Adult social care information for professionals in Northumberland.
Reports on a survey of the costs of care homes for older people and visit-based home care services carried out during summer 2022 to prepare for the planned (but subsequently deferred) implementation in October 2023 of reforms to adult social care funding. The government's Department of Health and Social Care (DHSC) asked all local authorities responsible for adult social care to survey care homes for older people and home care services in their area about the costs of providing their services. The specific reason for carrying out these surveys in 2022 was the plan to change the statutory framework for adult social care in ways which would entitle anyone needing care home accommodation to ask the local authority to contract for this, regardless of their financial circumstances. After the survey was completed, and the results submitted to DHSC, it was announced that those reforms would be deferred for two years, and we are not certain whether they will now proceed in their original form. Because local authorities usually at present contract only for people who cannot afford to pay care home fees themselves, the reforms would have made local authorities responsible for many people who under the current system would contract with a care home privately. Since many care homes for older people charge higher fees to private residents, this could have caused significant financial issues for both care home operators and local authorities. The government's expectation was that the survey would provide an indication of the extent to which fees paid by local authorities might need to rise as this change took effect, to minimise the impact on care home operators. The government had also carried out financial modelling which suggested that many local authorities were paying fees for both care home accommodation and visit-based home care services which were not as high as was necessary to sustain the long-term viability of the services.
DHSC published an impact assessment about the charging reforms that the Government was expecting to introduce in 2023 (PDF document) which explains their expectations about the impact of the reforms on care homes, and the increases to fee levels likely to be required. Guidance about the "fair cost of care" survey was published in July 2022. A summary of the background is available in a report to the council's cabinet about the survey and the associated Government grant (PDF document) .
The submitted documents are available below.
The council submitted in October 2022 the documents required by DHSC summarising the results of the "fair cost of care" survey and explaining its current plans for assessing the fees required to sustain care homes and home care services. It did not publish these documents at the time, since it understood that DHSC wished to review the submissions before publication, to ensure that the calculations included in them were robust and based on good quality evidence. Following the decision to defer the planned reforms, DHSC told local authorities in late December 2022 that they should now publish their submissions without waiting for DHSC approval. The documents as submitted to DHSC are available through the links below. These include the draft "Market Sustainability Plan", which the local authority is not required to publish, and which is now mainly of historical interest, since it discusses in detail what the implications of the planned reforms were expected to be. However, we have published it along with the survey reports in the interests of transparency, and because some of the issues which it discusses might again become relevant if the Government confirms the provisional intention to implement the same (or similar) reforms in 2025. DHSC have told us that we will be asked to produce a final Market Sustainability Plan on a different basis; we do not yet have details of their expectations for that. They have also indicated that they may still ask some local authorities to review the documents about the survey that they have submitted. We have so far had no indication that they will ask us to review the documents below, but we will publish revised versions on this page if DHSC contact us and we conclude that we should make changes. As explained in the documents and the report to the council's cabinet about this exercise, our conclusion was that, while the surveys provided useful information about the costs of services, there were too many issues about the data for it to act directly as a guide to future fee levels. Our understanding is that a similar conclusion was reached by many other local authorities, though varying assumptions were made about how best to calculate the figures returned to DHSC. Tables showing the figures from the survey as submitted to DHSC are included in this Excel spreadsheet. Explanations of how these figures were calculated are included in two separate documents, one covering the survey of care homes, the other the survey of home care services. The council's intended approach to setting fees in future (as it was in October before the deferment of the reforms) is in the Provisional Market Sustainability Plan. There are some minor redactions from the documents as submitted to DHSC. In the explanation of the care home survey results, we have redacted some information which could have identified information supplied in confidence by individual care home operators. In the Market Sustainability Plan, we have redacted one paragraph discussing legal issues. These documents were prepared to meet a tight timetable for the submission, and include some editing errors and typos, which we have left uncorrected since the sense is still clear. In the case of the explanation of the home care survey, two brief passages of unrelated text became accidentally included in the document as submitted; we have removed those from the published versions above to avoid confusion. If you have queries about any of these documents, please let us know by email to contracts@northumberland.gov.uk.
For Adult Social Care staff: If you are a member of adult social care staff and want to report a concern. Please complete a Request for a decision form, then submit to the safeguardingreferrals@northumberland.gov.uk. To report a crime: In an emergency, contact the police, phone: 999 If the person is not in immediate danger, contact the police, phone: 101
Safeguarding Adults multi-agency policy and procedures
Northumberland multi-agency Safeguarding Adults policy and procedures provide an overarching framework for Safeguarding Adults and sets out what actions staff and agencies should take to protect adults at risk of harm from abuse. Professionals should refer to the multi-agency safeguarding procedures and staff guidance to inform their actions when there is a concern about abuse or neglect. Click here to view the Northumberland Safeguarding Adults policy and procedures. Professionals may also consult the NSAB Safeguarding Adults Risk Threshold Tool to inform their decision making. Click here to view the NSAB Safeguarding Adults Risk Threshold Tool. A range of further practice guidance is also available to assist professionals, please see 'practice guidance' section below.
To find out more information on how to help if you believe someone you know is the victim of domestic abuse, please see the Domestic Abuse website.
A MARAC is a meeting where information is shared on the highest risk domestic abuse cases between representatives of local police, health, child protection, housing practitioners, Independent Domestic Violence Advisors (IDVAs) and other specialists from the statutory and voluntary sectors. A victim should be referred to the relevant MARAC if they are an adult (16+) who resides in the borough and are at high risk of domestic violence from their adult (16+) partner, ex-partner or family member, regardless of gender or sexuality. After sharing all relevant information, they have about a victim, the representatives construct a joint risk management plan that provides professional support to all those at risk and that reduces the risk of harm. The aim of the MARAC is to manage the risk to the adult victim but in doing this it will also consider other family members including any children involved and managing the behaviour of the perpetrator. Information shared at the MARAC is confidential and is only used for the purpose of reducing the risk of harm to those at risk.
At the heart of a MARAC is the working assumption that no single agency or individual can see the complete picture of the life of a victim, but all may have insights, knowledge and expertise that are crucial to their safety.
To make a referral to MARAC, please contact your Agency's designated MARAC lead. If you are not aware of who your MARAC lead is, please contact the Multi-Agency Safeguarding Hub via OneCall. If you require further information or advice contact: Lesley Pyle Northumberland & North Tyneside Domestic Abuse & Sexual Violence Coordinator Email: lesley.pyle@northumberland.gov.uk
The single point of contact for Adult Social Care MARAC referrals is: safeguardingadults@northumberland.gov.uk Tel: 01670 536400
Useful links and information
Alcohol Concern Alcoholics Anonymous Action Fraud Care Act 2014 fact sheets Care Quality Commission Citizens Advice Bureau Domestic Abuse Deprivation of Liberty Safeguards at a glance - SCIE Dignity in Care Disclosure and Barring Service Drinkaware Equality and Human Rights Commission Forced Marriage Unit Frank Friends against scams Gamcare (gambling) Hope for Justice Hourglass Independent Anti-Slavery Commissioner Karma Nirvana Mental Capacity Act 2005 MIND Modern Slavery helpline National Association for People Abused in Childhood National Domestic Abuse helpline National LGBT and Domestic abuse helpline National Referral Mechanism (NRM) National Working Group tackling CSE Northumberland Safeguarding Children Northumberland Safeguarding Children Board Procedures Rape Crisis Safer Northumberland Partnership Samaritans Shelter Social Care Institute for Excellence SORTED Northumberland Stop Loan Sharks Suzy Lamplugh Trust Suicide Prevention Network Respect: Men's Advice line Relate Telephone Preference Service Victim Support Womens Aid
On behalf of the Northumberland Children and Adult Safeguarding Partnership (NCASP), a range of multi-agency safeguarding adult and associated training is available.
If you work for Northumberland County Council and have a Learning Together account, please access safeguarding adults training via your personal log-in.
If you work for the private, voluntary & independent sector you can access safeguarding adult training via our on-line learning platform - Learning Together. If you already have an account, please use your log-in details. If you do not have an account and wish to apply, please contact learning and organisational development who will be able to assist with your registration. E-mail: learningandod@northumberland.gov.uk
Alternatively, you can also apply by contacting the social care training team who co-ordinate and manage the safeguarding adult training programme. Please e-mail: socialcaretraining@northumberland.gov.uk
For further information, advice and/or guidance about Safeguarding Adults and associated training please contact:
Leigh Waller, social care training team manager
Phone: 07580 309219 Email: leigh.waller@northumberland.gov.uk
Mental Capacity Act
The Mental Capacity Act (MCA) 2005 applies to everyone involved in the care, treatment and support of people aged 16 and over living in England and Wales who are unable to make all or some decisions for themselves. The MCA is designed to protect and restore power to those vulnerable people who lack capacity. The MCA provides the legal framework for making decisions on behalf of people who lack the mental capacity to make decisions themselves. For further information please see the Mental Capacity Fact sheet
Deprivation of Liberty Safeguards
The Deprivation of Liberty Safeguards (DoLS)apply to vulnerable people in England and Wales, aged 18 or over, who have mental health needs (this includes dementia), who are in hospitals and care homes, and who do not have the mental ability to make decisions about their care or treatment. If they lack capacity, or are unable to make these decisions, then the law allows decisions to be made in their best interests. To meet the requirements for an assessment under the Deprivation of Liberty Safeguards the following criteria must be met: 1. The person must lack capacity to consent to their care or treatment in the care home, hospital or other supported living arrangement. 2. The person is not free to leave. That means the person is not free to live where they want or with who they want. 3. The person is under continuous supervision and control. For example, do staff always need to be aware of where the person is, who they are with and make checks and take action if there is any doubt about this? If the above criteria are met, the local authority will undertake an assessment. This will be carried out by a best interests assessor and a specialist doctor, and will involve speaking to family or friends, or appointing an independent mental capacity advocate. The assessment will decide how long the authorisation will last (maximum 12 months), and when it will need to re-assessed. The person will be provided with a representative during the period of authorisation and has the right to challenge through the Court of Protection. If the above criteria are met and the person is being deprived of their liberty in any other living accommodation, then the local authority may need to apply to the Court of Protection to seek their authorisation. If so, then we would need to consult with the person, their carers, relatives and representatives. For further advice or information please contact: DoLS team Email: dolsnorthumberland@northumberland.gov.uk Phone: 01670 629 700 For further information relating to Mental Capacity and the Deprivation of Liberty Safeguarding please see this section of the Safeguarding Adults procedures.
Liberty Protection Safeguards
The Liberty Protection Safeguards (LPS) will replace the Deprivation of Liberty Safeguards (DoLS) and will provide protection for people aged 16 and above who are or who need to be deprived of their liberty in order to enable their care or treatment and lack the mental capacity to consent to their arrangements. The timescale for implementation has not been confirmed. Click here to see Liberty Protection Safeguards - at a glance.
Related guidance
Supporting people living with dementia to be involved in adult safeguarding enquiries.
This page contains operational guidance for front line staff.
Key guidance documents
Current versions of key guidance documents for our front-line staff are below. These are documents which may also be useful to professionals in partner agencies and others. Standard Operating Procedures (SOPs) and other procedural documents likely only to be of interest to adult social care staff working within the council are available to staff connected to the council network in SharePoint.
Guidance sheets
Referrals come from health and social care professionals following an assessment by a professional requisitioner e.g. district nurse, community nurse, care manager, occupational therapist, physiotherapist, paediatrician.
We have replaced our operating system with a new Equipment Loans Management System (ELMS2). To access the system, you will need to be registered, please send an email to JELS@Northumberland.gov.uk confirming your name – designation – base – phone number and email address. Once you are registered you can access the ELMS2 system by clicking here If you have any questions or queries, please refer to the attached user guide in the first instance or liaise with your team champion/colleagues for the solution. ELMS user guide If you continue to have a query do not hesitate to contact JELS using the JELS@Northumberland.gov.uk email address and a member of the team will get back to you.
Joint Equipment Loans Service Northumberland County Council 43 Colbourne Crescent Nelson Park Industrial Estate Cramlington NE23 1WB Phone Number: 01670 730595 JELS@Northumberland.gov.uk
Elms2 Online Access Module
Moving to supported living
The sense of security and independence that comes with taking on your own tenancy can help people feel more stable and confident about the future. It can also allow people more freedom of choice about their living environment and make better use of their income. A number of current registered residential services might now consider the potential benefits of independent supported living and will benefit from further information to inform any decision to change their status. The protocol document below supports a person-centred approach and the eight step individual pathway. This also includes good practice guides and resources to assist you through the process. If you are considering this option, please contact us before you progress by emailing us at:
contracts@northumberland.gov.uk
Resources
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