Liz Chidgey, Deputy Executive Director
Adults Health & Community Wellbeing
Policy Lead / Author: / David Williams / Helen Terry
Project Team: / Karen Wright, Teresa Ash, Shaun Lancaster, Amanda Julian, Rob Osborne, Ethan Tucker, Rebecca Halpin, Gillian Mcdonald, Kate Burke
Date: / 6 August 2008
Draft Versions only:
Comments to:
Deadline:
Putting People First
Validation of Support Plans and Personal Budgets
1. Policy Statement
1.1.This policy sets out the framework for the process of validating support plans and personal budgets under which the Council will:
- confirm the indicative budget that the person will use to draw up their support plan
- approve the support plan and
- confirm the final amount of the personal budget and authorise release of the money to the individual.
1.2.Validation is the process of approving the content of the support plan and confirming the final amount of the personal budget.
1.3.The Council retains its duty of care to ensure that the assessed, eligible social care needs of any individual are met. The Council must ensure that the indicative personal budget generated by the RAS represents a reasonable amount with which to plan the service user’s support. The Council also has a responsibility not to agree a support plan if there are serious concerns that it will not meet an individual’s needs or that it may expose anyone to unacceptable risk.
1.4.The Council must also ensure that public funds are used in accordance with the purposes for which they are provided and in a way that secures best value.
1.5. Before any money is released, the Council will therefore check and approve the Support Plan and confirm the final amount of the Personal Budget required to implement the plan.
2. Guiding Principles
2.1.The Validation process will operate in accordance with the following principles:
2.2.The proposals for meeting the person’s assessed eligible needs, as set out in the support plan,must be:
- Lawful – the proposals arelegitimately within thescope of the funds and resources that will be used. The proposals are lawful and regulatory requirements[i] relating to specific measures proposed have been addressed.
- Effective – the proposals will meet the assessed eligible needs and support the person’s independence and wellbeing. A risk assessment has been carried out and any risks identified in the plan have been addressed. The proposals make effective use of the funds and resources available in accordance with the principle of best value.
- Affordable – All costs have been identified and can realistically be met within the budget.
3. Scope and Exclusions
3.1.This policy will apply to all adult social care users and their carers who are assessed as being eligible to receive social care services under Fair Access to Care Services and who are eligible for SDS. It is envisaged that following establishment of the SDS model, this policy will be rolled out to all service users through a controlled implementation programme.
4. Regulatory and policy context
4.1.The Government, through the Department of Health, sets the strategic direction and the legal and policy framework for adult social care in England. Funding for social care comes from a combination of central government grants, council tax revenues and user charges. Individual local authorities are responsible for providing and managing social care services within the allocated funding.
4.2.The Government has released a number of policy documents setting the strategic direction of adult social care. The White Paper, Our Health, Our Care, Our Say establishes the principles that people should have more choice and control over the services they receive; people should be supported to remain independent and that services should be provided close to home.
4.3.In December 2007, the Government, councils, health authorities, professional bodies and voluntary organisations agreed on a strategy, Putting People First, to personalise care services. This involves giving people greater control over services and more opportunity to make choices and decisions for themselves, particularly through the introduction of personal budgets.
4.4.A list of key national policy documents and legislation is set out in Appendix A.
4.5.The Council has a statutory duty to assess adults and carers within their area to whom they may provide or arrange for the provision of community care services and, once assessed, shall decide if those assessed needs call for the provision of services to meet their eligible social care needs. Eligible needs are determined in accordance with the Department of Health’s guidance on Fair Access to Care Services.
4.6.The Council’s Adult Social Care service has issued Budget Rules and Principles to provide guidance to staff on the management of resources. It has also issued guidance on Good Practice in Purchasing in order to ensure consistent practice across the Council in determining how best to meet the assessed needs of service users.
4.7.The framework under which service users will plan their support under SDS, and the assistance that they can obtain to do this, is set out in the Support Planning and Review Policy. This outlines the key principles underlying the process and the structure and content of support plans.
4.8.The framework under which the indicative personal budget will be calculated is set out in the SDS Resource Allocation System Policy.
4.9.The framework for assessing and managing risks within Adult Social Care is set out in the Risk Enablement Policy.
4.10.This policy relates to the validation of the personal budget and approval of the support plan under SDS.
5. Policy Background
5.1.The support plan identifies how an individual’s assessed eligible needs will be met, using their personal budget. It does not cover Universal Services, which are available without charge to all service users.
5.2.While service users will be responsible for developing their own support plan, the Council retains its statutory duties to ensure that people’s assessed eligible needs are met. To discharge this responsibility, the Council therefore needs to make sure that the indicative personal budget generated by the RAS represents a reasonable amount within which the person can plan their support. It also needs to ensure that any risks have been properly identified and addressed. These include risks to the person or anyone else but also risks to the service or to the Council[ii]. Finally, the Council needs to check and approve the person’s support plan – the validation process.
5.3.The Council has a statutory duty to ensure that social care funds are used effectively and in accordance with the principle of best value. The Council therefore needs to make sure that the individual’s needs and desired support outcomes are taken into account and that the measures proposed in the support plan represent an effective use of the personal budget.
5.4.The Council recognises that some measures that involve a significant short term cost can eventually contribute to increased independence and thereby reduce support needs or avoid further costs in the long term. In these circumstances the Council will expect support planners to justify how short term measures will yield longer term benefits.
5.5.The Council recognises that there are some circumstances in which it will be appropriate to authorise exceptional additional costs, including:
- Compassionate circumstances (eg terminal illness)
- To avoid or prevent serious damage to the person’s mental or physical health
- The individual or their carer is providing financial resources or additional practical support to reduce the cost of the support plan. In this case the Council will exercise discretion.
5.6.During the Support Planning process, the capacity of the person to take control of developing their support plan will be assessed in accordance with the requirements of the Mental Capacity Act 2005[iii]. The Council will need to satisfy itself that, if the person appears to lack capacity, any issues arising have been identified and addressed. The service user will also need to decide how they want to receive and manage their personal budget[iv]. It is possible that an individual who does not have capacity to develop their support plan may have capacity to manage their personal budget, and vice versa. The Council will need to assess the person’s capacity in this context.
5.7.During Support Planning, the service user will also be supported to undertake a risk assessment to identify how any risks arising from their needs or proposed support will be addressed. Provided the risks are clearly identified and addressed in the support plan, the plan should be validated. If, following the support planning process any risks remain unresolved, managers should attempt to resolve these as part of the validation process. Difficult or contentious decisions may be escalated to more senior levels for resolution. A partially validated support plan or a managed service will be put in place where necessary to avoid any delay in meeting the person’s needs.
5.8.A service user who has the mental capacity to make a decision, and chooses voluntarily to live with a level of risk, is entitled to do so.
5.9.However the Council remains accountable for the proper use of public funds and whilst the individual is entitled to accept a degree of risk, the local authority is not obliged to fund it. In contentious cases, the process of validating support plans will need to address and resolve conflict about the treatment of risk.
5.10.As a provider or commissioner of services, the Council could be liable if it places people in a position in which they are exposed to risk. There is an important distinction between enabling people to choose to take a reasonable risk and putting people at risk. In such cases, the validation process will provide the means to consider the issue and find the correct balance.
6. Policy Requirements
6.1.The process of assessment, confirmation, support planning and validation is illustrated in the diagram below (see Appendix B for a full size version). The processes of assessment and support planning are dealt with under the policies on the Resource Allocation System and on Support Planning and review. This policy looks at the process of confirming the indicative personal budget and validating the support plan.
Confirmation of the indicative personal budget
6.2.A person’s eligible needs for social care services will be assessed by means of the supported self assessment questionnaire (SSAQ). The RAS will assign points to the needs identified in the SSAQ in line with FACS criteria. The points are then converted into a nominal financial amount – or indicative personal budget. This provides the person with a guide as to how much money they may have to fund their support plan. This process is set out in more detail in the SDS Resource Allocation System Policy.
6.3.Confirmation: Before the indicative budget figure is released to the service user and their support planner, the Team Manager will check that the person’s needs have been appropriately identified in the SSAQ and that the indicative personal budget generated by the RAS represents a reasonable amount for the service user to plan their support. At this point the Team Manager will also check that any additional sources of funding for which the person may be eligible (eg Independent Living Fund, Learning & Skills Council) are identified and incorporated into the indicative personal budget.
6.4.Where necessary the Council will authorise a temporary support package to meet the assessed eligible needs while support planning proceeds. This will ensure that the person’s needs are met in line with the Council’s statutory duties but that they retain the freedom to plan their own support on a longer time scale.
Treatment of Exceptions
6.5.There will be an Exceptions process to address cases where there are particularly high or complex support needs; where the RAS cannot generate an appropriate indicative budget or where the answers to the SSAQ do not reflect the levels of need identified in the rest of the assessment and this cannot be resolved by revisiting the SSAQ with the service user.
6.6.The RAS cannot be relied upon to calculate an accurate indicative budget for complex cases involving high levels of need. In these cases it will calculate an indicative personal budget up to a maximum threshold. For cases that meet or exceed this threshold, the RAS will flag this as an Exception.
6.7.In other cases, where the Team Manager believes that the indicative budget generated by the RAS is inappropriate and this cannot be resolved through revisiting the SSAQ with the service user, they should seek approval from the Operational Service Manager or Senior Operational Manager to treat this case as an Exception.
6.8.Likewise, where the Team Manager believes that the answers given to the SSAQ do not reflect the needs identified in the rest of the assessment, and this cannot be resolved through revisiting the SSAQ with the service user, they should seek approval to treat this case as an Exception as before.
6.9.Where it is agreed that a case will be handled as an Exception, a guide amount, determined in accordance with the best available evidence relating to the costs of support, will be provided to the service user and their support planner against which to plan their support. In these cases an ECC support planner should always be consulted for support and advice in the process of drawing up the support plan.
6.10.Once the support plan is completed, it will be submitted for validation in the normal way and, if necessary, escalated to more senior levels for a decision in line with the process described later in this policy. The final amount of the personal budget will be set as part of the Validation process.
6.11.It is important to note that the use of a maximum threshold within the RAS and the setting of a guide amount does not mean that the Council will not fund support above this figure. The Council has a statutory duty to meet the assessed eligible needs regardless. However it is expected that these cases are likely to involve a greater degree of complexity and will require more careful consideration to ensure that the person’s needs are met appropriately.
Validation of the support plan and the personal budget
6.12.Once service users know their indicative personal budget they will be supported to develop a personal support plan that identifies:
- Their support needs and priorities
- How they intend to meet their assessed needs and support goals using their personal budget
6.13.The process of support planning and the essential features of a support plan are described in more detail in the Support Planning and Review Policy, and the risk considerations are set out in the Risk Enablement Policy.
6.14.Once the person has drawn up their support plan it will be submitted to the Council for approval, known as validation. The Council will review the support plan against the principles set out below (Section x). If the Council is satisfied that the support plan meets these criteria, it will validate the support plan and confirm the final amount of the personal budget. No money will be released to the person until a validated support plan is in place.
6.15.In the majority of cases, it is anticipated that the support plan will be validated by the Team Manager. Where the support plan cannot be validated against any one of these criteria, the plan should be returned to the individual or their support planner with details of what further development is needed before the support plan can be re-submitted for validation.
6.16.If the issue cannot be resolved the support plan should be escalated for decision as defined in the scheme of delegation set out in paragraphs 6.13 onwards below.
6.17.If the issue is not likely to be resolved quickly, the Team Manager should consider whether the support plan can be partially validated (see paragraph 6.21 below) to avoid any delay in meeting the person’s needs. If this is not possible, a managed service should be put in place to ensure that the person’s needs are met while their support plan is under discussion.