Actions and Next Steps (Carers)
This procedure should be used to action the outcome of a contact or written referral regarding a carer with Support needs.
If the contact or written referral relates to a person with Care and Support needs you should use the relevant procedure for your team/service.
If the contact relates to a carer’s transition to adult care and support, refer to the guidance in the Preparing for Adulthood section of the procedures content list.
The Local Authority has a duty under section 4 of the Care Act to provide good information and advice relating to adult Care and Support/carer Support wherever it is requested or would be of benefit.
See: Providing Information and Advice to read more about the duty to provide information and advice under the Care Act, including how information and advice should be provided and the specific information and advice requirements around finances.
Information and advice about adult Care and Support can be accessed in a number of ways:
Online
For information and advice about all aspects of adult social care see: Social care and wellbeing
For information about providers that can offer care and support see: The Care and Support Directory
For information about activities and things to do in the local community see: Discover Hillingdon
In person
Information in person can be accessed from:
Citizens Advice Bureau
Uxbridge Bureau
The Colonnade
Civic Centre
Uxbridge
UB8 1UW
Tel: 0344 848 7903
Drop in: 9.30-4pm Monday-Thursday
Age UK (older people)
Uxbridge Information and Advice Centre
63a High Street
Uxbridge
UB8 1BJ
Tel: 01895 544250
E-mail: enquiries@ageukhhb.org.uk
Drop in: 10am-1pm Tuesday-Friday
Carers
Carers can also access bespoke information and advice from Hillingdon Carers:
126 High Street
Uxbridge
UB8 1JT
Tel: 01895 811206
E-mail: office@hillingdoncarers.org.uk
Drop in advice: 10am-2pm Monday, 10am-4pm Tuesday-Friday
Mental Health emergency help
Emergency help with a mental health issue can be accessed from a Single Point of Access (SPA) service provided by the Central and North West London NHS Foundation Trust:
Tel: 0800 0234 650
E-mail: cnw-tr.spa@nhs.net
This service is available 24 hours a day, 365 days a year.
Equipment and Adaptations
You can find out about local services able to provide a range of equipment and adaptations from the following online resources:
- The Care and Support Directory;
- Living Made Easy (incorporating Ask Sara);
- TelecareLine;
- Improvements to your home.
Financial assessment
The Financial Assessment Team can help with any queries relating to financial assessment:
Tel: 01895 250597
In addition information and advice can be found at Social care and wellbeing online.
See: Your financial assessment
You can also refer to a frequently asked questions tool in the tri.x Resources area. Note: This FAQ tool is based on statutory duties and powers and does not reflect Hillingdon's policy to provide all carers services on a non-chargeable basis.
Sometimes it is helpful to contact a well known national organisation with a dedicated information and advice service or help-line. See: National Organisations with Information and Advice Helplines for details of some national organisations offering this service.
Some national organisations do not have dedicated information and advice services but can still provide such support upon request. See: National Contacts for Adult Care and Support for a wider range of useful national contacts for adult Care and Support.
Information and advice must be provided in an accessible way so that the carer for whom it is intended can best understand and make use of it.
If you feel the carer for whom the information and advice is intended will need support to understand it then you should:
- Consider whether the carer has anyone appropriate who can help them to understand it;
- Consider any steps that you can take to support them to understand it (for example talking through the information over the telephone or summarising it in a simpler format); and
- Consider the benefit of independent advocacy.
Under the Care Act the Local Authority has a duty to not only provide information and advice where it is needed, but to ensure that the information and advice it provides has been effective.
Therefore, when information and advice has been provided you should agree appropriate arrangements to follow up with the carer to whom it was given in order to review how effective it has been.
The timescales for this follow up should reflect the individual circumstances and level of risk.
Where you are making arrangements for someone else to follow up on the information and advice you have given (rather than following up on it yourself) you must make sure that you have recorded this in a way that will ensure the person follows up on it at the agreed time.
The Local Authority has a common law and legal duty to safeguard the confidentiality of all personal information.
As an employee of the Local Authority you are bound contractually to respect the confidentiality of any information that you may come into contact with. Under no circumstances should such information be divulged or passed to any persons or organisation in any form unless you have authorisation to do so.
All information sharing that takes place must be in line with data protection legislation (namely the UK General Data Protection Regulation and the Data Protection Act 2018) and local policy.
The Caldicott Principles must also be regarded. The Caldicott Principles are a set of principles that apply to the use of confidential information within health and social care organisations and when such information is shared with other organisations and between individuals, both for individual care and for other purposes. For further information, see: The Caldicott Principles.
Any unauthorised disclosure of confidential information may result in disciplinary action or individual prosecution under the Data Protection Act 2018.
For further information and guidance see: Providing Information about a Person or Carer.
Anyone handling information about a data subject or responding to requests for information about a data subject should also have full regard to local Data Protection and Information Sharing Policies.
It is important that the carer making contact speaks to the right practitioner at the right time. Sometimes you may find that you are not the most appropriate practitioner to manage the contact.
When the carer making the contact requests specifically to speak to or be contacted by a particular person you should establish as quickly as possible whether the contact should be forwarded to that practitioner.
You should check available systems to establish whether the carer is allocated to the practitioner they have requested to speak to.
You should not transfer a telephone call to a named worker if it is clear that the worker is not allocated to the carer. This will not be helpful to the worker or to the carer as they will not be speaking to the right person to resolve the contact.
If the practitioner is not available
If the practitioner is not available you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a colleague or manager who may know.
If you know when the practitioner is likely to become available you should:
- Inform the carer of this;
- Leave the practitioner a message alerting them to the contact, any action undertaken and confirming the information given to the carer about when to expect a call back;
- Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required should the practitioner be unavailable for more than a few hours;
- Agree with the carer what they should do if the practitioner does not make contact at the expected time; and
- Make a proportionate record of all the above.
If it is not clear when the practitioner will become available you should:
- Inform the carer of this;
- Leave the practitioner a message alerting them to the contact, any action undertaken and what information has been given to the carer;
- Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required; and
- Agree with the carer what they should do if the practitioner does not make contact within an agreed timeframe; and
- Make a proportionate record of all the above.
When a written contact is addressed to a named worker you should establish as quickly as possible whether the contact should be forwarded to that practitioner.
You should check available systems to establish whether the carer is allocated to the practitioner that the written contact is addressed to.
You should not transfer a written contact to a named worker if it is clear that the worker is not allocated to the carer. This will not be helpful to the worker or to the carer as they will not be dealing with the right person to resolve the contact.
Before transferring the contact you should:
- Confirm that the practitioner the written communication is being transferred to is available within a reasonable timeframe for the action indicated by the contact, or that you have agreed with a manager how the contact will be managed;
- Where the communication is a letter or an e-mail, whether the practitioner wishes to receive the original contact (if not this should be filed securely); and
- Where a written response confirming the contact has been received is required or requested, agree who will provide this.
The most secure way to transfer a written contact is to send a message to the practitioner alerting them to the contact and where it can be found on the recording system.
Any original copies of e-mails must be sent via internal secure e-mail systems only and any original letters must be sent via internal postal services or secure delivery only.
If the practitioner is not available
If the practitioner is not available you should try and establish when they may become available by looking at any electronic calendars they use or speaking with a colleague or manager who may know.
If the practitioner is not available within a reasonable timeframe for the action indicated by the contact you should:
- Leave the practitioner a message alerting them to the contact, where it can be found on the recording system and any action undertaken, including what has been agreed with the carer if contact has been made with them;
- Undertake any actions that you are able to in order to resolve some or part of the contact, including any urgent actions that may be required and writing any acknowledgement letter to confirm arrival of the contact;
- When the practitioner is not available within any timeframes indicted in the written contact or for more than a few days inform the carer making the contact of this;
- Agree with the carer what they should do if the practitioner does not make contact within an agreed timeframe; and
- Make a proportionate record of all the above.
There are many kinds of prevention service available. Some are provided by the Local Authority and some are provided by the community or partner organisations, such as health. All available prevention services in the local area should be explored before undertaking a longer term intervention.
Under Section 2 of the Care Act the Local Authority has a duty to prevent needs for Support.
See Preventing Needs for Care and Support to read more about the duty to prevent needs for Support, including the types of prevention services recognised by the Care Act, when to provide prevention services and how to charge for prevention services.
If the information gathered during a telephone contact suggests the carer would benefit from further assessment or intervention a referral should be taken so long as:
- The carer the referral relates to is making the referral;
- The carer the referral relates to has given their consent to the referral; or
- The carer that the referral relates to is at risk of harm from abuse or neglect.
The following information should be included in a referral:
- All personal details, including the carer's full name (and also preferred name or previous surname), address and preferred contact details, date of birth, national insurance number and NHS number;
- The name, relationship and contact details of the person making the referral (if not the carer themselves);
- When and how the carer consented to the referral;
- What the presenting issue is from the carer's perspective and what they would like to happen;
- What the presenting issue is from the referrer's point of view (if the referrer is not the carer) and what action they may recommend;
- What options have been considered with the carer to resolve the issue so far, including what support the person has had from family and community networks;
- What information and advice has been provided to the carer or what information and advice may be required;
- What prevention services have been used, considered or may be of benefit;
- Any specific communication needs of the carer that need to be considered so they can understand and be involved in any adult Care and Support process;
- Whether the carer is likely to have substantial difficulty in any adult Care and Support process, and if so whether an independent advocate has been considered;
- Details of any previous or current Support services (whether the Local Authority is providing them or not);
- With the carer's consent the name and contact details of anyone involved in their life who should be involved in any assessment (family member, friend or professional); and
- Any other information deemed relevant by the carer or referrer (if the referrer is not the carer).
If, as part of any conversation or information gathering you become concerned that a vulnerable adult or child is experiencing, or at risk of abuse or neglect you must respond appropriately by raising a concern.
See Safeguarding Adults, which also includes information about how to raise a children's safeguarding concern.
If you are concerned that an adult or child is in imminent danger from abuse or neglect, or that a criminal act has taken place you should contact the police by dialing 999.
Whenever the outcome of a contact or referral is that the carer will be involved in any Care and Support process (including any assessment, review or Support Planning) the Local Authority has a duty under the Care Act to make an independent advocate available to the carer when:
- There is no appropriate other person to support and represent them; and
- They feel that the carer would experience substantial difficulty being fully involved in the Care and Support process without support.
See: Determining Substantial Difficulty for information about how to determine substantial difficulty.
tri.x has developed a tool that can be used as required to support effective and consistent decision making about when/which advocacy support should be made available.
See: Advocacy Decision Support Tool.
The Local Authority also has a power (but not a duty) to make advocacy available in other situations on a case by case basis if it deems this appropriate and is able to do so. This could include advocacy to support a carer to understand information and advice, or advocacy to support a carer to explore possible options available to them.
An appropriate person for general representation purposes is not the same as an appropriate person for independent advocacy under the Care Act.
See: An Appropriate Other Person for information about the difference and how to establish whether there is already an appropriate person.
The role of an independent advocate appointed under the Care Act is not the same as the role of a general advocate or any other type of advocate.
An independent advocate appointed under the Care Act must both facilitate and ensure the involvement of the carer with substantial difficulty in the Care and Support process that is taking place.
For information about the ways in which an independent advocate should fulfil their role, see: The Role of an Independent Advocate.
The advocacy referral can be made at any time and should be made without delay as soon as the duty applies. The Care and Support process requiring advocacy support should not begin until it is in place.
Advocacy referral forms can be found in the Local Resources area.
Regardless of whether or not independent advocacy is available in the local area the duty to provide it still applies. A failure to do so is a breach of this duty and of the law. It is the role of commissioners to ensure that advocacy services are in place and available when required, and it is the role of practitioners to make timely referrals to advocates to prevent unnecessary delays in the meeting of its duty.
If you are aware that advocacy support is required and is not yet available you must not proceed to carry out any Care and Support process until it is in place.
In some circumstances urgent interim measures may need to be agreed without an advocate in place in order to reduce immediate risk to the carer from inaction. However, Care and Support processes that will decide long term and important decisions must not be carried out without advocacy support.
For guidance on arranging urgent or interim support, see: Urgent or Interim Support.
The duty upon the Local Authority is to make independent advocacy support available to any carer who requires it. Once made available the duty is met.
If a carer decides that they do not wish to engage in the advocacy support that has been made available to them they do not have to do so, but the Local Authority must still provide it.
The Local Authority is expected under the Care Act to support the carer to understand the role of an advocate and promote its benefit to them so as to reduce the likelihood that they will not engage.
Hillingdon Council commission Hillingdon Carers to carry out non-complex carers assessments.
A referral should be made if:
- The circumstances are not complex;
- A joint assessment is not required; and
- The carer is in agreement.
Referrals should be made in line with local processes and requirements.
A decision to transfer the case internally should be made only when:
- A referral to Hillingdon Carers is not taking place; and
- The receiving team is not appropriate to carry out the intervention.
For example: - If the carer is deaf-blind or has specific communication needs and a practitioner working in a different area would possess more expertise; or
- If the person the carer provides support to is going to have a needs assessment by another service at the same time that a carer is going to have a carer's assessment and it is deemed appropriate for the practitioner assessing the person's needs to also assess the carer's needs.
Though not a requirement, it would be prudent to apply the same criteria that the Care Act requires to be applied when deciding the most appropriate worker:
- The views and wishes of the carer about which service/team would best support them must be regarded;
- The service/team must possess the skills, knowledge and competence to carry out the anticipated Care and Support functions; and
- The service/team must possess the skills, knowledge and competence required to work with the particular carer in question.
tri.x as developed a tool that can be used a required to support consistent decision making about team suitability.
See: Team Suitability Decision Support Tool.
Any process for transferring a carer's case between service areas or teams should be as simple and seamless as possible. It should involve the carer and the potential services with the aim of reaching a shared agreement. Any transfer should not negatively impact the carer or put them at risk through the delay of any Support needs being met.
The service area or team receiving the case should make effective use of the information gathered thus far and not make
Under the Care Act, when a carer is already receiving Support from the Local Authority they may request a change to their Support Plan at any time and the Local Authority must consider the request. Where the request is deemed reasonable the Local Authority has a duty to review the plan.
The review is the mechanism by which the need for a revision is determined. As such, under the Care Act a Support Plan can only be revised following a review.
Where a change is requested to a plan and there is no planned review scheduled consideration should be given to arranging an unplanned review. Any review must be proportionate to the needs of the carer and undertaken in a timely way so as to reduce the risk of a crisis developing and needs not being met.
If the carer has an allocated worker this person should carry out the review, unless the review is urgent and the worker in unavailable.
Before transferring the review request you should confirm that the practitioner the review request is being transferred to is available.
If the practitioner is not available you should speak with a manager to establish whether:
- The request should still be transferred to the allocated worker to action when they become available;
- Alternative arrangements should be made to carry out the review.
Where the information gathered at contact suggests there has been no change in the carer's needs, and that a change to the personal budget amount is not required may be possible to complete a 'light touch' review without further allocation.
John cares for his mother. He receives a personal budget which he uses to pay for a short weekend break 4 times each year. John would like to change his plan so that he can instead go on a 1 week break twice a year. John does not think his personal budget will need to change.
When the information gathered at contact suggests there has been a change in need or circumstance, and that a change in the personal budget amount is required any review carried out is likely to lead to a proportionate reassessment of need. Because this is a longer term intervention allocation for this should be considered.
John cares for his mother. He uses his personal budget to pay for 4 short breaks away each year. John does not think that 4 breaks a year is enough anymore as his mother's condition has changed and he is finding his caring role increasingly stressful. John would like to explore his mother going into respite provision for 4 weeks each year in addition to the breaks he current has.
Where the outcome decision is for the carer's case to be allocated to an individual worker to carry out an assessment, review or further intervention this allocation should take place in a timely way so as to:
- Avoid any unnecessary delays to the carer;
- Reduce the risk of a deterioration in the situation; and
- Maximise the use of measures that will prevent, delay or reduce needs.
Where there are a significant number of carers awaiting allocation for further work or assessment there should be a fair and consistent prioritisation process in place that takes into account:
- The level of risk;
- The level of need;
- Current support in place and the sustainability/effectiveness of this;
- The urgency;
- The likelihood of deterioration in the carers ability to carry out their role; and
- The potential for fluctuation.
An element of monitoring should be incorporated into any allocation process to ensure that you remain aware of every carer's situation and are able to respond appropriately to any changes or need to re-prioritise allocation.
The Care Act recognises that each worker (regardless of whether or not they have a professional qualification) will possess specific skills, knowledge and experience that will enable them to carry out different Care and Support functions or work with particular people well.
Because of this there is no expectation that a particular role should carry out a particular function; instead the Local Authority should allocate tasks to the most appropriate person for the job.
Allocation decisions should take into account:
- The skills, knowledge and experience of the worker in carrying out the function or process required;
- The skills, knowledge and experience of the worker in working with the particular needs of the carer (for example communication needs); and
- The views and wishes of the carer themselves in relation to the skills required of the worker and who they feel would best support them.
tri.x has developed a tool that can be used as required to support allocation decisions.
See: Allocation Support Tool.
You should complete the form 'Concerns about a Provider' whenever a concern has been raised about a care home or a domiciliary care service.
This can be found in the Local Resources area.
Last Updated: June 17, 2024
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