Care planning

Once you have been assessed and the local authority has decided which of your needs are eligible, the next step is for them to help you decide how your needs can be best met by drawing up a care and support plan. This plan will be a collaborative effort between yourself, your carer if you have one, and social services.

Your input is vital - you must formally approve of a care and support plan for it to be valid. The local authority must give you a reasonable amount of time to consider whether you approve of the plan before you sign off on it, and if you are not happy with it then the local authority must work with you towards a reasonable solution.

Local authorities should take every opportunity to ensure that the person is actively involved in the creation of their care plan. It may not always be appropriate for a person to be involved directly, for instance if they lack capacity to do so. In that case, the local authority has a duty to ensure that an appropriate person (a friend, carer or relative for example) is able to facilitate the person's involvement. If no such person is available, then the local authority must appoint an independent advocate to fulfil, this role. An independent advocate should be appointed as early as possible in order to ensure that the planning stage is as person-centred as it can be.

According to the Deafblind Guidance, any assessment of a deafblind person should be carried out by a suitably qualified assessor. The new Care Act Guidance states that following such an assessment a specialist should be included in the care planning stage. It goes on to say that preferably this should be the same person who carried out the assessment.

If at any point the proposed care and support plan goes before a panel for approval, then the Care Act Guidance states that a specialist should sit on the panel. Again, this should preferably be the same person who carried out the assessment.

What should be included in the plan?

The plan should include all of your needs that have been identified in the assessment. It should identify which needs are eligible, which are currently being met by carers and which are going to be met by the local authority. One of the main purposes of the plan is to record how these needs are going to be met.

It should include your strengths and assets – this could be your family and friends, neighbours and any other network of support, and how they may help you achieve your goals.

It should mention your agreed outcomes – these are goals that you hope to attain. The local authority has a duty to take account of your wishes wherever it can, and so certain desired outcomes that you agree with the local authority should be recorded in the care plan.

Finally, the care and support plan should include a full account of how your care is paid for. It should record details of your personal budget, direct payments and your own financial contributions to your care.

It is especially important that the local authority record any needs which are met by a carer. If needs are met by a carer, and that carer is willing and able to continue meeting them, then the local authority does not have to meet them. It must, however, make a record of what these needs are and whether they would be eligible for support were it not for the carer. This is so that they can step in and provide support if the carer is unable to.

Meeting needs

There should be no constraints on how your needs can be met. Services should be flexible and should be tailored to your needs. You should not be expected to make do with "one size fits all" existing services if they are not entirely appropriate for your needs. The Care Act talks of how a care and support plan can “meet needs”, rather than of "providing services". This is an important distinction.

The Care Act gives some examples of how needs may be met. Local authorities may:

  • Directly provide some type of support
  • Commission a care and support provider to provide some type of support
  • Make a direct payment and allow the person to purchase their own care and support
  • Use a combination of the above

The local authority's role is to ensure that needs are met in a reasonable and cost effective way. They should provide oversight to ensure that your needs are met in an appropriate and reasonable way.

Sometimes, a person's needs may be met by an organisation other than the local authority. In this case, local authorities must act as "brokers" and support the person in making a choice about which provider they want to use.

During the planning stage, it should be considered how the person may benefit from community-based and voluntary support. This could be for instance local community support groups, or services run by charities. Local authorities must particularly be mindful of such services if they may contribute to a person's mental and emotional wellbeing and help build friendships and social connections

If at the end of the care planning it is clear that the personal budget is not sufficient to meet the eligible needs then the budget must be increased. The final personal budget must be sufficient to meet eligible needs.

Combining plans

Local authorities should not develop plans without considering any other plans that a person might have or be affected by. The process of drawing up a care and support plan should not focus exclusively on a person's care and support needs if that person is receiving other forms of support. Local authorities must make attempts to establish whether other plans exist, and should ensure that all of these plans fit together.

Local authorities may combine various plans where this is appropriate. This could mean combining a person's plan with their carer's plan or a family member's plan or with a health plan if that person receives NHS health support.

Any combination of your care and support plan with a carer's or family member's plan must be done with your consent. If the combination involves a child's plan then they must either consent or if they lack capacity, the local authority must be satisfied that a combination would be in the child's best interests.

If you receive NHS funded health support, then it is worth remembering that you can now receive a personal health budget. In order to allow you greater control over how your needs are met and to avoid duplicating support, your health budget and your social care personal budget can be pooled.

First published: Tuesday 31 March 2015
Updated: Tuesday 22 December 2015