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Department of Health

Care Act 2014: How should local authorities deliver the care and support reforms? Please give us your views


Question 57: Is the guidance clear enough that the term ‘significant benefit’ is about the timing of the assessment? Is the guidance precise enough to ensure that ‘significant benefit’ is not open to misinterpretation and that people who should be assessed are assessed at the right time for them?

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6 comments

  1. Anonymous says:

    •Paragraph 16.6 could be further clarified if a definition of ‘significant benefit’ was included. Understanding the meaning of significant benefit would be an area that good practice guidance should cover.

    •It is not clear from the regulations who will do transition assessments –children’s or adult’s services? Although this may differ depending on whether a young person has an Education Health and Care Plan. It is important that it is clear to young people and their families who they should contact to request an assessment initially.

    .It is likely that there will be a substantial number of young people with autism who leave school unknown to children’s services but who require support as young adults. These young people may have been in receipt of some support at school via school action or additional SEN support from September 2014. The regulations (16.19) could be expanded on perhaps in good practice guidance about how adult’s services can proactively work with further education colleges to identify and assess these young people.

    •It would be helpful to add a point to the section of the regulations titled ‘Features of a Transition Assessment’ about joining transition assessments up with Annual Reviews for young people who have an Education Health and Care Plan.

    •In 16.8 under the heading ‘When a Transition Assessment Must be Carried Out’ it would be helpful to set out explicitly that the assessment should not take place at inappropriate points in a young persons life, for example during exams.

  2. Anonymous says:

    The term ‘significant benefit’ still needs further expansion to ensure clarity. The combat this maybe a definition of the term maybe prove useful. As what one agency may perceive as significant benefit may not be the same for another therefore having a clearer explanation of this term would hopefully alleviate any issues with the interpretation of this terminology.

  3. Anonymous says:

    Welcome the inclusion of person centred transition planning for a young carer’s transition to adulthood. It is positive to see that transition plans are based on the appearance of likely needs and are focused on building and fulfilling the aspirations of young carers. We believe this focus is essential so that young carers are enabled to fulfil their potential.
    We think the terminology of ‘significant benefit’ could be open to interpretation and think that the guidance should immediately address what it means by the term when it is initially referenced in 16.9
    It is very helpful to see that there is a duty on local authorities to work with external agencies to support transition planning for young carers including housing providers and educational institutions. In order to ensure these duties are implemented effectively, we believe local authorities need clear guidance on what they are expected to do specifically for young adult carers (who are, or are not in receipt of services and regardless of eligibility) in their transition arrangements.

  4. Anonymous says:

    The guidance is clear about the term ‘significant benefit’ and allows Local Authorities the flexibility to decide upon the timing of the assessment.

    However the guidance states that the transition assessment should be undertaken as part of one of the annual statutory reviews of the EHC plan. These reviews are generally facilitated and arranged by schools and are not the forum to complete an assessment, although they are an excellent source of information gathering towards the assessment process.

  5. Anonymous says:

    16.11 states if the term “significant benefit “ is the guidance precise enough as this will be based on the circumstances of the person not on the need of the person but more at the right time.

    Risks of not being more specific in my view are
    • People may fall through the net
    • Who is responsible for ensuring this doesn’t happen
    • Why wouldn’t we plan in the same way we do for young people moving into higher education.

  6. Anonymous says:

    This is a new phrase and concept, the purpose of which is designed to give LAs flexibility. LA instinct is to impose regulations, guidance etc. Theoretically broadens the scope of who we can offer advice to.

    If you have eligible needs before you’re 18 and these continue into adulthood then you cannot be charged under the new regulations. That is a lifetime commitment. Encourages joint commissioning with children and adult services.

    Tend to complete carer assessments at the same time and they too are subject to the ‘significant benefit’ test.

    Evident that there is currently uncertainty about the ‘right’ time to hold an assessment. Generally need to do it earlier than is currently the case.

    The vagueness of the phrase is both a strength and weakness.

    Some concern about the potential for different areas to take different approaches. Despite aspiration to avoid a ‘postcode lottery’ this type of flexibility may lead to precisely that.

    The ideal is a sort of rolling assessment programme and although this legislation doesn’t address that specifically it does help to create the conditions for that to take place.

    Yes, it is open to misinterpretation but that is the corollary of greater flexibility. Perhaps stating something like ‘typically this will take place between 16 and 17’ might help.

    16.11 in the guidance is the key section here. Is it clear enough? Still likely to be a tendency to associate this with needs rather than timing. On balance the feeling was that the guidance may be clear but the phrase itself isn’t and in practice most people don’t read the guidance.

    Clearly strengthens the case for young carers to have a needs assessment. (16.23)

    Limited support for the idea of being prescriptive and saying “at 16”.

    The group felt that ‘significant benefit’ if interpreted in financial terms would mean a greater likelihood of getting an assessment in advance of turning 18 to assure the individual doesn’t incur costs, which might have been applicable if the assessment was done when reaching adulthood. In practice, however, the majority of those who have childhood disabilities tend not to pay for their own care after the age of 18 due to lack of assets anyway. The principle underlying this was nonetheless welcomed.

    As with the other group there wasn’t much dispute about the clarity of the guidance but some question about whether most people would read the guidance with the term in itself being imprecise.

    It was acknowledged that the ambition of allowing flexibility was laudable although some felt that ‘flexibility’ was a cover for reducing costs.

    It may also create confusion with people being unsure why one person gets an assessment at ‘x’ moment and another doesn’t. Saying that this is because ‘significant benefit’ isn’t the same for everyone may provoke scepticism and/or confusion.

    Combining flexibility with some best practice guidelines might be the way forward e.g. “We suggest the optimum time for making an assessment tends to be between 16 and 17…”

    Needs to be consistency throughout the guidance so that all references to significant benefit are preceded with a reminder that it’s about timing not need.

    Need to make sure that it is clear this applies to young carers as well as those being cared for.

    Paragraph 16.11 makes it clear that it is about timing but it could be clearer who takes responsibility

    It is difficult to know when the right time is. It needs to be as early as possible to ensure all the relevant people are involved

    Use of the word “should” in “should be right time” is a concern

    In reality a Personal Care & Support team will react to crises and will therefore put off those assessments that are not an immediate problem. Need some goalposts to avoid this. The word “should” should be replaced by “must”

    What will be the procedures to:
    Ensure young people are identified when they are in Year 9, especially when there is workload pressure.
    Allow parents to contact ASC if they haven’t heard anything.

    Concern that the guidance will allow a Local Authority to make the initial contact at Year 9 then delay doing the assessment until as late as possible

    All the various organisations and individuals need to work together in partnership so the assessment is in place when the young person turns 18 – with the need to gather all the necessary information will take 2 years to complete.

    Need to be aware that the young person may not know what they want and parents won’t want to think about adulthood.

    Need to be aware that a young person can be in transition up to the age of 25 and therefore the transition work can continue after the age of 18.

    Young people with severe needs will be flagged for needing an assessment but there may be difficulties in flagging others that need an assessment. Therefore need to ensure that people have all the necessary information to enable them to flag up their needs and to know where to go. The Education Health Support plan may help in identifying people but won’t capture everybody.

    Also need to be aware that people will change their mind about what they want.

    The key point is that people need to be assessed at the right time.

    There was a concern that there is inconsistencies with use of the words “should” and “must”.

    Paragraph 16.9 states “Local Authority must carry out a transition assessment…” then the following paragraphs state that things “should” be done.

    Paragraph 16.14 states “Local authorities should seek to agree the best time”. It was felt that “should” could be replaced by “must”. Also “Local authorities should seek to agree the best time for assessments and planning …”. It was felt that “must” should replace “should”.

    Use of the word “should” may mean that timing of the assessment will be dependent on staffing and financial pressures rather than the needs of the young person.

    It was questioned whether “should” was used because if “must” was used it would open a local authorities up to legal disputes. To avoid this, would the use of the phase “must try” be better?

    The Case Study was discussed and it was felt that better examples should be used:
    Starting an assessment at the age of 16 is too late. The big questions need to be thought about as soon as possible.

    Need successful case studies that won’t frighten people off and to enable people to know what a good transition can look like. A case in point was a carer’s story where their son had made significant progress thanks to support the son got at transition.

    Parents and, sometimes, practitioners may hold the young person back because they are frightened to raise their expectations.
    The word “carers” was queried in “in order to get used to new carers”. It sounds like she is going to a new family, “staff” may be a better word to use.

    Seems a bit woolly. Timing is of paramount importance. Use “must” rather than “should”.

    Paragraph 16.11: The sentence “When considering if it is of ‘significant benefit’ to assess, the local authority should consider the circumstances of the young person or carer….” lacks the clarity necessary to decide when the assessment should be done. Also a concern that if the assessment is delayed then it could get forgotten about.

    Emphasis seems to be on reaching Year 9 as the trigger but there could be other circumstances that also trigger an assessment

    Paragraph 16.6: The phrase “child’s carer” is a bit confusing, “young person’s carer” would be more meaningful.

    Paragraph 16.14: Moving this paragraph to before paragraph 16.11 or merging the two paragraphs together may add clarity as they appear to be linked.

    Paragraph 16.49: There needs to be further guidance on who will be entitled to having their needs met for free by the local authority for the rest of their life. Could have financial risks for the local authority. What happens if someone receives a substantial inheritance?

    General agreement that there is a lack of clarity over when a local authority has to do an assessment.

    Case Study:
    Starting the assessment at 15 is too late, should be 14. Discussions highlighted an example where an individual has found new accommodation but cannot move until they reach 18 and receive funding from Adult’s services.

    Needs to be tweaked to include the housing element when planning for college. Needs to be on the housing register at 16.

    Overall the case study doesn’t appear to give the full story and seems to be making assumptions.

    The term “new carers” is not correct should be “new support workers”. The definition of carer is someone providing unpaid support, such as a parent.