Reassessment or Review? Legislation / guidance

Hello, in my local authority there has been a new Support Needs Assessment eform created and the Personalisation Review form has been discontinued entirely. The rationale behind this was that the review form conflated the assessment of need with the provision of service and did not offer a Resource Allocation Group scoring facility within it and that this was backed by legislation and guidance.

I am trying to find out what the legislation and guidance clearly states about the difference between assessment, reassessment and review and in what circumstances a review can be conducted without a full reassessment of need.

Whilst I understand that a significant change in circumstance or need for an individual would require a new full reassessment of need, the following examples involve neither of these but now require onerous and time consuming documentation:

Keeping the total numbers of hours in a service - and the service delivery - the same but re-writing support plans so that there is clarity on what is expected to be delivered by providers / expected from the LA / understood by proxies.

When the LA discovers it has been overfunding a service which no one had picked up due to the complexities of finance columns as it relates to shared supported accommodation services - three review form were written which kept the amount of actual staffing delivered exactly the same but ensured that what we were funding matched this.

Applying to the Independent Living Fund for more 1:1 support hours for individuals but not altering any other parts of a care plan - this comes at no cost to the LA, has great benefits to the individual and is much easier to do in a review document than through a full reassessment of need - which is putting people off applying for the ILF as it already can be a difficult process in terms of matching up the requirements of the LA / ILF and is made more complicated having to do a new SNA for everyone who has a new ILF award.

Changing ratios of support when someone moves into a service - some void variations are written into care plans, some are stand-alone documents. If there is a completely new person moving in (due to an extra room in the service) so the only change, for example, that had to be made across all of the existing residents are changes to nightshift split / costs, understandably this is much easier through a review type document rather than full SNA’s.

In one current example there will be large savings made across a household as a whole by having someone moving in, but one individuals support plan needs to increase by 3.5 hours due to them being originally underfunded for the support that they receive in practice and this will require a new full reassessment of need. Again, the actual support hours are the same but due to underfunding the provider should have been paid more.

These sorts of under / over funding services are common on Duty and they usually don’t result in any change in the delivery of service but require a new reassessment of need rather than a new eform.

These changes mean everything is slower, more bureaucratic, frustrating for proxies, more complicated for providers, disincentivise money saving moves like applying to the ILF, and impede timeously and proportionate reviews to eforms and has increased the waiting list for individuals being assessed.

I am trying to fund what the legislation / guidance says about reviews where there has not been a change of need / circumstance.

The Social Care (Self-directed Support) (Scotland) Act 2013: Statutory Guidance 2014 Section 6 (page 81 - 82) states that:

‘A significant change to a supported person’s needs or a request for a further assessment should prompt a review of the person’s needs. In addition, the supported person and/or the authority can also request a review of the choice of options under the 2013 Act…However, a review of a person’s choice under the 2013 Act can take place without a detailed review of needs. The person may decide that they do not wish to continue with the option that they have chosen’

This seems to state that the only circumstance that detailed review of need does not need to take place is for a change of choice of the options under the 2013 Act, but this would be lacking as it does not take into account the range of possible changes that, as above, detail why a review should not require a full reassessment of need.

Could anyone assist as to how they understand legislation and guidance in this issue. I assume that not every single local authority has not option but to use a full reassessment of need to make even the most minor financial adjustment through an eform?

Thanks very much

Presumably requiring a full reassessment where only a review is required is unnecessary and disproportionate, rendering the policy challengeable.

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Thanks. I believe it is unnecessary and disproportionate, however it is the current system, though we are trying to challenge this. Do you know how things operate in your local authority in relation to this issue? Thanks

I don’t know on this particular point. Is the local policy written down? Do you have a copy?

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I’ve heard a similar story about Access to Work. Hope it’s not becoming a trend.

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As in it requires a lot of paperwork / procedure to access?

It’s not really a policy, the LA announced that the review form was discontinued and so the only way any permanent changes can be made to care plans is through a complete SNA, rather than being able to make changes through a review form. It was stated that the review form was discontinued as there was no clear separation between assessment of need and provision of services, whilst it also didn’t offer an indicative budget scoring facility like the SNA does.

Does anyone have any examples from their own local authority about how this works or expertise on the legislation / guidance around this issue please?

As in they have scrapped reviews and require a full reassessment every time a plan needs changing. Apparently there has been a large increase in demand for access to work

Sorry, what does SNA stand for?

Review of plans is a thing in the statutory guidance, which is binding on Local Authorites. If they want to deviate from that they will need a very very good reason. No longer having a form for it is not a good reason.

Can you explain their reasoning a bit more as I don’t really understand it? To my mind, obviously, reviews that just look at changes of circumstances without repeating everything that has gone before are perfectly reasonable things to do. Especially with overworked social care departments.

I’d be inclined to ignore them and say “It’s OK, we’ll do a review as it says in the guidance. Don’t worry if you don’t have a form, I’ll make one up for you and fill it in myself and send it to you for your comments.”

Regarding expertise, reading the guidance should be sufficient. It talks about reviews. There’s stuff in the guidance and in the SDS Standards (if I recall correctly) about not creating unnecessary work for people, and not having overly onerous monitoring procedures.

That’s the same with us, full reassessment in place of a review

SNA = Support Needs Assessment. We can do reviews but the review has to go through a full reassessment of need in the SNA. There is no review document so the only pathway currently to making any changes in a care plan is through an SNA. We cannot change any qualitative or financial information except through this document. Have read the legislation and guidance but will look up the SDS Standards now thanks.

OK, is the process all done online? Is this a ‘computer says no’ situation or a ‘social work says no’ situation?

The process is all online and there is no getting round it. There has been so much feedback on the short notice changes with the discontinuation of the review form - with which social workers could make minor, technical and administrative changes to care plans without a full reassessment of need - and now for all workers to use a full support needs assessment that there are some in person feedback sessions on these changes. I am trying to gather experiences from other local authorities and combing through the guidance and legislation to back up my arguments about the need for a review form. The statutory guidance states that '‘The 2013 Act imposes additional and distinct review duties in relation to the narrower question of how the supported person’s support is arranged. In practice the two types of review – a review of the person’s 2013 Act options and a review of the person’s wider needs and outcomes – will tend to go hand in hand. However, a review of a person’s choice under the 2013 Act can take place without a detailed review of needs. The person may decide that they do not wish to continue with the option that they have chosen’. - The examples of changes that we wish to carry on making to care plans as detailed below are less intrusive and involved than changing someone’s choice under the 2013 Act

‘Alternatively, the person may decide that arranged services are not working out the way that they had thought and would like to reconsider the other options. The authority should view this as part of the on-going nature of assessment, and it should support the relevant practitioners to work with the supported person to consider what adjustments they would like to make’ - From this it can be taken that a review of a person’s wider needs and outcomes are not necessary when the support person would like to reconsider their options, that adjustments can be made to care plans, and that the local authority should see this as part of the on-going nature of assessment rather than something requiring a full reassessment of need.

I agree with you, but you may be in for a fight. Hopefully the Stadards can offer something.

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The Padfield case may be of some use here. If a policy thwarts the purpose of the legislation that it is made under, that policy may be unlawful. This is strongly looks like a policy, even if it’s not written down.

Thanks for your replies, do you have a link or more details re the Padfield case?

Consider Lord Reid’s words in Padfield v Minister of Agriculture, Fisheries and Food [1968] UKHL 1:

“Parliament must have conferred the discretion with the intention that it should be used to promote the policy and objects of the Act; policy and objects of the Act must be determined by construing the Act as a whole, and construction is always a matter of law for the court. In a matter of this kind it is not possible to draw a hard and fast line, but if the Minister, by reason of his having misconstrued the Act or for any other reason, so uses his discretion as to thwart or run counter to the policy and objects of the Act, then our law would be very defective if persons aggrieved were not entitled to the protection of the court.”

It seems to me that LAs frequently adopt policies and practices that frustrate the purpose of the 2013 Act.

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