“You can’t have an assessment, unless you try prevention and re-ablement first (for years!)”

As we’ve seen already, assessment is a virtual statutory right for anyone who can put together a half way coherent account of their struggles if they’re related to physical or mental impairment, illness or disability or disorder.

It is absolutely correct that a council can PAUSE an assessment by suggesting other things first.

A council might suggest any one of the following, some provided by the council, and some by other agencies:

  • counselling – to help a person help themselves – schemes exist whereby in some parts of the country, one can get 6 sessions for free, by going up an agreed local pathway (eg GP referral)
  • re-ablement – up to 6 weeks in general, a free service in one’s own homes – this might be regular help to help a person to help themselves back to a level of independence that would be tolerable for them, or a rapid response team for a person in crisis due to difficult circumstances at home
  • referral to another agency because it really isn’t the council’s job – for instance, referring someone to the CCG for a decision on CHC status (free care) on the basis of an appearance of need, yes, but an appearance of so much need, that a checklist was done there and then for onward transmission to the CCG
  • Equipment services. On an assessment, human help that is being provided for free must be ignored when recording the extent and scope of a person’s needs, but not the input of medication that helps, or equipment that helps or could help. So switching on equipment, especially because it must be free if provided by the council, is clearly a great strategy for minimising needs presenting through assessment.

However, it is not, NOT, NOT legal to say that a person CANNOT HAVE an assessment unless or until they have given prevention a go.

The asserted unmet need, in terms of what the social services person who’s there on the day on the phone or in the First Contact setting, is able to see or consider, already triggers the assessment function.

A person may have all sorts of reasons for not taking up assessment; what is offered might be obviously unaffordable in terms of transport to it; or inaccessible in terms of parking, when the person has nobody to take them and can’t afford cabs. It might be clearly and obviously a ridiculous suggestion: a friendship group in a pub, for someone struggling with alcohol, would be an example. Accessing a gym, but a gym that’s in the local mental health facility where one has spent a period of time recently, which did not work out well, would be another. A service where the provider is providing on their own account, even if grant funded by the council, where the charge to the potential customer for preventive inputs, is simply too much for the person, without any ‘voucher’ or subsidy from social services, is another obvious reason for being uninterested in prevention.

The reason that even though this is the law, people can’t risk just saying ‘No, thanks – just get on with your statutory duty, please’ is this. any council that is forced to assess people without their having first tried what is available locally, by way of prevention or reduction of need services, is going to have to decide whether the difficulty that the person has presented – even if they are unable to achieve, in the sense intended by the framework in the regulations – whether that inability is having a consequential significant impact on that person’s well-being.

If the person could have helped themselves, but had only a relatively ‘feeble’ sort of a reason for not doing so – or a positively dodgy one, such as racism, snobbery or prejudice, then a care manager can legitimately decide that the person’s inability to achieve, on assessment, is not such as to make the impact on them, significant. And thus the person could be denied eligibility, and that could be lawful. We do not make the law, we are only describing it, please note.

So a common sense approach and a coherent conversation between aspiring service user and the care manager, is required in all discussions about prevention. Signposting people ‘willy nilly’ to services by way of prevention – services that don’t have any vacancies, or have admission criteria of their own that the person doesn’t meet, or which shut last year when the grant was cut, or which are tricky to get to, even, such that it would use up all one’s mobility component money, or one’s benefits, to fuel the mobility car to get there, etc etc is not an approach that can be rationally adopted as to what’s offered in the first place as suitable means of prevention and reduction of need.

And refusal to engage with that unlawful sort of ‘help’ cannot be regarded as relevant to consequential impact, it is suggested. So if you are offered preventive input that has no hope of working, for reasons that you can get over, make sure you say that that’s your position: it’s not a rational offer in the first place, if it could not possibly do the job.

Marshal your evidence, and you will have done half of our job!

 

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