Actions and Next Steps (AAT)

You will often receive telephone contacts requesting to speak to a named worker or a particular service. However, this may or may not be the best person for them to speak to.

When the person/carer making the contact requests specifically to speak to or be contacted by a particular team or practitioner you should establish as quickly as possible whether the contact should be forwarded to that practitioner/team.

You should check available systems to establish whether:

1. The person/carer is allocated to the practitioner they have requested to speak to; or
2. The service/team is responsible for either the assessment or review of the person/carers needs.

You should not transfer a telephone call to a named worker if it is clear that the worker is not allocated to the person/carer. This will not be helpful to the worker or to the person/carer as they will not be speaking to the right person to resolve the contact.

If the practitioner is not available

If the practitioner is not available you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a member of the service/team they are based in.

If you know when the practitioner is likely to become available you should:

1. Inform the person/carer of this;
2. Leave the practitioner a message alerting them to the contact, any action undertaken and confirming the information given to the person about when to expect a call back;
3. Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required should the practitioner be unavailable for more than a few hours;
4. Agree with the person/carer what they should do if the practitioner does not make contact at the expected time; and
5. Make a proportionate record of all the above.

If it is not clear when the practitioner will become available you should:

1. Inform the person/carer of this;
2. Leave the practitioner a message alerting them to the contact, any action undertaken and what information has been given to the person/carer;
3. Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required; and
4. Agree with the person/carer what they should do if the practitioner does not make contact within an agreed timeframe; and
5. Make a proportionate record of all the above.

When a written contact is addressed to a named worker you should establish as quickly as possible whether the contact should be forwarded to that practitioner.

You should check available systems to establish whether the person/carer is allocated to the practitioner that the written contact is addressed to.

You should not transfer a written contact to a named worker if it is clear that the worker is not allocated to the person/carer. This will not be helpful to the worker or to the person/carer as they will not be dealing with the right person to resolve the contact.

Before transferring the contact you should:

1. Confirm that the practitioner the written communication is being transferred to is available within a reasonable timeframe for the action indicated by the contact, or that there is a mechanism in place for the written contact to be received and managed by the service in which they work;
2. Where the communication is a letter or an e-mail, whether the practitioner wishes to receive the original contact (if not this should be filed securely); and
3. Where a written response confirming the contact has been received is required or requested, agree who will provide this.

The most secure way to transfer a written contact is to send a message to the practitioner alerting them to the contact and where it can be found on the recording system.

Any original copies of e-mails must be sent via internal secure e-mail systems only and any original letters must be sent via internal postal services or secure delivery only.

If the information gathered during a telephone contact suggests the person/carer would benefit from further assessment or intervention a referral should be taken so long as:

1. The person/carer the referral relates to is making the referral;
2. The person/carer the referral relates to has given their consent to the referral; or
3. The person/carer that the referral relates to lacks mental capacity to make a referral and a decision has been made under Best Interests that a referral should be made; or
4. The person that the referral relates to is at risk of harm from abuse or neglect.

The following information should be included in a referral:

1. All personal details, including the persons/carers full name (and also preferred name or previous surname), address and preferred contact details, date of birth, national insurance number (where known) and NHS number;
2. The name, relationship and contact details of the person making the referral (if not the person/carer themselves);
3. When and how the person/carer consented to the referral;
4. If the person has not consented to the referral, was a mental capacity assessment carried out and is the referral being made under Best Interests;
5. What the presenting issue is from the person's/carer's perspective and what they would like to happen;
6. What the presenting issue is from the referrer's point of view (if the referrer is not the person/carer) and what action they may recommend;
7. What options have been considered with the person/carer to resolve the issue so far, including what support the person/carer has had from family and community networks;
8. What information and advice has been provided to the person or what information and advice may be required;
9. What prevention services have been used, considered or may be of benefit;
10. Any specific communication needs of the person/carer that need to be considered so they can understand and be involved in any adult Care and Support process;
11. Whether the person/carer is likely to have substantial difficulty in any adult Care and Support process, and if so whether an independent advocate has been considered;
12. Details of any previous or current Care and Support/Support services (whether the Local Authority is providing them or not);
13. With the person's/carer's consent the name and contact details of anyone involved in their life who should be involved in any assessment (family member, friend or professional); and
14. Any other information deemed relevant by the person/carer or referrer (if the referrer is not the person/carer).

Sometimes it is clear which service in the Local Authority should receive the referral that has been made. Where this is clear local processes should be followed to transfer the referral to that service.

Sometimes it is less clear which service should receive a referral. For example, if the person/carer's needs could potentially be met by more than one team.

Decision making in this instance should be as simple and consistent as possible. It should involve the person/carer and the potential services with the aim of reaching a shared agreement. Any delays should not negatively impact the person/carer or put them at risk through the delay of any Care and Support/Support needs being met.

Though not a requirement, it would be prudent to apply the same criteria that the Care Act requires to be applied when deciding the most appropriate worker:

1. The views and wishes of the person/carer about which service/team would best support them must be regarded;
2. The service/team must possess the skills, knowledge and competence to carry out the anticipated Care and Support functions; and
3. The service/team must possess the skills, knowledge and competence required to work with the particular person/carer in question.

tri.x as developed a tool that can be used a required to support consistent decision making about team suitability.

See: Team Suitability Decision Support Tool

The service area or team receiving the referral should make effective use of the information gathered thus far and not make the person/ carer (or anyone else previously consulted) repeat information unnecessarily.

Whenever the outcome of a contact or referral is that the person/carer will be involved in any adult Care and Support process (including any assessment, review, reassessment or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person/carer when:

1. There is no appropriate other person to support and represent them; and
2. They feel that the person/carer would experience substantial difficulty being fully involved in the Care and Support process without support.

Decisions about the need for advocacy should be made as early as possible because advocacy must be provided before the Care and Support function to be carried out can begin. As such if you know that advocacy will be likely you should discuss this with the person and make a referral at the same time as you transfer the request for a review or reassessment.

The Local Authority has a duty to provide good information around finances at an early stage. This provides people with an understanding from the beginning about how they may be expected to contribute financially towards the cost of any Care and Support/Support they receive so that they can start thinking about and planning how they could use their financial resources flexibly to fund a range of potential care options. You should take any opportunity to provide this information, and should particularly make sure that it has been provided whenever a transfer is made to another service that may result in an assessment, review or reassessment.

See: Specific Requirements on the Provision of the Information and Advice around Finances for guidance on the requirements of the Care Act.

See the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment.

Whenever the outcome of a contact or referral is that the person/carer will be involved in any adult Care and Support process (including any assessment, review, reassessment or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person/carer when:

1. There is no appropriate other person to support and represent them; and
2. They feel that the person/carer would experience substantial difficulty being fully involved in the Care and Support process without support.

Decisions about the need for advocacy should be made as early as possible because advocacy must be provided before the Care and Support function to be carried out can begin. As such if you know that advocacy will be likely you should discuss this with the person and make a referral at the same time as you transfer the request for a review or reassessment.

The Local Authority has a duty to provide good information around finances at an early stage. This provides people with an understanding from the beginning about how they may be expected to contribute financially towards the cost of any Care and Support/Support they receive so that they can start thinking about and planning how they could use their financial resources flexibly to fund a range of potential care options. You should take any opportunity to provide this information, and should particularly make sure that it has been provided whenever a transfer is made to another service that may result in an assessment, review or reassessment.

See: Specific Requirements on the Provision of the Information and Advice around Finances for guidance on the requirements of the Care Act.

See the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment.

AGE UK

AGE UK info & advice service - free and confidential advice for older people and their family members and carers and local community connections.

North, West & South Dorset

Online: Age UK North South and West Dorset

Telephone: 01305 269444

East Dorset

Online: Age UK Bournemouth, Poole & East Dorset

Telephone: 01202 530530

Citizens Advice Bureau

Citizens Advice Bureau - An independent service providing free, confidential, and impartial advice to everybody.

Online: Contact Us - Citizens Advice Central Dorset (centraldorsetca.org.uk)

Telephone: 0800 144 88 48

Help and Kindness

Help and Kindness Directory - A project to Dorset that helps people find local support when they need it.

Online: Welcome to #HelpAndKindness for Dorset

Telephone: 01305 595958

Carer Support Dorset

Carer Support Dorset - Organisation to support unpaid carers access support and services to assist them in their caring role.

Online: Carer Support Dorset, Supporting Carers in Dorset

Telephone: 0800 368 8349

Mental Health

People affected by Mental health can get information, and support from advice from Dorset healthcare University NHS foundation trust.

Online: Access Mental Health Dorset (dorsethealthcare.nhs.uk)

Telephone: 0800 652 0190 or NHS 111 

Housing

First Point work alongside people aged 16+ providing hep and support to reduce homelessness.

Online: First Point DIPS - The You Trust - Dorset Integrated Prevention Services

Telephone: 0330 1232550

Sometimes it is helpful to contact a well known national organisation with a dedicated information and advice service or help-line. See: National Organisations with Information and Advice Helplines for details of some national organisations offering this service.

Some national organisations do not have dedicated information and advice services but can still provide such support upon request. See: National Contacts for Adult Care and Support for a wider range of useful national contacts for adult Care and Support.

You can also see the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment, including questions relating to Disabled Facilities Grants.

Information and advice must be provided in an accessible way so that the person/carer for whom it is intended can best understand and make use of it.

If you feel the person/carer for whom the information and advice is intended will need support to understand it then you should:

1. Consider whether the person/carer has anyone appropriate who can help them to understand it;
2. Consider any steps that you can take to support them to understand it (for example talking through the information over the telephone or summarising it in a simpler format); and
3. Consider the benefit of independent advocacy.

Whenever the outcome of a contact or referral is that the person/carer will be involved in any adult Care and Support process (including any assessment, or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person/carer when:

1. There is no appropriate other person to support and represent them; and
2. They feel that the person/carer would experience substantial difficulty being fully involved in the Care and Support process without support.

tri.x has developed a tool that can be used as required to support effective and consistent decision making about when/which advocacy support should be made available.

See: Advocacy Decision Support Tool

The Local Authority also has a power (but not a duty) to make advocacy available in other situations on a case by case basis if it deems this appropriate and is able to do so. This could include advocacy to support a person/carer to understand information and advice, or advocacy to support a person/carer to explore possible options available to them.

Having substantial difficulty is not the same as lacking mental capacity.

See: Determining Substantial Difficulty for information about how to determine substantial difficulty.

See the Mental Capacity Act 2005 Resource and Practice Toolkit, with guidance about assessing capacity and making best interest decisions.

An appropriate person for general representation purposes is not the same as an appropriate person for independent advocacy under the Care Act.

See: An Appropriate Other Person for information about the difference and how to establish whether there is already an appropriate person.

The role of an independent advocate appointed under the Care Act is not the same as the role of a general advocate or any other type of advocate (for example an Independent Mental Capacity Advocate or an Independent Mental Health Advocate).

An independent advocate appointed under the Care Act must both facilitate and ensure the involvement of the person/carer with substantial difficulty in the Care and Support process that is taking place.

For information about the ways in which an independent advocate should fulfil their role, see: The Role of an Independent Advocate.

People who lack capacity will likely be legally entitled to advocacy under both the Care Act and the Mental Capacity Act 2005.

The Care Act statutory guidance recognises that it would not normally be appropriate or practical for a person to have 2 advocates and gives the Local Authority the responsibility to make a decision about the best type of advocacy support.

There are various factors that should influence this decision (such as existing rapport with an advocate or whether any important decisions are likely to be the outcome of the Care and Support process) and the Local Authority must ensure that whatever it decides, it does not deny the person any of the specialist advocacy skills they need or are entitled to.

tri.x has developed a tool that can be used as required to support effective and consistent decision making about when/which advocacy support should be made available.

See: Advocacy Decision Support Tool

People eligible for an Independent Mental Health Advocate (IMHA) under the Mental Health Act 1983 will likely be entitled to advocacy under the Care Act.

The Care Act statutory guidance recognises that it would not normally be appropriate or practical for a person to have 2 advocates and gives the Local Authority the responsibility to make a decision about the best type of advocacy support.

There are various factors that should influence this decision (such as existing rapport with an advocate or the likely outcome of the Care and Support process) and the Local Authority must ensure that whatever it decides, it does not deny the person any of the specialist advocacy skills they need or are entitled to.

tri.x has developed a tool that can be used as required to support effective and consistent decision making about when/which advocacy support should be made available.

See: Advocacy Decision Support Tool

The advocacy referral can be made at any time and should be made without delay as soon as the duty applies.

In Dorset, advocacy is provided by the South West Advocacy Network (SWAN).

For information about SWAN and to make a referrals, see: South West Advocacy Network (swanadvocacy.org.uk)

Regardless of whether or not independent advocacy is available in the local area the duty to provide it still applies. A failure to do so is a breach of this duty and of the law. It is the role of commissioners to ensure that advocacy services are in place and available when required, and it is the role of practitioners to make timely referrals to advocates to prevent unnecessary delays in the meeting of its duty.

If you are aware that advocacy support is required and is not yet available you must not proceed to carry out any Care and Support process until it is in place.

In some circumstances, urgent interim measures may need to be agreed without an advocate in place in order to reduce immediate risk to the person/carer from inaction. However, Care and Support processes that will decide long term and important decisions must not be carried out without advocacy support.

The duty upon the Local Authority is to make independent advocacy support available to any person/carer who requires it. Once made available the duty is met.

If a person/carer decides that they do not wish to engage in the advocacy support that has been made available to them they do not have to do so, but the Local Authority must still provide it.

The Local Authority is expected under the Care Act to support the person/carer to understand the role of an advocate and promote its benefit to them so as to reduce the likelihood that they will not engage.

Where the decision is for the person/carer's case to be allocated to an individual worker to carry out an urgent assessment, review or other intervention this allocation should take place in a timely way so as to:

1. Avoid any unnecessary delays to the person/carer;
2. Reduce the risk of a deterioration in the situation; and
3. Maximise the use of measures that will prevent, delay or reduce needs.

The Care Act recognises that each worker (regardless of whether or not they have a professional qualification) will possess specific skills, knowledge and experience that will enable them to carry out different Care and Support functions or work with particular people well.

Because of this there is no expectation that a particular role should carry out a particular function; instead the Local Authority should allocate tasks to the most appropriate person for the job.

Allocation decisions should take into account:

1. The skills, knowledge and experience of the worker in carrying out the function or process required;
2. The skills, knowledge and experience of the worker in working with the particular needs of the person/carer (for example health needs or communication needs); and
3. The views and wishes of the person/carer themselves in relation to the skills required of the worker and who they feel would best support them.

tri.x has developed a tool that can be used as required to support allocation decisions.

See: Allocation Support Tool