Actions Following a Reablement Review

If the current service is being ended because you have concerns about the provider you have a responsibility to:

1. Take any appropriate action under safeguarding; and
2. Raise general concerns.

See Safeguarding Adults.

Also see: Reporting Concerns about a Service Provider.

The reablement service should be ceased/arranged in line with local processes and requirements. These can be found in the Mosaic Guidance and Processes section of the Southwark Policies and Procedures.

In the following circumstances plans should be made to end reablement:

1. It is no longer deemed appropriate through a process of review;
2. All of the outcomes in the Reablement Plan have been achieved; or
3. The person no longer consents to reablement (and has capacity to do so).

Reablement may also no longer be appropriate when:

1. The person has not been able to demonstrate an ability to 'carry over' learning from one day to the next;
2. The person has not been open to being supported in an enabling way; or
3. The person has not demonstrated a desire to become more independent.

Decisions to end reablement (including the timeframe to end reablement) must give regard to:

1. The views of the person about ending reablement;
2. The impact of ending reablement on the person's Wellbeing;
3. The views of any carer about ending reablement; and
4. The views of anyone else consulted or involved in the review process.

The decision about the timeframe to end reablement should take into account:

1. Whether there are any outstanding outcomes to be met by reablement and how long it may take to do so;
2. Whether there were any actions agreed in the review for the reablement service to carry out before ending reablement (for example supporting a person to access a community activity or arrange alternative support);
3. Whether any on-going needs are already being met through an existing Care and Support Plan; and if not
4. How long it may take to carry out the Care and Support processes required to determine the eligibility of needs; or
5. How long it may take to arrange urgent or interim Care and Support; and
6. Whether specific transitional arrangements between reablement and any new service are required.

It may be useful to develop a formal withdrawal plan to monitor outstanding actions and progress towards meeting on-going needs so that reablement ends at an appropriate time.

If, following review it is clear that the person no longer has any appearance of need at all the duty to carry out any further assessment, determine eligibility and meet eligible needs does not apply.

In this situation you must:

1. Explain to the person that they do not have an appearance of need so are not eligible for further assessment or support from the Local Authority at this time;
2. Provide information and advice about what can be done to prevent or reduce the development of needs in the future;
3. Explain what they should do if their needs change;
4. Carry out any outstanding actions agreed at review; and
5. Arrange to end reablement.

All of the above information should be provided in writing when it is originally communicated via telephone.

If the person disagrees

The only ground upon which the Local Authority can lawfully refuse any adult an assessment is where there is no appearance of need. It does not matter whether the appearance of need is likely to prove eligible after any assessment. As such, it is unlikely that many people who request an assessment will be refused.

If the person does not agree with any decision that you have made that they do not have any appearance of need you should discuss this with your line manager to be sure that the decision to refuse an assessment is legally sound.

Note: Under no circumstances must you ignore on-going needs or close the case. The Local Authority has a duty to determine the eligibility of assessed needs and to meet eligible needs and is in a breach of the Care Act if it fails to do so.

If there is a Care and Support Plan 

If the person has a Care and Support Plan that is meeting all needs there is no further action required and you may proceed to end reablement as agreed.

If the person has a Care and Support Plan that does not appear to be meeting the person's needs a review of the plan should be requested. This should be made to the allocated practitioner or team with responsibility for reviewing the plan. You should inform the person and seek their consent to make the review request, although even if the person does not consent you should still make the request. This is because the consent of the person is not required to request the review (only to carry it out).

When requesting the review you should provide the following information:

1. Why the review is being requested and the sense of urgency (specifically when reablement is scheduled to end)
2. Whether the person has consented to the review;
3. The information gathered during reablement to support the request;
4. The on-going role of the reablement service (if reablement is not yet scheduled to end)
5. Whether there is a need to provide urgent or interim support.

If the person (or carer) is not happy about the request to review they should be advised to discuss this with the practitioner who contacts them to make review arrangements.

Sometimes you may be asked to carry out the review on behalf of the allocated worker or team. You should discuss any such requests with your line manager. You should arrange to carry out the review (using the links below) when the request is:

1. Deemed appropriate; and
2. You have the capacity to carry out the review; and
3. You possess the skills and knowledge required to carry out a Care and Support Plan review.

If there is no Care and Support Plan 

If the person does not have a Care and Support Plan you will need to agree with the person what steps need to be taken to:

1. Ensure that any urgent needs for Care and Support are met;
2. Ensure that the likely needs identified at review are confirmed through a proportionate assessment;
3. Ensure that the eligibility criteria is applied to determine which of the on-going needs are eligible; and
4. Where needs are found eligible, explore with the person whether they wish for the Local Authority to meet their eligible needs.

If a practitioner from an appropriate service is already involved with the person you should:

1. Notify them that a reablement is ending and the person has likely on-going needs for Care and Support; and
2. Provide them with access to the information gathered during the review (and previous assessment) so they can prioritise and consider the most appropriate course of action.

Sometimes you may be asked to carry out the required Care and Support processes on behalf of the allocated worker or team. You should discuss any such requests with your line manager. You should arrange to carry out the processes (using the links below) when the request is:

1. Deemed appropriate; and
2. You have the capacity to carry out the required process/s; and
3. You possess the skills and knowledge required to carry out the Care and Support process/s required.

If the person is not known to an appropriate service you will need to decide whether to:

1. Proceed to carry out the required Care and Support processes yourself; or
2. Make a referral to an appropriate service; and
3. Consider any steps that you may need to take to ensure that urgent needs for Care and Support are met in the interim.

If a decision is made that you will be carrying out the further Care and Support processes required you should use the links below to access relevant procedures.

Establishing needs 

• Introduction, Legal Requirements and Tools;
• Preparing to Establish Needs; 
• The Skilled Conversation; 
• Agreeing Needs and Making a Formal Record.

Eligibility Criteria

• Understanding and Applying Eligibility Criteria; 
• Communicating the Outcome and Next Steps. 

Meeting Needs 

• Requesting a Financial Assessment;
• Setting an Indicative Budget;
• Care and Support Planning;
• Signing off a Care and Support Plan and Agreeing a Final Personal Budget; 
• Arranging Support and Services.

Reviewing Support and Services

• Legal Requirements of a Care and Support Plan Review; 
• Preparing to Carry out a Care and Support Plan Review; 
• The Full Review Conversation; 
• The Light Review Conversation; 
• Deciding the Outcome of a Contact or Written Referral; 
• Actions following a Care and Support Plan Review; 
• Monitoring Urgent or Interim Support and Services;
• Review of a Direct Payment. 

You can proceed to end reablement when:

1. There are no outstanding actions for the reablement service following the review;
2. The person has been provided with all information and advice required (or that would be beneficial);
3. Steps have been taken to ensure that any eligible on-going needs for Care and Support will be met from the time that reablement ends (either through urgent/interim services or through Care and Support planning).

If, as part of any conversation you have with a person or their family you become concerned that a vulnerable adult or a child is experiencing, or at risk of abuse or neglect you must respond appropriately.

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.

Where the safeguarding is in respect of the person receiving reablement a decision will need to be made about the need to pause the reablement process to allow a safeguarding enquiry to take place.

There are 2 possible options:

1. The reablement process continues alongside any safeguarding process; or
2. Reablement is paused with no on-going intervention by the person whilst a safeguarding process takes place.

Any decision should involve the reablement service, the person who will be carrying out any safeguarding process, the person with Care and Support needs (or their representative) and any carer.

You must consider any appropriate action required to authorise deprivations of liberty whenever:

1. The person lacks capacity to make decisions about the Care and Support provided to them; and
2. You feel the level of restriction being imposed on the person is depriving them of their liberty; or
3. You feel the level of restriction required to meet their care and support needs following assessment is likely to deprive them of their liberty.

See: Recognising and Responding to Deprivations of Liberty.