Generally speaking, health and social care services are most sensibly arranged by the authority in whose area the service user usually lives, especially if the client is to be provided with homecare. But crises can sometimes occur when people are away from their normal place of residence, and authorities do not have limitless funds to spend on people who have ever once had a connection with their area. Thus the general principle in the law is that health services are provided by the authority where the person is usually resident (this will soon be determined by where they have registered with a GP) and social services are provided by the authority where the person is ‘ordinarily’ resident. One person could therefore be factually in area A, being provided with services from a HA in area B and social services from the LA in area C.
The law says that arguments over which authority is responsible for making health and social care arrangements should not deter the actual making of the arrangements – authorities are supposed to thrash out the rights and wrongs of individuals’ cases behind the scenes, and usually, it makes more sense for the authority ‘on the spot’, where the client is actually in need of help, to get on with contracting for care in the meantime.
In an emergency situation, the authority is allowed to make provision regardless of the ordinary place of residence of the person concerned, and without that meaning that the authority is conceding liability for the future.
In intractable disputes between authorities, an officer in the Department of Health is available for arbitration. Use of this procedure is mandatory, although the outcome could still be challenged in court, in our view, if the DoH got the law wrong.