Short breaks eligibility and allowance for service users and carers in adult social care services. - Find a freedom of information request

I am requesting information regarding how Lincolnshire County Council determines its short breaks eligibility and allowance for service users and carers in adult social care services.

1. What do LCC offer in terms of short breaks/short-term respite care? Is the offering different for elderly people vs adults with physical disabilities, mental health needs, learning disabilities and/or Autism?

2. Are the number of days/weeks and amount of funding allocated decided by measuring the needs of the service user and the impact on the carer combined? Is this measured by bands? If not, how is the short breaks offering calculated?

Any documents relating to this will be useful, including but not limited to:

- Adult social care Assessment Of Need template in Word or PDF format.

- Adult social care Assessment Of Carer's Need template in Word or PDF format.

- Adult social care Support Planning template in Word or PDF format.

- Adult social care RAS / Financial Resource Cost Allocation Tools which Determines Adult Care Cost Package in time, units and pounds/money.

- Adult social care Adult Care Short Breaks Allocation Tools.

- Whatever RAS model is being used, please provide your Indicative Allocation Table or other mechanism for converting points to days/money.

- Whatever RAS model is being used, please provide your list of resource allocation questions and the associated weighting/factor that calculates the points for the short breaks allocation.

- Adult social care Financial Resource guidance when determining Adult Care Cost Package.

1. The current Short Breaks and Emergency Provision Service consists of two contracts providing building-based care solutions through 15 beds; across two different settings – one in the north and one in the south of the county. The current short break service is the only dedicated provision available. This service provides dedicated capacity to support individuals whose arrangements might be in crisis, ensuring a safe alternative support mechanism in the short term. The service provides short breaks on a planned basis and emergency provision to adults aged 18+ with a learning disability (LD), profound, complex and multiple learning disabilities (PMLD), with Autistic Spectrum Disorders (ASD), behaviours that challenge and/or physical disability (PD) on a planned and unplanned (including emergency or urgent) basis.

2. A whole family approach is taken to ensure the needs of the person with care and support needs and the needs of their informal carer are looked at a a whole when care and support planning.  

Under the Care Act, carers have to be a part of the cared for person's assessment, even if the cared for person does not want them to be. This is because the Local Authority needs to:

1. understand the person's needs, how they are currently being met and whether this is appropriate and sustainable; and
2. identify and support carers.

When a person has not consented to the carer being a part of the assessment, you should:

1. advise the person that you have a duty to involve the carer;
2. explain the benefits of the carer being involved; and
3. agree the most appropriate way to involve the carer (for example, a separate meeting with the carer).

Under the Care Act, it is important that the person's needs are considered within the context of their family network of support and not in isolation. This is what is meant by a whole family approach.

Taking a whole family approach enables the Local Authority to:

1. understand the impact of the person's care and support needs on all family members, not just those that may be instantly recognisable as carers; and
2. identify and support carers (both these things are duties under the Care Act).

Taking a whole family approach also builds the resilience of families and increases the likelihood that a non-service led, self-sustainable method of meeting needs will be identified.

There are four key steps to adopting a whole family approach:

1. Think family;
2. Get the whole picture;
3. Make a plan that works for everyone;
4. Check its working for the whole family.

https://lincolnshireadults.trixonline.co.uk/chapter/the-skilled-conversation

When determining the level of need you must give regard to:

1. the views of the person about the level of need;
2. the impact of the need on the person's wellbeing;
3. the views of any carer about the level of the person's need; and
4. the views of anyone else consulted or involved in the assessment process.

The decision that you make about the level of need must be evidence-based and robust. This means you must be able to demonstrate the information that you have used to reach a decision about need if challenged. https://lincolnshireadults.trixonline.co.uk/chapter/agreeing-needs-and-making-a-formal-record

How are the short breaks offering calculated- See screen shot attached.

Any documents relating to this will be useful, including but not limited to:

- Adult social care Assessment Of Need template in Word or PDF format. – ‘Adult My Assessment’ and ‘Adult My Assessment – Person Data’ attached

- Adult social care Assessment Of Carer's Need template in Word or PDF format. – ‘Adult Carer Assessment’ attached

- Adult social care Support Planning template in Word or PDF format. – ‘Adult My Care and Support Plan’, ‘Adult My Care Package – Planned services’, ‘Adult My Care Package – Unplanned and Amendments’, ‘Adult My Review’, ‘Adult My Review – Person Data’, ‘Adult Carer Support Plan’, ‘Adult Carer Support plan costings’, ‘Adult Carer Support Plan Review’

- Adult social care RAS / Financial Resource Cost Allocation Tools which Determines Adult Care Cost Package in time, units and pounds/money.
Ready Reckoner is used to calculate an Indicative Planning Budget, calculated based on expected costs / the cost the Local Authority have agreed with providers through contracts.

- Adult social care Adult Care Short Breaks Allocation Tools – Screenshot above is used and attached.

- Whatever RAS model is being used, please provide your Indicative Allocation Table or other mechanism for converting points to days/money. – see screen shot attached.

- Whatever RAS model is being used, please provide your list of resource allocation questions and the associated weighting/factor that calculates the points for the short breaks allocation. – RAS used is the Ready reckoner above. No RAS questions, points or weighting. Short break allocation is based on the Assessment.

The Ready Reckoner Approach is being used in Lincolnshire to give an indication of the amount of money that may be required to meet eligible support needs.

The Lincolnshire Ready Reckoner was developed through extensive consultation with a range of stakeholders, including people receiving services.

The Ready Reckoner is an optional element included in the Adult Care My Assessment and should be used whenever an assessment or review needs to generate a new or revised indicative planning budget.

- Adult social care Financial Resource guidance when determining Adult Care Cost Package.

From ‘Resource Allocation Guidance; Use of the Adult Care Ready Reckoner Approach to generate an indictive planning budget’ for Adult Care and Community Wellbeing only.  

“The rationale for Resource Allocation should be evident in and consistent with the level of need identified in the assessment. The Ready Reckoner Approach ensures that an Adult who is eligible for care and support following a strength-based conversation and assessment will be provided with a planning amount. The amount gives the individual an indication of the personal budget that may be available to enable them to consider their choices and options of how and when their unmet eligible care and support needs will be met, and by whom. The final personal budget is the amount required to meet eligible assessed needs that we have a duty to meet established through assessment and support planning processes.

The amount that the local authority calculates as the personal budget, must be sufficient to meet the Adult’s eligible unmet needs which the local authority is required to meet under Care Act section 18 or 20(1), or decides to meet under section 19(1) or (2) or 20(6). It must also take into account the reasonable preferences to meet needs as detailed in the care and support plan. • The Care Act states that the personal budget must be an amount that is the cost to the local authority of meeting the Adult’s eligible unmet needs. In establishing the ‘cost to the local authority’, consideration should therefore be given to local market conditions and costs of local quality provision. This will ensure that the personal budget reflects local market conditions and that appropriate care that meet needs can be obtained for the amount specified in the budget.

Lincolnshire County Council’s resource allocation approach will not be based on statements and pre-determined amounts but will work on the practitioner's estimation of the number of hours needed to meet unmet eligible needs in a range of areas multiplied by the cost per hour or per night the authority pays for those services. Time is the focus of the calculation because this aspect is something that the Adult and /or their representative can relate to, and workers can relate to cost more easily.”

https://lincolnshireadults.trixonline.co.uk/chapter/setting-an-indicative-budget

An indicative planning budget is a 'ball-park' figure calculated immediately following the assessment. It estimates the amount of money it may take to meet eligible needs and is based on information gathered during any assessment process.

The indicative budget is refined during the care and support/support planning process to arrive at a personal budget figure that represents the final amount the Local Authority agrees is sufficient to meet all of the persons/carers eligible needs. The final amount may be greater or less than the original indicative budget estimated.

Should you require the attachments mentioned above please contact customerinformationservice@lincolnshire.gov.uk with the below reference number and this can be provided.