Care and support planning
Care Act 2014
Outline of content
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Introduction
Production of the plan
Planning for people who are at risk of harm
Planning for people who lack capacity
Combining plans
Sign off and assurance
Summary
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Personalisation in social care and
health
The Care Act 2014
Our Health, Our
Care, Our Say
Putting People
First
Direct
payments
Community
Care
Reforms
Griffiths
Report
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Person centred care and support
planning
Person not
services
Person has
control
Person centred
planning
Emphasis
on assets
and
capabilities
First person
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The Care Act and person-centred
planning
 Care and support planning should put people in control of their care
 The person must be actively involved and influential throughout the
planning process
 Independent advocates must be instructed early in the planning
process for those who have substantial difficulty and have no other
means of accessing appropriate support to facilitate their involvement
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Person-centred care and support
planning
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Production of the plan
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Involving the person
Key elements
Context
Further considerations
Direct payments
Constraints
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Involving the person
 The local authority must take all reasonable steps to involve the
person, their carer and relevant others
 The local authority must instruct an independent advocate if there is
no one else that can facilitate involvement
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Key elements of the plan
Needs and assets
Assessed and eligible
Co produced outcomes
Final plan must
include
How needs will be met/
reduced
Personal budget
Own financial contribution
Direct payments
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Context
Take a holistic
approach
Record needs being
met by carer
Consider a combined
plan to meet both the
person’s and carer’s
needs
Consider universal
services and
community-based
and/or unpaid support
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Further considerations for the plan
Be
proportionate
but compliant
with rules
Take account
of fluctuating
needs
Make sense to
the person
Must be
agreed with
the person or
their
representative
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Direct payments
 The local authority must inform the person which, if any, of their needs
may be met by a direct payment
 The person should be provided with appropriate information and advice
concerning the usage of direct payments and how they differ from
traditional services
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Constraints
 There should be no constraint on how assessed, eligible, unmet
needs are met as long as this is reasonable
 The local authority has to satisfy itself that the decision is an
appropriate and legal way to meet needs
 Limited list of prescribed providers must be avoided
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The person prepares the plan jointly
with the local authority
Appropriate
people
Secured
Information
Person’s
Best
Interests
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Planning for people who are at risk
of harm
 The person will have been subject to and/or remain at risk of abuse or
neglect
 They will have been subject to a local authority section 42 enquiry into
their situation and will have an agreed safeguarding plan
 The plan must actively involve the person in agreeing what outcomes
they want and how they will be achieved
 While aiming to meet the person’s outcomes the plan must also
balance risk appropriately by using the least restrictive options
 The plan will be subject to review under the local multi-agency
safeguarding procedures
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Planning for people who lack
capacity
 The Mental Capacity Act 2005 (MCA) requires local authorities to
assume that people have capacity and can make decisions for
themselves, unless otherwise established
 A person must be given all practicable help to make specific decisions
before being assessed as lacking capacity
 Where an individual has been assessed as lacking capacity, the local
authority must commence care planning under the ‘best interests
principle’ within the meaning of the MCA
 The duty to involve the person remains throughout the process
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Minimising and authorising
deprivation of liberty for people who
lack capacity
 The Mental Capacity Act 2005 (MCA) provides legal protection for acts
of restraint only if the act is:
 necessary to prevent harm to the person
 a proportionate response to the likelihood of the person suffering
harm and the seriousness of that harm, and
 in the person’s best interests
 If the degree and intensity of restrictions and restraints are so
significant that they amount to a deprivation of liberty, this must be
authorised under the Deprivation of Liberty Safeguards (DOLS) under
the MCA
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Combining plans
Consider if multiple plans exist
Obtain consent from all parties
Establish a lead organisation
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Sign-off and assurance
Sign off
Should
Occur
when
• Sufficient time has been taken to ensure the plan is
appropriate to meet identified needs
• There is consensus on the factors in the plan
• Addresses how the needs in question will be met
• Includes the final personal budget
• Final agreement is recorded
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Sign-off and assurance
 In the event that the local authority decides that it cannot sign-off a
plan, or where a plan cannot be agreed, it should state:
 the reasons for this
 the steps which must be taken to ensure that the plan is signed-off
 The local authority must give a copy of the final plan to:
 the person for whom the plan is intended
 any other person they request to receive a copy
 their independent advocate if they have one
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Summary
 The person must be actively involved throughout the planning process
 An independent advocate must be instructed at an early stage if a
person has substantial difficulty in engaging in the process
 The plan must describe what needs the person has, and which needs
the local authority is to meet
 The plan must include: the personal budget and direct payments
 The local authority must inform the person which, if any, of their needs
may be met by a direct payment
 The local authority must give a copy of the final plan to the person and
others requested by the person in an accessible format
 The local authority has a duty to keep the person’s plan under review
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