CQC We and I Statements
Theme 1 – Working with People: Supporting people to live healthier lives
We support people to manage their health and wellbeing so they can maximise their independence, choice and control. We support them to live healthier lives and where possible, reduce future needs for care and support.
I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally. I am supported to plan ahead for important changes in my life that I can anticipate.
- Under the Care Act, the local authority is responsible for setting up and maintaining – including review – information and advice services relating to care and support.
- All adults – including carers – in the local authority area, who need information and advice about care and support, must be able to access the service.
- The local authority must ensure that the information provided is of good quality, easily accessible and relevant.
- The local authority should take opportunities to provide or signpost people to advice and information when people in need of care and support are in contact.
MANCHESTER SPECIFIC GUIDANCE
- 1. Introduction
- 2. The Local Authority’s Legal Duty to Establish and Maintain a Service
- 3. Terms Used
- 4. Who are Information and Advice Services for?
- 5. Quality of Information and Advice
- 6. Content
- 7. Opportunities to Provide Information and Advice
- 8. Accessibility of Information and Advice
- 9. Adult Safeguarding
- 10. Complaints
- 11. National Organisations
- 12. Further Reading
Having access to good quality information and advice is very important to enabling people, carers and families to take control of and make well informed choices about their care and support and how they will 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 part of preventing or delaying people’s need for care and support.
The local authority has a legal duty to ‘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).
The local authority must ensure that information and advice services cover more than just basic information about care and support, and cover a 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 any other areas required.
Local authorities should consider who are the people they are communicating with on a case by case basis, and signpost them towards information and / or advice that may be particularly relevant to them.
Local authorities must also provide independent advocacy to assist a person’s involvement in the care and support assessment, planning and review processes where they would otherwise have substantial difficulty in understanding, retaining or using information given to them, or in communicating their views, wishes or feelings and where there is nobody else who can offer this support (see Independent Advocacy chapter).
2. The Local Authority’s Legal Duty to Establish and Maintain a Service
Under the Care Act, 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. This should be in conjunction with partner organisations and be informed by local Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies (see also Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies chapter).
It is also responsible for ensuring appropriate quality assurance and review of the service. This should include feedback from local people who use it, to make sure that the service learns from people’s experiences and continuously improves.
3. Terms Used
The Care and Support Statutory Guidance uses a number of different terms, which are included in this chapter.
‘Information’ means the communication of knowledge and facts about 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.
‘Advocacy’ means 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.
‘Independent’ financial information or advice means services independent of the local authority. It also refers to ‘regulated’ financial advice which means advice from an organisation which is regulated by the Financial Conduct Authority (FCA) which can include 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 to help them plan and pay for their care.
4. Who are Information and Advice Services for?
The local authority is responsible for ensuring that all adults – including carers – who are in its area, and have a need for information and advice about care and support, can access the service.
People who are likely to need information and advice may include:
- 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 Care 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 chapter);
- people who have not contacted the 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 also Preventing, Reducing or Delaying Needs chapter);
- people who become known to the local authority (through referral, including self-referral), at first contact where an assessment of their needs is being considered (see Assessment chapter);
- 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 who have eligible needs for care and support which 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 chapter);
- 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 chapter);
- adults who are subject to adult safeguarding concerns (see Adult Safeguarding chapter);
- people who may benefit from financial information and advice on matters concerning care and support. Local authorities must consider 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 chapter), 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 way to the local authority combining an assessment of a person needing care and support with a carer’s assessment (see Section 6, Carers’ Assessments, Assessments chapter), but may be more appropriately considered 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.
Local authorities should ensure that information supplied is clear, meaning that information can be understood and acted upon by the person/s receiving it.
It 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. See Section 8, Accessibility of Information and Advice.
All reasonable efforts should be taken to ensure that information and advice provided meets the adult’s requirements, is comprehensive and is given at an early stage. The local authority must make sure that all relevant information is available to people so they make the best informed decision in their particular circumstances. Leaving out or withholding information is not acceptable.
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 organisation, rather than by the local authority itself. This is particularly likely to be the case when people need advice about if, how and when to question or challenge the decisions of the local authority.
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. This includes an outline of what the ‘process’ may involve e and the judgements that may need to be made; specific information on what the assessment process, eligibility, and review stages are; how to complain or make a formal appeal to the authority, what this involves; and when independent advocacy should be provided. It also includes wider information and advice to support individual wellbeing; the charging arrangements for care and support costs ; 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. 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 should be included;
- how to access independent financial advice on matters relating to care and support – including 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. Details of the 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.
Depending on local circumstances, the service should also include 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 healthcare arrangements (see Continuing Healthcare – NHS chapter);
- availability and quality of health services;
- availability of services that may help people remain independent for longer such as home improvement agencies, handyperson 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 from children’s services to adult care and support services;
- 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 people 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 also use 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 home 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 Making Your Service Accessible, 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.
Printed products should be produced to appropriate guidelines with important materials available in easy read, large print and languages other than English. Telephone services or face to face services should also be available to people who do not have access to the internet or who need services to be delivered in another way to meet their specific needs. Local authorities should particularly be aware of the needs of individuals with complex but relatively rare conditions, such as deafblindness and those with hidden disabilities (see Working with Adults with Hidden Disabilities chapter).
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 a range of accessible formats or the provision of help with communication support. When a person contacts the information or advice service, they should be asked what the best way for information is to be given to them and how they prefer to communicate.
Advice and information content should be available in a range of formats, including:
- face to face contact;
- use of social and professional 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 needs. These may include:
- 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 those with dementia, may benefit from an independent person to help them to access necessary information and advice. From the point of first contact with, or referral to, the local authority the provision of independent advocacy to support involvement in assessment, planning and reviews should be considered (see Independent Advocacy chapter).
9. 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 their needs, keep safe. But this does not prevent them making their own choices and having control over their lives. Everyone should understand the importance of safeguarding and help keep people safe (see Adult Safeguarding chapter).
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 and how to support people to keep safe.
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 Manchester Safeguarding Partnership works.
Anyone who is dissatisfied with a decision made by the local authority can make a complaint about that decision and have that complaint dealt with by the local authority. 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 chapter.
11. National Organisations
The local authority should consider 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 website;
- NHS Helplines and Forums;
- Care Quality Commission website;
- Local Government and Social Care Ombudsman;
- consumer websites providing people with information and advice, including on managing their finances well, for example Later Life Care (Which?)
- 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, Alzheimer’s 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. Referral or signposting to national sources however should only occur where deemed to be in the person’s best interests.