CARE ACT 2014
Local authorities must develop and maintain services for people living in their area, to provide information and advice relating to care and support for adults and support for carers.
MANCHESTER SPECIFIC GUIDANCE
November 2018: This chapter was amended to include a link to Your Guide to Social Care for Adults in Manchester, published by Manchester City Council as linked above.
- 1. Introduction
- 2. Terminology
- 3. The Duty to Establish and Maintain a Service
- 4. Audiences for the Information and Advice Service
- 5. Quality of Information and Advice
- 6. Content
- 7. Opportunities to Provide Information and Advice
- 8. Accessibility of Information and Advice
- 9. Proportionality
- 10. Adult Safeguarding
- 11. Complaints
- 12. Developing and Reviewing an Information and Advice Service Plan or Strategy
Information and advice is fundamental to enabling people, carers and families to take control of, and make well informed choices about their care and support and how they fund it. Not only does information and advice help to promote people’s wellbeing by increasing their ability to exercise choice and control, it is also a vital component of preventing or delaying people’s need for care and support.
The local authority must: ‘establish and maintain a service for providing people in its area with information and advice relating to care and support for adults and support for carers’ (Section 4, Care Act 2014).
It has an active and critical role in the provision of information and advice and must take an active role. To fulfil its duty, a local authority is likely to need to go further than providing information and advice directly (though direct provision will be important) by working to ensure the coherence, sufficiency, availability and accessibility of information and advice relating to care and support across the local authority area. Importantly, this duty relates to the whole population of the local authority area, not just those with care and support needs or who are in some other way already known to the system.
It is important to be clear that the duty to establish and maintain an information and advice service is distinct from the duty to meet eligible needs (see Eligibility): this is true for both people with care and support needs and their carers. While a person’s eligible needs may be met by the provision of information and advice, this will be an individual response following a needs or carers assessment. The local authority cannot fulfil its universal information and advice duty simply by meeting eligible needs, nor would information and advice always be an appropriate way of meeting eligible needs.
The local authority must ensure that information and advice services established cover more than just basic information about care and support and cover the wide range of care and support related areas. The service should also address prevention of care and support needs, finances, health, housing, employment, what to do in cases of abuse or neglect of an adult and other areas where required. In fulfilling this duty, local authorities should consider the people they are communicating with on a case by case basis, and seek to actively encourage them towards the types of information and / or advice that may be particularly relevant to them.
Separately to the duty to establish and maintain an information and advice service, local authorities must provide independent advocacy to facilitate the person’s involvement in the care and support assessment, planning and review processes where an individual would experience substantial difficulty in understanding, retaining or using information given, or in communicating their views, wishes or feelings and where there is nobody else appropriate (see Independent Advocacy).
The availability and provision of information and advice, whether more general information about the way the system operates in the local authority area or more personalised information on a person’s specific needs, are essential building blocks to all of the reforms and many of the specific duties the Act introduces. This chapter should therefore be read in conjunction with the following:
- promoting individual wellbeing (Promoting Wellbeing);
- prevention of needs for care and support (Preventing, Reducing or Delaying Needs);
- integration of care and support with health and housing related services (Integration, Cooperation and Partnerships);
- promoting diverse and high quality services (Market Shaping and Commissioning of Adult Care and Support);
- assessment and eligibility (Assessment and Eligibility);
- personal budgets, personal care and support planning and direct payments (Personal Budgets, Care and Support Planning and Direct Payments);
- deferred payment agreements (Deferred Payment Agreements);
- continuity of care (Continuity of Care);
- safeguarding (Adult Safeguarding);
- transition to adult care and support (Transition to Adult Care and Support);
- independent advocacy (see Independent Advocacy).
The Care and Support Statutory Guidance (2016) uses the term ‘information’ to mean the communication of knowledge and facts regarding care and support. ‘Advice’ means helping a person to identify choices and/or providing an opinion or recommendation regarding a course of action in relation to care and support.
The guidance also uses the term ‘advocacy’ to mean supporting a person to understand information, express their needs and wishes, secure their rights, represent their interests and obtain the care and support they need.
It talks about ‘financial information and advice’ which includes a broad spectrum of services whose purpose is to help people plan, prepare and pay for their care costs. In places it talks of ‘independent’ financial information or advice which in this document means services independent of the local authority. This guidance also refers to ‘regulated’ financial advice which means advice from an organisation regulated by the Financial Conduct Authority (FCA) which can extend to individual recommendations about specific financial products. Local authorities should ensure that people are able to access all of these types of financial information and advice which help people plan and pay for their care.
3. The Duty to Establish and Maintain a Service
The local authority must establish and maintain a service for providing people in its area with information and advice relating to care and support for adults and support for carers. In doing so local authorities should take account of the services currently in place and actions already taken and plans with partner organisations resulting from Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies (see also Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies). The information and advice service must cover the needs of all its population, not just those who are in receipt of local authority funded care or support. For example, people may often require information and advice before they need to access care or support services, to consider what actions they may take now to prevent or delay any need for care, or how they might plan to meet the cost of future care needs.
People need information and advice across many areas to support them to make informed choices about their care and support.
The local authority should ensure that they engage widely with people with care and support needs, carers, the wider public and local providers of information and advice and other types of care and support, to identify what is available and exactly what is needed locally, and how and where information and advice should best be provided.
Whilst the local authority must establish and maintain a service, it does not mean it has to provide all elements of the service itself. It should make use of other local high quality statutory, voluntary and / or private sector information and advice resources available to people within their areas. It may result in providing a service with another local authority, health service, children’s service, or reuse of information from other local or national sources. Consideration should be given as to whether services should be provided by the local authority directly or by another agency, including independent providers.
4. Audiences for the Information and Advice Service
The local authority is responsible for ensuring that all adults including carers in its area with a need for information and advice about care and support are able to access the service. This is a very broad group, extending much further than people who have an immediate need for care or support. It will only be achieved through working in partnership with the wider public and local advice and information providers.
People (carers included) who are likely to need information and advice include, but are not restricted to:
- people wanting to plan for their future care and support needs;
- people who may develop care and support needs, or whose current care and support needs may become greater. Under the duty of prevention in the Act, local authorities are expected to take action to prevent, delay and / or reduce the care and support needs for these people (see Preventing, Reducing or Delaying Needs);
- people who have not presented to local authority for assessment but are likely to be in need of care and support. Local authorities are expected to take steps to identify such people and encourage them to come forward for an assessment of their needs (see Preventing, Reducing or Delaying Needs);
- people who become known to the local authority (through referral, including self-referral), at first contact where an assessment of needs is being considered (see Assessment);
- people who are assessed by local authority as currently being in need of care and support. Advice and information must be offered to these people irrespective of whether they have been assessed as having eligible needs which the local authority must meet;
- people whose eligible needs for care and support the local authority is currently meeting (whether the local authority is paying for some, all or none of the costs of meeting those needs (see Care and Support Planning);
- people whose care and support or support plans are being reviewed (see Review of Care and Support Plans);
- family members and carers of adults with care and support needs, (or those who are likely to develop care and support needs). Local authorities are expected to have regard to the importance of identifying carers and take action to reduce their needs for support (see Assessment);
- adults who are subject to adult safeguarding concerns (see Adult Safeguarding);
- people who may benefit from financial information and advice on matters concerning care and support. Local authorities must have regard to the importance of identifying these people, to help them understand the financial costs of their care and support and access independent financial information and advice including from regulated financial advisers (see Financial Information and Advice), and;
- care and support staff who have contact with and provide information and advice as part of their jobs.
The local authority must recognise and respond to the specific requirements that carers have for both general and personal information and advice. A carer’s need for information and advice may be separate and distinct from information and advice for the person for whom they are caring. These distinct needs may be covered together, in a similar manner to the local authority combining an assessment of a person needing care and support with a carer’s assessment (see Assessments – Carers), but may be more appropriately addressed separately. This may include information and advice on:
- breaks from caring;
- the health and wellbeing of carers themselves;
- caring and advice on wider family relationships;
- carers’ financial and legal issues;
- caring and employment;
- caring and education; and,
- a carer’s need for advocacy.
5. Quality of Information and Advice
The local authority must ensure that there is an accessible information and advice service that meets the needs of its population. Information and advice must be open to everyone who would benefit from it. People access information and advice from a wide variety of sources. The authority should take account of information standards published by the Information Standards Board for Health and Social Care.
Local authorities should ensure that information supplied is clear. Information and advice should only be judged as clear if it is understood and able to be acted upon by the individual receiving it. Local authorities will need to take steps to evaluate and ensure that information and advice is understood and able to be acted upon.
Information and advice provided within the service should be accurate, up to date and consistent with other sources of information and advice. Staff providing information and advice within a local authority and other frontline staff should be aware of accessibility issues and be appropriately trained.
All reasonable efforts should be taken to ensure that information and advice provided meets the individual’s requirements, is comprehensive and is given at an early stage. The local authority must seek to ensure that all relevant information is available to people for them to make the best informed decision in their particular circumstances. Omission or withholding of information would be at odds with the duty as set out in the Act.
There will be some circumstances where impartial information and advice are particularly important and the local authority should consider when this may be best provided by an independent source, rather than by the local authority itself. This is particularly likely to be the case when people need advice about how and whether to question or challenge the decisions of the local authority or other statutory body.
The local authority must ensure that information and advice is provided on:
- how the local care and support system works locally – about how the system works. An outline of what the ‘process’ may entail and the judgements that may need to be made. Including specific information on what the assessment process, eligibility, and review stage is, how to complain or make a formal appeal to the authority, what they involve and when independent advocacy should be provided and be widely available. This also includes wider information and advice to support individual wellbeing; the charging arrangements for care and support costs (utilising current and developing national resources; how a person might plan for their future care and support needs and how to pay for them, including provision for the possibility that they may not have capacity to make decisions for themselves in the future
- how to access the care and support available locally – where, how and with whom to make contact, including information on how and where to request an assessment of needs, a review or to complain or appeal against a decision;
- the choice of types of care and support, and the choice of care providers available in the local area – including prevention and reablement services and wider services that support wellbeing. Where possible this should include the likely costs to the person of the care and support services available to them. This should also include information on different types of service or support that allow people personal control over their care and support for example, details of Independent Service Funds, and direct payments (see Market Shaping and Commissioning of Adult Care and Support);
- how to access independent financial advice on matters relating to care and support – about the extent of their personal responsibilities to pay for care and support, their rights to statutory financial and other support, locally and nationally, so that they understand what care and support they are entitled to from the local authority or other statutory providers. Including what information and advice people may wish to consider when making financial decisions about care so that they can make best use of their financial resources and are able to plan for their personal costs of care whether immediately or in the future;
- how to raise concerns about the safety or wellbeing of an adult with care and support needs and also consider how to do the same for a carer with support needs.
The breadth of the circumstances under which information and advice must be provided, and the overall duty to promote individual wellbeing, means that local authorities must ensure that the subject matters covered by their information and advice available to people in their areas go much further than a narrow definition of care and support and cover all those subject matters listed above. Depending on local circumstances, the service should also include, but not be limited to, information and advice on:
- available housing and housing related support options for those with care and support needs;
- effective treatment and support for health conditions, including Continuing Health Care arrangements;
- availability and quality of health services;
- availability of services that may help people remain independent for longer such as home improvement agencies, handyman or maintenance services;
- availability of befriending services and other services to prevent social isolation;
- availability of intermediate care entitlements such as aids and adaptations;
- eligibility and applying for disability benefits and other types of benefits;
- availability of employment support for disabled adults;
- children’s social care services and transition;
- availability of carers’ services and benefits;
- sources of independent information, advice and advocacy;
- the Court of Protection, power of attorney and becoming a deputy;
- raise awareness of the need to plan for future care costs;
- practical help with planning to meet future or current care costs;
- accessible ways and support to help people understand the different types of abuse and its prevention.
7. Opportunities to Provide Information and Advice
Local authorities have a number of direct opportunities to provide – or signpost to – advice and information when people in need of care and support come into contact with them. These include:
- at first point of contact with the local authority;
- as part of a needs or carer’s assessment, including joint Continuing Healthcare Assessments;
- during a period of reablement;
- around and following financial assessment;
- when considering a financial commitment such as a deferred payment agreement or top‑up agreement;
- during or following an adult safeguarding enquiry;
- when considering take up of a personal budget and / or direct payment;
- during the care and support planning process;
- during the review of a person’s care and support plan;
- when a person may be considering a move to another local authority area;
- at points in transition, for example when people needing care or carers under 18 become adults and the systems for support may change.
The local authority and its partners must use the wider opportunities to provide targeted information and advice at key points in people’s contact with the care and support, health and other local services. These may be at key ‘trigger points’ during a person’s life such as:
- contact with other local authority services;
- hospital entry and/or discharge;
- diagnosis of health conditions – such as dementia, stroke or an acquired impairment for example;
- consideration or review of Continuing Healthcare arrangements;
- take up of power of attorney;
- applications to the Court of Protection;
- application for, or review of, disability benefits such as Attendance Allowance, Personal Independence Payments, and for Carers Allowance;
- access to work interviews;
- contact with local support groups, charities, or user-led organisations including carers’ groups and disabled person’s organisations;
- contact with or use of private care and support services, including homes care;
- change or loss of housing;
- contact with the criminal justice system;
- admission to or release from prison;
- ‘guidance guarantee’ in the Pensions Act 2014;
8. Accessibility of Information and Advice
The local authority should ensure that products and materials (in all formats) are as accessible as possible for all potential users. Websites should meet specific standards such as the Web Content Accessibility Guidelines and guidance set out in the Government Digital Service’s (GDS) service manual, printed products should be produced to appropriate guidelines with important materials available in easy read, and telephone services should also be available to those with hearing impairments. Local authorities should particularly be aware of the needs of individuals with complex but relatively rare conditions, such as deafblindness.
As required under the Equality Act 2010, reasonable adjustments should be made to ensure that disabled people have equal access to information and advice services. Reasonable adjustments could include the provision of information in accessible formats or with communication support.
Advice and information content should, where possible, be provided in the manner preferred by the person and will therefore often need to be available in a number of different formats. The duty in the Care Act will not be met through the use of digital channels alone, and information and advice channels are likely to include all of the following:
- face to face contact;
- use of peer to peer contacts;
- community settings;
- advice and advocacy services;
- mass communications, and targeted use of leaflets, posters and so on (for example in GP surgeries);
- use of ‘free’ media such as newspaper, local radio stations, social media;
- the local authority’s own and other appropriate internet websites, including support for the self-assessment of needs;
- third party internet content and applications;
Some groups in need of information and advice about care and support may have particular requirements. Local authorities must ensure that their information and advice service has due regard to the needs of these people. These include, but are not limited to:
- people with sensory impairments, such as visual impairment, deafblind and hearing impaired;
- people who do not have English as a first language;
- people who are socially isolated;
- people whose disabilities limit their physical mobility;
- people with learning disabilities;
- people with mental health problems.
Some people, including some people with dementia, may benefit from an independent person to help them to access or avail themselves of necessary information and advice. Any such need for help to facilitate access to this universal information and advice needs to be considered in planning for delivery of the service, although the duty to make arrangements for an individual to have an independent advocate available to them in certain circumstances only applies in relation to an individual’s involvement in the assessment, planning and review processes. From the point of first contact with or referral to the local authority, consideration of the duty to provide for independent advocacy to support involvement in assessment, planning and reviews should be undertaken (see Independent Advocacy).
The type, extent and timing of information and advice provided should be appropriate to the needs of the person. More complex issues may require more intensive and more personalised information and advice, helping people to understand the choices available to them, while general enquiries may require a less intensive approach. It is also important that the right level of information and advice is provided at the right time, recognising that a person’s need for information or advice may vary depending on the circumstance. For example, providing a person with too much information, more than they can take in, perhaps at a time of crisis, can be counter-productive.
There are clear messages from past public consultations and from research that people ‘don’t know what they need to know’ in relation to their care and support. This can prevent them asking the right questions and can mask the articulation and identification of needs that they have, for which they could benefit from information and advice. All contact for information and advice should take account of this and be able to respond with an assessment of needs when appropriate (see Assessment).
Local authorities should help ensure that information and advice is proportionate to the needs of those for whom it is provided. This could include enabling access to the support of registered social work advice for those providing information and advice to people contacting the local authority. This can help ensure that the potential for complexity is recognised early on and the person receives help to access non-statutory services and / or initial statutory sector support proportionate to their needs.
In providing an information and advice service, local authorities must be providing more than just leaflets and web based materials. The focus should be on enabling people to access what they need through a tailored range of services that assists people to navigate all points and aspects of their journey through care and support. In doing this, local authorities should think about how they are reaching out and joining up with other providers of information and advice to ensure the coherence of the overall ‘offer’ (see Integration, Cooperation and Partnerships).
10. Adult Safeguarding
The local authority and its partners have a duty to help people with care and support needs, and who may be at risk of abuse or neglect as a result of those needs, keep safe. But this must not mean preventing them making their own choices and having control over their lives. Everyone in the community should understand the importance of safeguarding and help keep people safe (see Adult Safeguarding).
The local authority must provide information and advice about how to raise concerns about the safety or wellbeing of an adult who has care and support needs. It should also support public knowledge and awareness of different types of abuse and neglect, how to keep oneself physically, sexually, financially and emotionally safe, and how to support people to keep safe. The information and advice provided must also cover who to tell when there are concerns about abuse or neglect and what will happen when such concerns are raised, including information on how the local Safeguarding Board works.
Current complaints provision in relation to local authority social services is set out in regulations. The provisions of the regulations mean that anyone who is dissatisfied with a decision made by the local authority would be able to make a complaint about that decision and have that complaint handled by the local authority. The local authority must make its own arrangements for dealing with complaints. As an essential part of how the whole system operates, the local authority’s arrangements must ensure that those who make complaints receive, as far as reasonably practicable, assistance to enable them to understand the complaints procedure or advice on where to obtain such assistance. See Complaints.
12. Developing and Reviewing an Information and Advice Service Plan or Strategy
Manchester City Council’s information for citizens is hosted on Manchester City Council’s website.
Local differences and different starting points will mean that each local authority will need to develop and implement a plan regarding its information and advice services that matches its circumstances and meets the needs of its population. The information and advice service should be aligned with wider local authority strategies such as market shaping and commissioning (see Market Shaping and Commissioning of Adult Care and Support), and with joint area strategies with health (see Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies). The development of such plans should have regard to some common principles, including:
- involving people who use services and carers, interested organisations and service providers in determining what is needed and how it is provided;
- being available at the right time for people who need it, in a range of accessible formats and through a range of channels;
- meeting the needs of all groups;
- being clear, comprehensive and impartial;
- be consistent, accurate and up to date;
- meeting quality standards, such as the Advice Quality Standard;
- being based on a detailed analysis of the needs of the local population served by the local authority;
- being commissioned in tandem with other relevant support and independent advocacy services;
- avoiding unnecessary duplication;
- directing people to sources of further information;
- be used to inform future planning;
- ensuring appropriate quality assurance and review, including citizen feedback to make sure that the service learns from experience and continuously improves.
The plan should build on local and national best practice and make best use of national resources, including guidance on principles for local information and advice strategies, case studies and practice examples.
The local authority must exercise its functions under the Care Act, including the duty to provide an information and advice service, with a view to integrating care and support provision with health and health related issues (including housing). It must also co-operate more generally with each of its relevant partners taking account of their respective functions (see Integration, Cooperation and Partnerships). The Local Government and Public Involvement in Health Act 2007 (as amended by the Health and Social Care Act 2012), provides that local authorities are under a duty to work with their local Clinical Commissioning Groups (CCGs), and other partners through the Health and Wellbeing Board to undertake Joint Strategic Needs Assessments for their areas and to develop Joint Health and Wellbeing Strategies. See Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies.
The development and implementation of a wider plan or strategy on the provision of information and advice on care and support should be led by the local authority, acting as the coordinator and where appropriate the commissioners of information and advice services.
The development of information and advice plans and their implementation should be an ongoing and dynamic process, involving all relevant stakeholders, rather than a one off occurrence. The plan and the resulting service should adapt to changing needs and as a result of feedback and learning on what works best. The plan should be reviewed at agreed intervals. As a minimum, the process of developing a local plan should include:
- engagement with people, carers and family members, to understand what is working and not working for them, their preferences and how their information advice and advocacy needs can best be met;
- adopting a ‘co-production’ approach to their plan, involving user groups and people themselves, other appropriate statutory, commercial and voluntary sector service providers, and make public the plan once finalised;
- mapping to understand the range of information, advice and advocacy services, including independent financial advice and different providers available;
- coordination with other statutory bodies with an interest in care and support, including local CCGs, Health and Wellbeing Boards, local Healthwatch and neighbouring local authorities;
- building into the plan opportunities to record, measure and assess the impact of information and advice services rather than simply service outputs.
In deciding the types of information and advice services to be provided, each local authority will need to analyse and understand the specific needs of its population. Some of the factors and circumstances that local authority should consider in doing this will often be identified in the Joint Strategic Needs Assessment. These factors may include, but are not limited to:
- the ethnic composition of the local area, including languages used;
- the identity and nature of hard to reach groups;
- the split between those whose care and support is (or is likely to be) arranged or funded by the person and the state;
- demographic trends relating to health and care needs, age and disability;
- how people access information and advice at the moment and the quality of information and advice services;
- an appropriate balance between the needs of its local population for information and the needs people will have for access to advice;
- the current sufficiency of supply and the range of information and advice providers from different sectors (including their prospects for growth).
The local authority should review and publish information about the effectiveness of the information and advice service locally, including citizen satisfaction and may decide to build these into the local Joint Health and Wellbeing Strategies.
These actions will support local authorities to meet their duties for understanding and promoting the efficient and effective market of services for meeting care and support needs in its area (see Market Shaping and Commissioning of Adult Care and Support).
As part of their plans, local authorities should consider the persons and / or places most likely to come into contact with people in need of information and advice at these and other critical points in the person’s care and support journey. This may be another statutory party, such as a GP or other NHS professional, other professionals, such as a solicitor or funeral director, care and support and housing providers, or a local group, user-led or charitable organisation, rather than the local authority itself. Local authorities should consider whether independent sources of information and advice may in some circumstances be more trusted – and therefore more effective – than the local authority itself (see Integration, Cooperation and Partnerships).
In addition or instead of direct provision, local authorities should consider whether it is in a person’s best interests that they be signposted, directed or referred to independent sources of information and advice. In particular, people should be signposted to appropriate independent information and advice when they are entering into a legal agreement with a local authority or other third party, such as a deferred payment agreement or committing to a top-up, or they wish to question, challenge or appeal a decision of the local authority or other statutory body.
People often come into contact with care and support services and need to make important decisions at a time of crisis. A local authority plan should therefore allow for the urgent provision of information and advice when necessary. It should work with health organisations and other partners to provide targeted information and advice to people in such critical situations and where people have long term health conditions.
In their information and advice planning, local authorities will need to weigh up the likely demand and effectiveness of these different channels of communication, some of which will incur substantially higher costs than others. A plan that relies disproportionately on provision of information and advice through the authority’s website, or third party websites, is unlikely to meet the authority’s duty under the Act to establish and maintain a service to provide information and advice on care and support.
The local authority will need to consider in their information and advice planning the appropriate interface and balance between local and national sources of information and advice. Where appropriate, it should signpost or refer people to national sources of information and advice where these are recognised as the most useful source. Examples might include:
- NHS Choices website;
- Carers Direct;
- Money Advice Service;
- The Care Quality Commission website;
- Local Government Ombudsman;
- consumer websites providing people with information and advice, including on managing their finances well, for example which.co.uk/elderly-care
- national charities and/or advice services supporting people with disabilities or older people and those with expert knowledge of specific conditions (e.g. deafblind). For example, Age UK, Independent Age, Alzheimers Society and Sense, and their national telephone advice/ help lines
- national charities and advice services for carers, for example Carers UK or Age UK
- resources related to housing, accommodation and housing related support, for example First Stop Care Advice, and Foundations
Some national providers offer free access to tools, resources and information that can be integrated into local authority websites or delivered in paper format. The local authority should explore how best to utilise partnership opportunities with national providers. Referral or signposting to national sources however should only occur where deemed to be in the person’s best interests. It should not take the place of local services necessary for the local authority to discharge its duty under the Act. Local authorities will need to find the appropriate balance between local and national provision to cost-effectively meet their local need.
Information and advice, whether provided directly by a local authority or by third parties as part of the information and advice service that the local authority establishes and maintains, should be of a good standard and, where appropriate, delivered by trained or suitably qualified individuals.