Changes to Care
During a person’s lifetime, their need for care and support can change. Changes to care provider, placement, funding, the area in which someone lives, or the level of their needs, can give rise to queries or disputes where legal advice may be helpful. Our guide below covers how changes to care may be identified and implemented.
After a care plan or package of care is in place, a local authority will typically review this annually, unless otherwise reasonably requested to do, as per their duty under the Care Act 2014. Requests to review can be made by the person themselves, their advocate, friends/family, or carers. Reviews should look at whether the care and support in place is still working well and whether the person is happy with the support they receive. The review should identify any areas which are not working as well and is relevant to the person and their current needs. During a review, it can become apparent that a package of care, a placement, or a care provider, are no longer appropriate due to one or more of the following scenarios:
When an individual’s needs have increased, it can mean that their current placement is no longer able to meet their needs. CHC assessments can often be triggered when an individual’s health care has become more complex. More information on CHC assessments can be found HERE.
It could also be that the equipment or resources in the current placement are not sufficient to meet needs, and a move to a more specialist or more well-equipped placement is necessary. For example, a person may no longer be able to walk and need full assistance with eating but currently lives on the 3rd floor of an assisted living facility with only 2 hours of support a day.
In some cases, where a person has recovered from a period of ill health, or has been encouraged to be more independent, their current placement may no longer suit their needs. The person may wish to have more access to the community or meet more of their needs themselves.
Some individuals who have had a stay in hospital or residential care have objected to remaining there or have expressed a preference to return to their home. This could be for a multitude of reasons but should mean that consideration is given as to whether this is an available option. Issues such as whether the home is still owned by them, whether the home needs adaptations, and whether a package of care could be implemented at home, can be contentious.
Reviews can often highlight where a person is unhappy with their current placement for some reason other than their level of needs have changed. For example, there may have been safeguarding concerns, they may not have access to amenities due to the location, or they may wish to move closer to family or friends.
Sometimes, the most appropriate placement to meet a person’s needs is not within the area in which they are currently living. Perhaps they need dementia specialist care, but there is nowhere within that area that has an available place for them. A person and/or their friends and family may also feel that they would have more ability to see loved ones if they lived in a different area. Sometimes this can mean moving to a different local authority and changing those responsible for funding the care.
Reviews can highlight where a person who has been funding their placement is no longer able to do so, and as a result, may have to ask the local authority to pick up the funding. The local authority may request that if the person is to remain in the placement of their choice, they or someone supporting them may be required to pay a top-up amount. The local authority may suggest a move into a more affordable placement.
Any of the above scenarios can create situations where legal advice and representation is required. We can help with:
- Who to approach if you feel you or someone you care for should have a review of their care and support needs
- Supporting you to understand how and when a review should take place
- Advice and representation to challenge where the local authority are not meeting their requirement to review or meet assessed needs
- Complaints against health and social care where your views and wishes are not being considered, including approaching the Ombudsman and other legal redress routes
- Guidance on how key legislation such as the Care Act 2014 or the Mental Capacity Act 2005 apply to your circumstances
- Representation at assessments and reviews
- Legal advice in relation to financial assessments, personal budgets, care contracts, top ups and deferred payment agreements
- Legal advice in relation to CHC assessments and reviews
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