Does the new well-being principle, and the approach to needs and outcomes through care and support planning, create the right focus on the person in the law?
Answer questions by topic
Does the new well-being principle, and the approach to needs and outcomes through care and support planning, create the right focus on the person in the law?
I think it goes the right way we have to make peoples care personal involving both the individual and ther families giving them personal care plans and a dedicated budget goes some way in answering this question but these plans have to be detailed and must involve the persons views at all times people should not feel pressured into agreeing if not comletely happy and they should always be able to complain and know who to complain to if they are not satisfied with the care they are receiving.
I think that all private involvement in the NHS and care systems needs to end. This bill is a license to print money for Andrew Lansley and Jeremy Hunts friends in the private health care companies. It is a universally known and uncontested fact that the moment the private sector intervenes in health and social care, the moment standards plummet and prices soar. Only through a 100% nationalised and collectivized health care system can we hope to achieve competitive standards of health and social care. The deaths, neglect and abuse need to end- it is far far too high a price to pay for a few shareholders to rake it in.
It is so easy for the people at the top to theorise care in the community, but in practise it is a very different story. I do feel this one size fits all must stop before any more people suffer the wrong type of care. where do you draw the line between domicilliary care and nursing care? How much care seems to be another stumbling block, I am afraid it will all be down to money again so how will this be any different to the past. It is fairly easy to draw up a care package for someone, but things can change on a daily basis. I wonder if the people who make up the rules and regulations have had any experience with care in the community.
Consistency in care and support planning and review is positive; it is also pleasing to see the inclusion of deferred payments.
NFOP agrees that the inclusion in law of the well-being is essential and the current proposals create a sound framework. Failure to provide appropriate levels of funding for the transition to the new structure could result in inadequate compliance.
We are pleased to see a focus on overall well-being and the approach to understanding the needs and outcomes of the individual. Clause 1, point 3b refers to local authorities having regard to ‘adults views, wishes and feelings’. We would request that this goes further to include the adults aspirations for the future so an understanding of their long term outcomes and needs can be understood and considered when planning care and support. This should also be referenced in clause 9, point 4 rather than just the ‘outcomes that the adult wishes to achieve in day-to-day life’. In addition, we would like to see specific reference to the local authority having regard to the adult’s privacy and dignity as detailed in CQC Outcome 1 (respecting and involving people who use services) and Regulation 17 of the Social Care Act 2008, which refers to the ‘dignity, privacy and independence of the service user’.
A key part of ensuring the focus is on the adult in need of the care and support is developing a person centred approach, however, there is no reference to this within the well being principle or in the needs and outcomes of the adult. The concept of ‘personalised care and support’ is specifically referenced in the White Paper Caring for Our Future and the Bill should reflect this.
When conducting the care and support assessment and completing the care and support plan, we note that there is no mention of the use of an advocate when consulting the adult. Where it has been identified under the Mental Capacity Act, that an adult requires support to make decisions regarding their care and support, an advocate would be required to consult at assessment and when developing the care and support plan. We would therefore encourage a specific mention to this within clause 9, point 5 and clause 24 point 3. While both clauses state ‘any person whom the adult asks the authority to consult’, those who require an advocate due to mental capacity, should be made clear as a separate point.
Some services lend themselves to being placed in the hands of private companies more readily than others. It seems to me that there are very real and obvious dangers about taking this approach to the provision of care. Anyone who knows anything at all about how the private care agencies work can see already that the fact that they are profit-led means that both their service-users and their employees lose out on a daily basis. I am sixty years old and currently in good health but I have seen this kind of ‘care’ in action. As a consequence, it is my daily prayer that I will never be in a position where my well-being depends on it.
By closing some Day Centres aided by Older People’s benefits being at risk by this coalition government, will only exclude people from social networking. How can this policy help with people’s well being? Funding is essential for the compliance of our health and well-being.
BASW support the principle of well being and the focus on the responsibility for this being care and support planning – which should include not just social care. However BASW members report being under huge pressure to move very quickly on cases, with inadequate time for proper care planning. It is going to be very difficult to delive on this, particularly at a time when so many people are experiencing the affects of the recession
The new well-being principle, and the approach to needs and outcomes through care and support planning, create a much better principle for the provision of care. Failure to provide appropriate levels of funding for the transition to the new structure and for the new structure will leave Service Users disillusioned and potentially inadequate care, If, the needs and outcomes of the individual are not met and not properly financed this could result in inadequate compliance.
• Features covered in the opening Clauses of the draft Bill should have a significant impact on the wellbeing of individuals and carers. SCIE would assume they will be considered alongside the wellbeing principle as defined in Clause 1 in developing a new culture of engagement in care and support planning. These features include expectations that
- the local market in care and support will respond to diverse needs, aspirations and circumstances, and deliver a diverse range of provision. SCIE’s website Find Me Good Care (Oct 2012) will support these expectations by providing advice and information about choosing care along with a comparable database of services
- professionals and services will learn to work with individuals and carers as partners, sharing understanding, information and advice, and promoting independent living
- social care, the NHS, housing and other services will be able to offer integrated responses to people and families with complex needs. SCIE’s integration resources help to share evidence and practice implementation on this multi-faceted topic
- without infringing their rights to self-determination, a stronger focus on prevention and early intervention will enable people and carers to sustain independence, avoid breakdown, and reduce reactive emergency responses. SCIE’s SCTV films on Avoiding unnecessary hospital admissions show what is possible.
• In SCIE’s view, the draft Bill’s approach to needs and outcomes is basically sound. Many local authorities would however admit they have some way to go in matching these approaches, and will require significant investment in staff and management development to implement them. Some of the principles in Clause 1(3) are particularly relevant: the assumption that the individual is best placed to judge their own well-being; taking account of their views, wishes and feelings; ensuring that decisions about them are made having regard to all their circumstances; their participating as fully as possible in decisions, and being provided with the information and support necessary to enable them to participate.
• The notion of “a balance between the adult’s well-being and that of any friends or relatives who are involved in caring for the adult” (Clause 1(3)) could be problematic, and may need reconsidering and/or rewording to acknowledge possible tensions and conflicts of interest. The care and support plan for the individual, and the carer’s support plan, will be increasingly important parts of the process for coordinating care and support, and should be capable of being used on an inter-disciplinary and inter-agency basis.
I am unclear how an “adult’s contribution to society” (Clause 1(2)(g)) is relevant to any assessment of their well-being or the services & support that they may require. What is the thinking behind this?
In relation to Clauses 9 and 10, there needs to be clarification as to what will trigger a Local Authority’s duty to assess. What notifivation/evidence will make it “appear” to a Local Authority that an adult may have needs?
In situations where direct payments are inappropriate – particularly where there are issues with regard to capacity – how will the assessed needs of an adult and/or their carer be met?
Derbyshire County Council is supportive of the approach to defining the wellbeing principle in terms of individual outcomes, which we think are comprehensive.