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COVID-19: Implementation of Easements

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COVID-19: Implementation of Easements COVID-19: Implementation of Easements This resource has been prepared for tri.x customers. Its purpose is to support practitioners and managers on the frontline when the local authority has decided to implement some or all of the easements to the Care Act 2014 set out in sections 14 and 15 of the Coronavirus Act 2020. It provides information about carrying out revised adult care and support duties and functions, and which procedures this is likely to have an impact upon. Use the Contents list on the following page to find the information you are looking for. Updated 13.10.20 NOTE: If your local authority is managing to sustain all duties under the Care Act this guidance does not apply. Key decision makers should see Care Act easements: guidance for local authorities for guidance on deciding whether/when to apply the easements. Contents 1. Making Decisions-key section to be read by all 2. General Responsibilities of the Care Act 3. Safeguarding and Risk Assessment 4. Referrals and Assessment 5. Eligibility 6. Meeting Needs 7. Review/Revision of Plans 8. Transition 9. Financial Assessment & Charging 10. NHS Continuing Healthcare 11. Hospital Discharge 12. Continuity of Care Arrangements 13. Protecting Moveable Property and Belongings 14. End of Life 15. No Recourse to Public Funds 16. AHMP Appendix 1: Government Guidance Links 1. Making Decisions Local authorities will still be expected to do as much as they can to comply with their powers to meet needs during any period of easement and the duty of care they have towards an individual’s risk of serious neglect or harm still remains. In all cases When making decisions about whether or not to do something, how to do it or should do it you should apply available ethical frameworks to guide decision-making, supported by the views of lead professionals, collaboration across disciplines and organisations, and the extent of information available in each particular circumstance. See: COVID-19: ethical framework for adult social care Responding to Covid-19 framework principles one pager Covid-19 Pandemic-Ethical Guidance for Social Workers (BASW) Social Work England Professional Standards Social Work England Professional Standards Guidance HCPC Standards of Proficiency for Occupational Therapists Individuals who may lack capacity The Coronavirus Act 2020 has not amended any of the duties in or principles of the Mental Capacity Act 2005. As such, if there are concerns that a person may lack capacity these should still be fully applied as part of any decision making process. See: Coronavirus (COVID-19): looking after people who lack mental capacity Mental Capacity Act (MCA) and the COVID-19 crisis-SCIE Best Interests Decisions: A COVID-19 Quick Guide The Mental Capacity Act 2005 Resource and Practice Toolkit The duty to meet needs and Human Rights Under the Coronavirus Act 2020, the duty to meet needs only applies when doing so necessary to avoid a breach of an adult’s/carer’s Convention rights. See: Human Rights Act 1998 2. General Responsibilities of the Care Act All general responsibilities of the Care Act continue to apply under the easements. Use the links below for further guidance as required. Promoting Individual Wellbeing Preventing Needs for Care and Support Providing Information and Advice Co-operation Promoting Integration of Care and Support with Health Services Promoting Diversity and Quality in Service Provision There is a range of guidance to support effective implementation of the general responsibilities during the current pandemic, particularly around the provision of good information and advice. The following list is an example only: Supporting people who are isolated or vulnerable during the COVID-19 crisis Being a deputy or attorney during the coronavirus outbreak COVID-19 help and advice for informal carers Coronavirus (COVID-19): guidance for people receiving direct payments Personal Assistants returning from shielding-TLAP Factsheet 3. Safeguarding & Risk Assessment Procedures impacted Adult Safeguarding Procedures Risk Assessment Lone Working Safeguarding The Coronavirus Act 2020 has not amended any of the duties and responsibilities of the local authority in regards to safeguarding. As such, if there are concerns that a person may be experiencing, or at risk of abuse or neglect concerns must still be raised and enquiries undertaken. There is recognition that safeguarding during the pandemic is more challenging and Covid-19 specific guidance to support practice has become available; Safeguarding adults during the COVID-19 crisis Guidance for Safeguarding Adults during Covid-19 Risk Assessment The BASW ethical guidance for social workers states that any assessment of risk carried out at the current time (including risk to a person/carer or to yourself or a colleague) should include the risk of Covid-19 infection. 4. Referrals and Assessment Procedures impacted Deciding the Outcome of a Contact or Referral (all versions) Actions and Next Steps (all versions) Preparing to Establish Needs (all versions apart from transition) The Skilled Conversation The Skilled Conversation (Adult Carer’s Assessments/Carers) Agreeing Needs and Making a Formal Record (all versions) The duty to assess needs Where there is an appearance of need, there remains a duty to establish what those needs are and whether or not there is a requirement to meet them. However, under the easements, this assessment does not have to be a full and comprehensive needs assessment, as set out in sections 9 and 10 of the Care Act. Prioritising assessments Needs must be established as soon as possible after a request/referral has been received. Requests for assessments should be prioritised so that those people with the highest level of need receive support first. When deciding whether or not a timeframe is reasonable, and how high a person’s/carer’s needs are, this should be considered in the context of human rights. Under the easements, it of paramount importance that human rights are not jeopardised. See: Human Rights Act 1998 At times, it may be challenging to make decisions about priority and available decision making guidance should be used to support this. See: Making Decisions. Effective records of decision making around prioritisation should be kept. This should: Include the rationale for the decision/evidence used; Demonstrate professional judgement and use of ethical frameworks; and Where necessary, record how human rights have been considered. High risk cases where assessment is delayed should be monitored and re-prioritised should human rights became jeopardised. Independent Advocacy There is nothing in the Coronavirus Act 2020 that alters the duty to provide independent advocacy when any care and support process is being carried out and the person lacks capacity or person/carer has substantial difficulty. Advocates may have to carry out their functions remotely, making effective use of technology. The process of assessment The government expects each local authority to use a simplified assessment process under the easements. This should ensure that the information gathered is comprehensive enough for a determination about the level and impact of needs on human rights to be made. If you are unclear about the assessment process being used by your local authority you should seek the support of your line manager or the Principal Social Worker. The method of assessment Any decision about the method of assessment should take into account the individual needs and abilities of the person/carer and have regard to the Equality Act 2010 (reasonable adjustments). Supported self-assessment If the local authority already uses an appropriate supported self-assessment process (or can adapt it as necessary) it should be promoted, so long as it is accessible to the person/carer (or they have appropriate support). Other methods Due to the current measures with regards to social distancing, it is important to be as flexible as possible when considering options. The government guidance suggests the following possibilities: Use of third party/allied professionals to carry out the assessment; Use of telephone assessments; Use of video technology. When using video or other technology you should refer to available guidance to ensure this is the most appropriate method and is carried out in the most effective way: Digital capabilities for social workers: Ethical considerations Guidance on working virtually Technology checklist for video calling an adult or carer Face to face assessment Face-to-face assessment should still take place when it is necessary, for example to meet communication needs, assess risk or if there are concerns about human rights. During face- to-face visits regard must be given to current guidance on social distancing, shielding and self- isolation. See: Appendix 1: Government Guidance Links Depending on your setting, further guidance about face to face visits can be found in the following documents from BASW. This includes guidance about deciding whether or not a face to face visit is necessary, preparing for a face to face visit, multi-agency visits as well as a host of useful links: Professional practice guidance for home visits during Covid-19 Pandemic Professional practice guidance for hospital social work with adults during Covid-19 Deciding who should carry out the assessment Managers with responsibility for allocation should exercise pragmatism, flexibility and good health and safety practice (Social Workers Union). Under the easements, the local authority will not be penalised
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