Introduction

It is the statutory responsibility of the Council to provide and fund a package of care that meets a person’s assessed, eligible social care needs. This policy supports us in offering individuals choices in how their care and support should be delivered. The policy provides a framework of support in helping to make decisions about the provision of care; regardless of the person’s age or care needs.  

Principles and assessment process

The Care Act 2014 introduced the Wellbeing Principle to consider the views, wishes, feelings and beliefs of the person being assessed. Once the assessment of needs has been completed, the National Eligibility Criteria for care and support is applied to determine if the individual has eligible needs and how those needs can be met.

An individual is deemed to have eligible needs under the Care Act 2014 where the needs arise from (or relate to) a physical or mental impairment or illness which results in them being unable to achieve two or more of the following outcomes which is, or is likely to have, a significant impact on their wellbeing: 

• managing and maintaining nutrition
• maintaining personal hygiene  
• managing toilet needs  
• being appropriately clothed  
• being able to make use of the home safely  
• maintaining a habitable home environment  
• developing and maintaining family or other personal relationships  
• accessing and engaging in work, training, education or volunteering  
• making use of necessary facilities or services in the local community, including public transport and recreational facilities or services; and carrying out any caring responsibilities the adult has for a child.  

The decisions about care provision shall be:  

• person centred, promote independence and wellbeing whilst involving the person and their family/representative 
• based on the Care Act Assessment of the person’s social care needs, mental health and wellbeing outcomes and where applicable best interests, reflecting individual choice and preference
• robust, fair, consistent and transparent
• have regard to staff safety, providing the care package for safety and appropriate care, including protection of staff and individuals from abusive behaviour during delivery of care, whilst ensuring that there are no less restrictive options

Meeting needs

The assessment will identify where needs can be met within the least restrictive setting such as in your home, in extra care housing or in a care home.

The cost of a person’s care will be based on their Financial Assessment. The assessment and support plan will assess needs and identify support options. This includes taking account of each option available to meet the assessed needs of the individual and weighing this up against risk, effectiveness and cost and consideration of least restrictive means.

Risk management must be proportionate to meet the individual’s needs for safe care delivery at home.

The available options shall be considered based on the local care market, the individual's preference, the assessed care needs, the availability of providers and the level of risk. 

Preference

Individuals receiving adult social care funding can choose their accommodation if the following conditions are met:

a) Their choice of accommodation will meet their needs:

The chosen accommodation is the same type of specified accommodation and will meet the individual assessed and eligible needs. They may still express a preference for a particular care home to live in, and this will be taken into account, but may not be offered depending on the other criteria described here set out in this policy.

b) Their choice of accommodation will cost no more than the Council would usually pay:

In the first instance the best value placement within the specified accommodation, available at the time, is identified and offered. If a person’s needs could be met in more than one type of specified accommodation then the cost of the best value type of accommodation will be offered. Should a person wish to choose a more expensive provision than the identified best value option, then a top-up payment will need to be arranged. Please refer to the Council Contributions Policy here.

c) Their choice of accommodation is available:

The preferred choice of provision must be available and, where the council is commissioning the support, the provider agrees to deliver the care under OCC’s usual terms and conditions.

The above conditions cannot always be met if an individual identifies a preferred accommodation; the council will always follow the Care Act Statutory Guidance when establishing the most appropriate care and support package. The council will fully consider the individual’s preferences as well as consider the best value when identifying the setting in which the care is to be delivered.

The Care Act Statutory Guidance in paragraph 10.27 states the following:

• In determining how to meet needs, the local authority may also take into reasonable consideration its own finances and budgetary position, and must comply with its related public law duties.
• This includes the importance of ensuring that the funding available to the local authority is sufficient to meet the needs of the entire local population.
• The local authority may reasonably consider how to balance that requirement with the duty to meet the eligible needs of an individual in determining how an individual’s needs should be met (but not whether those needs are met).
• However, the local authority should not set arbitrary upper limits on the costs it is willing to pay to meet needs through certain routes – doing so would not deliver an approach that is person-centred or compatible with public law principles.
• The authority may take decisions on a case-by-case basis which weigh up the total costs of different potential options for meeting needs, and include the cost as a relevant factor in deciding between suitable alternative options for meeting needs. This does not mean choosing the cheapest option; but the one which delivers the outcomes desired for the best value.

The Council will take decisions on a case-by-case basis; considering an individuals personal budget and weighing up the total costs of different options for meeting the individual’s needs. In doing so, the council can include cost as a relevant factor in deciding between suitable alternative options for meeting needs and delivering the desired outcomes for the best value.

If an individual wants to meet their needs in a way that is more expensive than best value, then the individual will be required to fund the additional amount above cost of the provisions offered by the council. In such circumstances, individuals are advised to consult the Council’s Support Planning Policy and Contributions Policy.

As part of this decision-making process, the council will consider the Wellbeing Principle and consider an individual’s views, wishes, feelings and beliefs. This includes preferences such as the time of day care is received and the gender of the person delivering care. The council will not always be able to meet all preferences, but will ensure that a persons’ care needs are met.

Mental capacity

Where an individual has been assessed as lacking the mental capacity to express choice of care and support, the council must follow the Mental Capacity Act Code of Practice around ‘Best Interest’ decision making.

Where the individual requires help to make choices, the Council will work with the person, their family carers and a legally appointed representative.

Where necessary the council will arrange for an advocate or an IMCA to support the person.

Where a person lacks the mental capacity to make decisions around their choice of care and support but has nominated a Lasting Power of Attorney for health and welfare, the council will consult the nominated attorney in line with best practice.

Review

Approved: 07/08/2023

Next review: 07/08/2025