Out of county placement notifications Adults Services Policy and Procedures Version: 1.1 Effective from: August 2012 Next review date: October 2015 Signed off by: Jenny Daniels Title: Head of Health and Social Care Practice Date: 4 th May 2012
Out of county placement notifications guidance 2 Current issue: Status New policy and guidance document Version number 1.1 Issue date May 2012 (updated August 2012) Author Greg Slay, Health and Social Care Practice Development Manager Owner Jenny Daniels, Head of Health and Social Care Practice Signed off by Jenny Daniels, Head of Health and Social Care Practice Date 4 th May 2012 Changes history: Issue Date Author Principal Changes number 1 May 2012 Greg Slay 1.1 August 2012 Greg Slay Inclusion of reference numbers for template notification letters now available for staff use (Frameworki reference numbers SIT254 and SIT255) Feedback: Our customers expect first class service and we aim to provide it. We therefore welcome feedback about our policies and procedures. If you have any comments about this document please e-mail: socialcare@westsussex.gov.uk
Out of county placement notifications guidance 3 Contents Equality and diversity statement 4 Policy 1. Our approach to safeguarding our customers interests 5 2. The legal context 7 Procedures 3. Arrangements within adult social care 8 4. Sources of further information on the internet 9 Appendix 1 10 Template letter to be sent to a local social services authority
Out of county placement notifications guidance 4 Equality and diversity As part of our commitment to equality and diversity the county council will ensure that we treat all customers of our services with fairness, dignity and respect irrespective of race, disability, gender, age, sexual orientation and religion and belief. The Equality Act 2010 seeks equal opportunities in the workplace and in wider society; and prohibits discrimination on the grounds of the following protected characteristics: Age Disability Gender Reassignment Race Pregnancy/maternity Marriage/civil partnership Sex Religion or belief Sexual orientation As a public body, the county council must have regard to the following when shaping policy, delivering services, and in relation to staff: To eliminate unlawful discrimination, harassment, victimisation and any other conduct prohibited by the Act; To advance equality of opportunity between people who share a protected characteristic and people who do not share it; and To foster good relations between people who share a protected characteristic and people who do not share it. These equality aims apply across the county council and to any organisation acting on behalf of the county council, including those delivering services on a contractual, commissioned or voluntary basis.
Out of county placement notifications guidance 5 Policy 1. Our approach to safeguarding our customers interests 1.1 West Sussex, as a net importer from other local social services authorities is periodically notified in writing by other local authorities about customers or potential customers moving into our area. We want to ensure to ensure that adults placed by the county council in the area of other local social services authorities are not taken advantage of. Background context Winterbourne View A BBC Panorama television programme Undercover Care: the Abuse Exposed - in May 2011 secretly filmed the abuse of people with learning difficulties at Winterbourne View Hospital, a registered nursing care home in Bristol. The abuse included staff kicking and slapping the residents, and in some cases drenching them with water. As a result the home was closed on 24 th June 2011. The Care Quality Commission subsequently told the Castlebeck Care Group that it had serious concerns about a number of other services run by that organisation. In four cases where there were particularly serious concerns, enforcement action was taken. In addition, the Care Quality Commission subsequently also followed up inspections of Castlebeck's services with a major review of learning disability assessment and treatment services elsewhere in England. The results have been reported on the Commission s website (see: cqc.org.uk/ldreview). A Serious Case Review report, commissioned by South Gloucestershire Council s Safeguarding Adults Board, was published in August 2012. 1.2 West Sussex has a low number of people with learning difficulties who are funded in a hospital setting. All have allocated care managers and many people are visited monthly; all have been reviewed since June 2011. Those that require it have been referred to an independent advocate. 1.3 We have developed a strategic approach led by our Public Health and Joint Commissioning staff - to ensure that everything possible is being done to strengthen the safeguarding arrangements in place. The strategic approach consists of four interlocking themes, namely to: Improve the information flows from people (including relatives and professionals) who regularly visit care homes in the county;
Out of county placement notifications guidance 6 Develop an integrated service model to incentivise the delivery of good quality care in care homes; Encourage people to join Link or Healthwatch scrutiny groups so that there are more lay people skilled up to visit care homes and hospitals; and to Appoint two safeguarding guardians on the Adults and Children s Services Select Committees to ensue that safeguarding is considered and scrutinised in all actions of the county council. 1.4 We have a responsibility to protect all people living in care homes in the county whether they are placed by ourselves, another local social services authority or are funding their own care. Where people are placed in care homes by West Sussex County Council staff regular reviews of their care will be undertaken. Alongside the raising and investigating of safeguarding issues, the contract for all placements at the particular care home will be reviewed and monitored by county council staff who specialise in this area of practice. 1.5 Increasingly more attention is being given to quality assurance through commissioning and contracting and to achieving greater collaboration with other local authorities where services are commissioned by more than one local authority. 1.6 A proactive and preventive approach is being undertaken by NHS Sussex, the clustering organisation for the three primary care trusts across Sussex. NHS Sussex has developed a Sit and See programme which is intended to improve care and compassion. Lay people visit hospitals and observe the care given and then report back on what they see. 1.7 The regulator for health and adult social care is the Care Quality Commission that makes sure that the care provided meets essential standards of quality and safety. A new rating system for care homes now places a greater emphasis on self-reporting. This, in turn, places a greater expectation on the local social services authority and its safeguarding partner organisations to ensure quality of care is also provided in care homes. 1.8 Within the county of West Sussex, approximately 60% of the care homes are members of West Sussex Forum, the largest local representative body for community care providers. The Forum seeks to create an environment in which providers can continue to deliver and develop the high quality care that our community requires and deserves. The Forum does not have a role or authority to intervene but provides an open communication route to the local social services authority and its partner organisations that has been found to be positive. The way in which the Forum works with the county council has been shared with the Care Quality Commission. 1.9 Where safeguarding alerts or concerns are raised about practice in individual care homes, the Contracts Unit initiates a review. A new integrated service model using the 2 million NHS monies for Social Care (2011-2013) is under development. A multi-disciplinary quality and performance monitoring
Out of county placement notifications guidance 7 team will be established to deal with these issues on a day-to-day basis. The team will help to develop the ability of the independent care and nursing home sector to: reduce potentially inappropriate hospital admissions; assist early supported hospital discharge; reduce safeguarding alerts; and to scope the potential to encourage providers to support good quality care. 2. The legal context 2.1 It has been the case for the past two decades that local social services authorities have been charged with ensuring that information is passed on about any customers known to themselves who move to another area. The relevant guidance was incorporated in Local Authority Circular (93) 7, specifically paragraphs 8 and 10 of that Circular. 2.2 The 1993 guidance made it very clear that there should be no placements made by the local social services authority of existing customers without the new authority being made aware in writing (paragraph 8). Where an adult chose to settle in a new geographical area, and in so doing became ordinarily resident there, but was not otherwise known to the local social services authority from where they had moved, the onus was placed on the new local social services authority to assess the needs of the customer for social care services. If however the former local social services authority became aware that the customer might be in need of social care services in future, the local authority was encouraged to inform the new local authority about this (paragraph 10). 2.3 Local Authority Circular LAC (93) 7 was superseded in the 2010 Ordinary Residence: Guidance on the identification of the ordinary residence of people in need of community care services, England (DH Gateway reference 15971), updated further in April each year. The nearest equivalent to paragraphs 8 and 10 of the 1993 guidance are paragraphs 57 and 105 in the latter: If a local authority places someone out of area in accommodation provided by the independent sector, they should always inform the host authority of the placement. This is to ensure the host authority is aware of the person in their area and to enable both authorities to agree on the suitability of the placement. The placing authority should also ensure that satisfactory arrangements are made before the placement for any necessary support services, such as day care, and that clear agreements are in place for funding all aspects of the person s care. For example, the placing local authority may negotiate for support services to be provided by the host authority and reimburse the costs (paragraph 57); and
Out of county placement notifications guidance 8 When a person who is not being provided with Part 3 accommodation by a local authority chooses to relocate permanently to another local authority area of their own volition, perhaps to be near their family or to move from a self-funded care home into independent living accommodation, they generally acquire an ordinary residence in their new area. If the person needs community care services, they would therefore need to approach their new local authority for an assessment (paragraph 105). Procedures 3. Arrangements within adult social care 3.1 In terms of improving information flows, people who live in care homes can expect to receive a range of visitors. For many, family visitors will be the most important whilst for some the only visitors they may see on a regular basis will be health and social care professionals such as GPs and therapists, and social care workers or nurses who are undertaking statutory monitoring of a person s care arrangements. It is important that where there are concerns about the quality of care appropriate information is collected and collated - and a culture of an open environment that protects the vulnerable and supports quality provision is promoted. 3.2 People living in care homes and their families need to be made aware of what actions they should take if they are not satisfied about the care received. A keeping safe information pack has been developed for people being discharged from hospitals or from so-called step down beds to care homes. The information pack includes information about keeping safe and what to do if there are concerns. Similar information has been prepared for the families of those already in care homes. 3.3 Where customers of the county council are placed and funded in the area of a.n.other local social services authority we are required to notify the other authority of the placement. A template letter is attached as Appendix 1. The easiest way to find the address of a local social services authority is to search for this using a proprietary search engine on the internet, making sure to include the word council after the name of the placement town: for example, Swindon and council produces a result for Swindon Borough Council. This is not in fact a local social services authority, and it would be necessary to contact Swindon Borough Council direct to find the name and contact details of the relevant local social services authority in that area (Wiltshire County Council, in fact). Alternatively, the annual Social Services Yearbook, available in Area Offices, can be consulted. 3.4 A copy of the letter should be attached to the customer record on Frameworki and an entry made in the diary record to the effect that the letter
Out of county placement notifications guidance 9 has been sent. The Contracts Unit at County Hall should also be notified of these actions. 3.5 When placements out of county are made by the county council from the pooled mental health budget, copies of any funding agreements should be provided for care co-ordinators, in order to assist with the care plan monitoring and review arrangements. Where funding is agreed for support packages outside the county, care co-ordinators should be reminded that the customer will fall within the new local authority s responsibility for social care support under the revised Ordinary Residence guidance. 4. Sources of further information on the internet Department of Health (2011). Ordinary Residence: Guidance on the identification of the ordinary residence of people in need of community care services, England. Gateway reference 15971. Available in electronic format only, from dh.gov.uk Department of Health (2012). DH Review Winterbourne View: Update and Action Needed. Gateway reference 17155. Available in electronic format only, from dh.gov.uk South Gloucestershire Safeguarding Adults Board (2012). Winterbourne View Hospital: A Serious Case Review. Written by Margaret Flynn. Available from: southglos.gov.uk
Out of county placement notifications guidance 10 Appendix 1 Notification letters to other local social services authorities Template letters (SIT 254 and SIT255) have now been produced and are accessible on Frameworki for staff to use. Letter to be typed on headed paper from a West Sussex County Council office address Director of Adults Services Name of local social services authority Headquarters address Date Dear Sir/Madam Reference: Name and address of West Sussex customer I am writing to you in line with the 2010 Ordinary Residence: Guidance on the identification of the ordinary residence of people in need of community care services, England. AND EITHER USE: West Sussex County Council has recently placed (name of customer) out of our area of jurisdiction and in accommodation provided by the independent sector, in your area. We have established arrangements for any necessary support services to be provided and clear agreements are in place for funding all aspects of this person s care. For further information, please contact me at the above address. OR West Sussex County Council understands that (name of customer) has chosen to relocate permanently to your local authority area of their own volition, to be near to their family or to move from a self-funded care home into independent living accommodation (delete whichever of these is not required). In so doing it is our understanding that if (name of customer) needs community care services in future, they will need to approach your organisation for a community care assessment. Yours faithfully (Type in) name and designation of social care worker