Articles in Category: Introduction

Terms Used on this Website

on Monday, 03 June 2013. Posted in Introduction

Here are some terms which appear in the directory, or which people may come up against at other times. see also "Abbreviations"
All Wales Strategy A strategy developed in the 1980s by the Welsh Office to provide integrated services for people with learning disabilities in Wales.
Advocacy Helping someone to express their own wishes and preferences. An advocate is someone who supports another person by voicing the views of that person.
Assessment Process of identifying the health and social care needs of an individual and evaluating their impact so that appropriate action can be planned.
Autism A condition which is associated with a disposition to behave in ways which suggest that the person finds social interaction difficult.
Child Development Centre A centre housing various health and other professionals. A pre-school child may be referred to such a centre for an assessment of their needs. Some centres will house playgroups, nurseries and/or parent support groups.
Carer A person providing care who is not employed to do so by an agency or organisation. A carer is usually a relative or friend looking after someone at home who is frail or ill; the carer can be of any age.
Carer’s Assessment A carer’s assessment formally acknowledges the carer’s contribution as a partner in the caring process. It determines the carer’s own support needs, so that they can continue to care. This assessment is carried out by social services.
Care Co-ordinator Under the Unified assessment process, the care co-ordinator acts as the communication focus for the different professionals involved with an assessment and, most importantly, for the person assessed themselves and their carer. The care co-ordinator should lead the assessment and care planning.
Care Manager A Social Services worker who has responsibility for assessing need and planning how needs will be met.
See also Care Co-ordinator
Care Package Services designed to meet a person’s assessed needs as part of the care plan arising from their assessment. Consists of one or more services, which may be residential and/or community-based.
Care Plan A written statement of the service(s) a person can expect to receive following assessment. Included in the care plan are details about which organisation will provide the service(s), and who to contact if problems arise.
Care Planning Process based on an assessment of an individual’s needs that determines the level and type of support required to meet those needs and the objectives and potential outcomes to be achieved. Care planning leads to a care plan being written for the individual who should have fully participated in the care planning process.
Case Manager A professional (e.g. nurse, doctor, social worker) affiliated with a care plan who is responsible for co-ordinating the care of an individual enrolled in a managed care plan.
See also Care Co-ordinator.
Commissioning Commissioning describes the means by which the local authority and health authority plan, organise and purchase services for people.
Community Based Services Services provided to support a person living in the community.
Community Care The provision of services and support to people who are affected by problems such as ageing, mental health, learning disabilities, or physical or sensory disability, and who need such services to be able to live independently in their own homes, or in homely surroundings in the community (including residential and nursing homes).
Complex Needs A term used by professionals to describe someone who requires the support of a number of professionals / individuals to meet the needs identified in the Care Plan.
Cymorth Cymorth is the Children and Youth Support Fund provided by the Welsh Government. It aims to provide a network of targeted support to improve the lives of children and young people from disadvantaged families.
Day Centre Facility, run by social services, health or a voluntary organisation, that provides care, stimulation and activities for people who need support during the day and is thus also a valuable source of respite for carers.
Direct Payments Direct Payments give recipients the means of controlling their own care at home, giving more choice and flexibility. They are regular monthly payments from Social Services enabling people to employ their own personal assistants for care, instead of receiving help arranged by Social services.
Domiciliary Care Services provided to people at home, to assist them in living independently within the community, eg meals on wheels, community nursing, and home help.
Domiciliary Service Services provided for people in their own homes. They include home care and the services of health workers (e.g. physiotherapists who treat people in their own home).
Educational assessments for children attending school Some children will have their special educational needs identified before attending school, but for others this isn't the case. The stages are similar to a child attending an early years setting.
Early Support Early Support is a mechanism for achieving better co-ordinated, family focused services for young disabled children and their families, to support the Welsh Government's aim to ensure that young children who are disabled or have complex health needs receive:
Co-ordinated services, high quality support and information, child and family-centred approaches and support that enable them and their families to live ordinary lives.
Educational Psychologist (EP) An educational psychologist is a qualified teacher who has additional training as a psychologist. Educational psychologists help children who find it difficult to learn or to understand or communicate with others. They can assess a child’s development and provide support and advice.
Education Social Worker (ESW) (also known as Education Welfare Officer EWO)
A person employed by an LEA to help parents and LEA's meet their responsibilities on school attendance.
ESTYN A government department responsible for the inspection of all schools in Wales.
Families First Families First is an innovation programme that promotes the development by local authority areas of effective multi-agency systems and support, with a clear emphasis on prevention and early intervention for families, particularly those living in poverty.
Generic The grouping of types of people under one heading e.g. disability, age etc.
Health Visitor Someone who specialises in the care of babies and young children at home. They are based at your GPs surgery and can offer advice, training and a sympathetic ear. They can also help you arrange to get a whole range of other services that might be needed.
Home Care Care that is provided to someone in their own home. Also known as domiciliary care.
Independent Living Fund A government agency set up in 1988 to administer funds to support people with severe disabilities living in the community.
Independent Mental Capacity Advocate (IMCA) Someone who provides support and representation for a person who lacks capacity to make specific decisions, where the person has no-one else to support them. The IMCA service was established by the Mental Capacity Act 2005 and is not the same as an ordinary advocacy service.
Individual Education Plan A document for teachers to record short-term targets and strategies for an individual pupil that are different from or additional to other pupils in his/her class.
Independent School A school which is not maintained by an LEA and charges fees but may be approved by the Secretary of State as being suitable for children with special educational needs.
Keyworker Person responsible for co-ordinating the care plan of an individual receiving social care, for monitoring their progress, and for staying in regular contact with the agencies and individuals involved.
See Care Co-ordinator.
Lasting Power of Attorney A Power of Attorney created under the Mental Capacity Act 2005 appointing an attorney (donee), or attorneys, to make decisions about the donor's welfare, including healthcare, and/ or deal with the donor's property and affairs.
Learning Disability A term describing people who have considerable barriers to learning and who therefore may find activities that involve thinking and understanding difficult. They may need help and support with their everyday lives and education. Some people with a learning disability may also have an additional impairment such as sensory impairment or a physical disability.
Learning Support Assistant (LSA)
(also known as Teaching Assistant)
A person providing support for an individual pupil or group of pupils with special educational needs and/or disabilities
Local Education Authority (LEA) Local government body with a wide range of responsibilities for children's education. For children with special educational needs this includes carrying out statutory assessments and maintaining statements of special educational need
Maintained School A school maintained by an LEA, including community voluntary aided and foundation schools.
Mental Capacity Act 2005 Legislation that governs decision-making for people who lack capacity to make decisions for themselves or who have capacity and want to make preparations for a time when they may lack capacity in the future. It sets out who can take decisions, in which situations, and how they should go about this.
Multi-disciplinary Referring to a team made up of professionals from different specialisms, typically including Doctors, Nurses, Psychologists, Social Workers and Occupational Therapists.
Ombudsman A representative of a public agency or a private non-profit organization who investigates and resolves complaints made by or on behalf of individuals.
Occupational Therapist (OT) They visit the person you care for and can advise on and provide special equipment to help with daily life, for example help with the bath, toilet or the stairs. They can teach you the best and easiest way to do things and how to use the equipment they provide.
Person Centred Planning (PCP) Person Centred planning is a way of enabling people to think about what they want now and in the future. It is about supporting people to plan their lives, work towards their goals and get the right support.
Physiotherapist (Physio) They visit at home and help disabled or ill people with special exercises either to improve things or at least stop something getting worse. Sometimes they assist with special breathing techniques and can advise on special care that is sometimes needed.
Portage Home based educational support for pre-school children with special education needs.
Primary Care Health Care provided to people in the community to maintain their well-being and/or to deal with problems which might otherwise require more intensive intervention eg GP’s.
Providers Any person, group of people or organisation supplying a community care service. Providers may be in either statutory or non-statutory sector services.
Purchaser See Commissioning.
Referral A request for help from someone in need of an assessment, which has usually been written down in brief notes. A referral can also be made by a third party on someone else’s behalf, eg a GP for a patient, or a relative on behalf of a family member.
Respite Care A range of services that provide a break for an individual and/or their carer. This may take place in the person’s own home, in a day centre or in a setting away from the home. It may be for very short periods of a few hours, or for longer periods.
School Action This is when a teacher or SENCO identifies that your child has special educational needs and needs additional or different support to what's offered in the general curriculum.
School Action Plus When a request for help from external services or a specialist such as an educational psychologist is made.
School Nurse A school nurse is a medical nurse, based in a school, who provides support for children’s medical needs.
Self Advocacy Advocating on behalf of oneself, possibly with support.
Service Providers Organisations of all shapes and sizes which run activities or facilities designed to help people in some way.
Service Users People who receive health and social care services. They may be individuals who live in their own homes, are staying in care or are being cared for in hospital.
Social Services Council department which organises social care for vulnerable children and adults.
Social Worker (also known as a Care Manager/Care Co-ordinator)
Social workers can help people to get the support and services that they need. This can be practical help in your home, benefits money, information about other organisations nearby that could help, a break for you from caring and information about a local carers group.
SENDIST An independent Special Educational Needs and Disability Tribunal that hears parents' appeals against LA decisions on their child's special education needs, or parents' claims of disability discrimination against their children in schools.
Special Educational Needs Co-ordinator (SENCO) Member of staff of a school or early education setting who has responsibility for co-ordinating SEN provision within that school. This may be a headteacher or deputy in a small school.
Special Needs Health Visitor A specialist health visitor has additional training and experience of working with young children with medical problems or disabilities. They can act as a bridge between hospital and community health services in the pre-school years.
Special Schools State schools in England and Wales which are provided by local education authorities for certain children with special educational needs.
Speech and Language Therapist A speech and language therapist is a health professional specialising in communication development and disorders (and associated eating and swallowing difficulties). They offer support and advice to parents of children with any type of communication problem. They assess, diagnose and develop programmes of care to help children develop their communication, language and speech, including sign language.
SpLD Specific Learning Difficulties This term may be used to describe dyslexia and related difficulties.
Statement(ing) of Special Educational Needs The process of assessing in England and Wales that a child has special needs which will require special services from the local authority. Introduced in the Education Act 1981 to implement the recommendations of 'Special Educational Needs' (Warnock Report) replacing the previous mechanisms of ascertainment.
Statutory Assessment A Statutory Assessment is a comprehensive, formal, multi-agency assessment of a child's needs and it is coordinated by the Local Authority (LA). Assessment is generally requested by the school or other professional but parents have the right to make a direct request in writing to the LA if they wish.
Supported Accommodation/ Living A permanent or temporary home where clients are also provided with general counselling and support by their landlord/lessee or someone acting on their behalf.
Supporting People New initiative for funding housing for vulnerable people. The system for planning, monitoring and funding all housing related support services.
Third Sector The 'third sector' is the term used to describe the range of organisations that are neither public sector nor private sector. It includes voluntary and community organisations (both registered charities and other organisations such as associations, self-help groups and community groups), social enterprises, mutuals and co­operatives. Third sector organisations (TSOs) are independent of government, are 'value-driven', and reinvest any surpluses generated in the pursuit of their goals.
Unified Assessment The purpose of Unified Assessment is to develop and integrate the process of health and social care assessment and care provision. It is person centred, avoids duplication and integrates new eligibility criteria.
Voluntary Sector Organisations, often registered as charities, which operate on a non profit-making basis, to provide help and support to the group of people they exist to serve. They may be local or national, and they may employ staff, or depend entirely on volunteers. They are now sometimes referred to as the 'Third Sector'
Young Carer People under the age of 18 who have to care for someone in their family like a parent, grandparent, brother or sister.

 

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Appeals, Complaints and Comments

Appeals, Complaints and Comments

You can appeal against a decision if you disagree with it.  Examples of the sort of decision you can appeal against are:

  • a decision that you do not appear to need an assessment.
  • following a specialist or comprehensive assessment, a decision that you do not qualify for a service.
  • if you think you need more services or different services from those which are proposed or being provided.

You can complain if you think the processes have not been followed properly or because the quality of your service is poor.

There are several ways of dealing with disputes ranging from the informal to the formal, by contacting a councillor, AM or MP to a judicial review or an appeal to the European Court.

If a complaint or a dispute with social services arises, you may use the local authority's complaints procedure where the following procedures apply:

  • Anyone can make a complaint and can act on behalf of an individual. 
  • Complaints normally dealt with by an external provider may also be referred if the complainant is dissatisfied. 
  • The complaints process has three distinct stages.  You may make your initial complaint at either stage 1 or 2.

Stage 1 Local Resolution

Most problems are best sorted out by the staff who are working with you.  Contact the person in charge of your local services or contact the social services complaints officer who will speak to that person on your behalf.  You can do this face to face, by telephone in writing or by e-mail.  They will do their best to sort things out quickly.  This should be no more than two weeks.

Stage 2 Formal Consideration

If not satisfied at Stage 1 you can process your complaint to Stage 2.  Contact the social services complaints officer who will arrange for someone not involved providing your service to investigate your complaint.  You have the right to expect a response from the council within 5 weeks.  You may contact the complaints officer to make your initial complaint or after having spoken to the staff who work with you.

Stage 3 Independent Panel Hearing

if you remain unsatisfied at this stage you can ask for a review of how social services have dealt with your complaint by an independent panel. 

You may ask for more detailed information about the complaints procedure first to help you decide whether you want to make a complaint. 

Remember its your right to complain if you are not happy with the quality of the services you receive and it is social services duty to look into your complaint and try to resolve it.

Assessment

Assessment

Unified Assessment is the name given to the assessment process which involves health and social care professionals working together to assess and manage care and share information. Please note that the following guideline may need reviewing in light of recent legislative changes such as the Social Service & Well Being Act but principles remain similar. 

Assessments underpin any funding decisions that are taken so it is essential that you prepare for and participate in this process. If you do not agree with decisions you have the right to appeal against a decision and free advice and assistance is available. Please contact us for information if in any doubt.

There are three main stages in the process:

Stage 1 Assessment

This is the process of collecting information from the individual, the carers and others about the individual's needs and wishes.  Assessment should be carried out according to the following:

  • Local authorities have a duty to assess individuals if they have the 'appearance of need', including people with higher-functioning autism and Asperger's syndrome.
  • They aim to empower people, by enabling them to make informed choices and maximise their independence according to their individual circumstances. 
  • The main purpose of an assessment is to identify needs and how to meet them.
  • Assessments should be carried out without reference to financial resources, availability of local services or locally preferred options.
  • Authorities have a duty to provide users and carers with a full range of information about all services and the rights of users and carers.
  • Information gained during assessment is confidential and shared only if the law says it should be.  Users or their agents have a right to access the information under certain conditions. 
  • A care co-ordinator will carry out the assessments, who would usually be the most appropriate professional.
  • Assessments should be carried out in a timely manner, in informal settings such as the home, and be proportionate to the level of need. 
  • There are specific types of need included in government guidance.  All needs should be assessed in the light of their impact on independence, daily functioning and quality of life.  The focus should always be on outcomes for service users and their carers.
  • A person-centred approach should be taken during assessment and care planning.  Person-centred planning and reviews also take place in addition to an assessment, if appropriate.
  • Carers have a right to have their views acknowledged in the assessment process both in helping to identify the individual's needs and wishes and also to express their own views of the individual's needs and wishes as well as their own needs.  The role of carers continues once the individual has left the family home.

Carers may request an assessment both of their own ability to care for an individual and of their own need for services for themselves.  Carer's must be informed of their right to an assessment.

Stage 2 Making the Service Provision Decision

The service provision decision for social services makes clear which needs are eligible for support.  The needs identified as a result of the assessment will be considered with the service user/carer and agreement sought on the most appropriate way of meeting them.  This may involve support provided within the family network, by accessing voluntary sector services, statutory services or signposting to other sources of help and support.

The procedures to be applied are as follows:

  • All risks are balanced against the independence of the individual in the light of the four key factors of independence, i.e. the individual's autonomy and freedom to make choices, health and safety, management of daily routine and involvement in other activities. This is based on the what would happen if no help were to be provided.
  • There are four categories of eligibility (critical, substantial, moderate and low) laid down in the local authority's Eligibility Criteria.  Once the risks are assessed, professionals should determine the position of the individual's needs within these bands.  If the needs are above a threshold determined by the authority they become eligible needs and must be met.  A holistic approach is taken, according to the four key factors of independence, even though the needs are identified separately.
  • At this stage there should be no reference to financial resources, locally preferred options or the local availability of services.

Stage 3  Care Planning

This is the process of arranging provision of services:

  • Care planning should address the eligible needs of the individual, the views of the individual and of the carer(s) and cost considerations.  Services should be needs led with full information on a range of services. 
  • Care planning should be responsive to the age, living circumstances, location, disability, gender, culture, faith, personal relationships and lifestyle choices of users.
  • Care planning should be flexible and adaptable to desired outcomes and expectations.
  • Care planning should identify outcomes, i.e. the desired changes aimed at improving independence and quality of life.  A recordmust be made, with timescales for achievement.
  • Care planning should involve service users, carers and professionals in reaching an agreed care plan and identify the most appropriate aervices to acheive the desired outcome.
  • Care planning services should be provided as holistically as possible to suit individual needs and maximise their potential for independence.

Where there is a genuine choice of services, the authority may choose a service based on quality and cost, taking the user's and carer's preferences into account.  Cost ceilings may be used as a guide only and if lack of finance is a reason for making a choice, it must be shown by evidence.  The authority should not impose its own preferred models of care.

Reviews or re-assessments must take place regularly and have a review date.  They should focus on the needs of users and their carers and be evaluated according to a list of factors laid down in guidance.

Services may only be withdrawn if certain conditions are followed, i.e. if a full re-assessment has taken place to show that the individual no longer has eligible needs or if they can be met some other way.  There can be no assumption of alternative support from carers.  The withdrawal of services may go against the user's natural rights.

Users and carers may play an important role in monitoring services and may request support in doing so.  Should a service break down, the original need for the service still applies and it is the authority's duty to provide for it.

There is no charge for an assessment or for giving advice and information.  A person may have to pay for community care services depending on how much service they get and how much money they have.  See the section on financial matters for more information.  If eligible, they will receive free nursing care in their home or in a care home, although there may have to be a contribution towards other aspects of care such as personal care, food and accommodation costs.

Person Centred Approaches to Assessments and Care Planning

The Service Principles and Unified Assessment Guidance state clearly that social services and health should always take a person centred approach to assessment and care planning.  (It should be noted that a person centred approach is not the same as person centred planning.)

 

Also see Carers' assessment

Direct Payments

Direct Payments

What are Direct Payments?

Direct Payments are cash payments to an individual from a local authority that are an alternative to directly arranged community care services. Rather than the local authority social services department providing or arranging the community care services it has assessed you as needing, you receive money to enable you to arrange your own services, allowing you more choice and control over the way your care and support needs are met.

Direct Payments can be made to people who are eligible to receive support from Social Services, allowing them to arrange their own care by directly employing a personal assistant or contracting with an independent agency.

The payments are available to disabled adults and children, and can be made to people with physical or sensory impairments, learning difficulties or mental ill health. They are also available to non-disabled people who have caring responsibilities, allowing them to continue with their role of looking after a disabled adult or child. Older people who need support to continue living in their own home may also be eligible to receive Direct Payments.

Direct Payments give people the power to make their own care or support arrangements, putting the service user in control and offering much greater flexibility by allowing individuals to make arrangements that suit their lifestyles.

Direct Payments can now also be made to ‘suitable people’ assessed by the local authority as being able to receive a Direct Payment on behalf of someone without the capacity to agree to receive a payment. A ‘suitable person’ will usually automatically be someone who has the power to make welfare and health decisions granted by a Lasting Power of Attorney, or having been appointed by the Court of Protection. Such a person has to agree to become a ‘suitable person’.

Otherwise, the local authority can agree that someone else can become a ‘suitable person’ who is best placed to promote the interests, wishes, and beliefs of the person without capacity. There is a process of assessment to be followed in all cases.

The ‘suitable person’ will be required to sign the local authority’s ‘Terms and Conditions' agreement in order to receive a Direct Payment.

You may be given conflicting information on what and how direct payments are  to be used. Seek advice if you feel that you are being treated unfairly since many families have different experiences and decisions that you feel are unfair may be open to challenge! 

Information for Service Users

Information for Service Users

The Information Sub-group of the Cardiff and Vale Unified Assessment Project has produced 4 leaflets:

  1. Unified Assessment – Helping you achieve a better quality of life. This is for all the agencies involved, i.e. Cardiff Council and the Vale of Glamorgan Council, Health boards, the Trust and other partners. It is aimed at anyone wanting to know about UA - not just service users. It is introducing people to Unified Assessment.
  2. Your assessment This is a joint Cardiff & Vale of Glamorgan local authority leaflet. It does not include Health or any other partner. It is for people about to undergo an assessment for social care needs.
  3. Looking after your social care information This is also a joint Cardiff & Vale local authority leaflet for people about to undergo an assessment. It  may also be used whenever the local authorities collect information (especially when seeking permission to share information) and service users have not already had a copy or have lost their copy and forgotten what it said.
  4. Community Care Services – A guide to social services for adults This is also a joint Cardiff & Vale local authority leaflet. It is for people undergoing an assessment or review.

To obtain copies of the above leaflets, please contact the Cardiff Learning Disability Team or Vale Community Support Team
Copies of these leaflets can also be downloaded from the Councils’ websites:

Where a Unified Assessment has identified an area of need that is eligible for services and which meets the Fair Access to Care Services eligibility criteria, the Local Authority will identify and propose a care package that is suitable and appropriate to meet that assessed need. However, if the service user does not want the package offered but wants another package instead, the Local Authority is not obliged to provide that other package

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