Actions and Next Steps (ACCESS)

It is important that the person/carer making contact speaks to the right practitioner at the right time.

You will often receive telephone contacts requesting to speak to a named worker or a particular service. However, this may or may not be the best person for them to speak to.

When the person/carer making the contact requests specifically to speak to or be contacted by a particular team or practitioner you should establish as quickly as possible whether the contact should be forwarded to that practitioner/team.

You should check available systems to establish whether:

  1. The person/carer is allocated to the practitioner they have requested to speak to; or
  2. The service/team is responsible for either the assessment or review of the person/carers needs.

You should not transfer a telephone call to a named worker if it is clear that the worker is not allocated to the person/carer. This will not be helpful to the worker or to the person/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 member of the service/team they are based in.

If you know when the practitioner is likely to become available you should:

  1. Inform the person/carer of this;
  2. Leave the practitioner a message alerting them to the contact, any action undertaken and confirming the information given to the person about when to expect a call back;
  3. 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;
  4. Agree with the person/carer what they should do if the practitioner does not make contact at the expected time; and
  5. Make a proportionate record of all the above.

If it is not clear when the practitioner will become available you should:

  1. Inform the person/carer of this;
  2. Leave the practitioner a message alerting them to the contact, any action undertaken and what information has been given to the person/carer;
  3. 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
  4. Agree with the person/carer what they should do if the practitioner does not make contact within an agreed timeframe; and
  5. 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 person/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 person/carer. This will not be helpful to the worker or to the person/carer as they will not be dealing with the right person to resolve the contact.

Before transferring the contact you should:

  1. 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 there is a mechanism in place for the written contact to be received and managed by the service in which they work;
  2. 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
  3. 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 member of the service/team they are based in.

If the practitioner is not available within a reasonable timeframe for the action indicated by the contact you should:

  1. 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 person/carer if contact has been made with them;
  2. 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;
  3. When the practitioner is not available within any timeframes indicted in the written contact or for more than a few days inform the person/carer making the contact of this;
  4. Agree with the person/carer what they should do if the practitioner does not make contact within an agreed timeframe; and
  5. Make a proportionate record of all the above.

If it is not going to cause unnecessary delays, the team should endeavour to establish ordinary residence before taking any new referrals following a contact or enquiry.

See: Ordinary Residence Procedure for guidance. 

Sometimes it is clear from the point of enquiry that a person/carer is not ordinarily resident in the area. They may tell you so or trusted information to this effect may be gathered through consultation with others. In this instance they are still legally entitled to an assessment by the Local Authority, but if the Local Authority finds after assessment that they have eligible needs it does not have a duty to meet those needs in the same way as it does for people who do live in the area. Instead, there is only a power to meet urgent needs (to meet urgent needs if they decide to do so). After meeting urgent needs the Local Authority must then contact the other authority to discuss how they intend to meet the person's/carers on-going needs and seek reimbursement for any costs incurred in meeting the urgent needs.

If a person/carer who is not ordinarily resident does not appear to have urgent needs an assessment by the Local Authority may not be in their interests or give them an assessment. Information and advice should be provided to support the person/carer to understand ordinary residency and the benefits of having their non-urgent needs assessed by the Local Authority in which they are ordinarily resident:

  1. That the Local Authority in which they are ordinarily resident will have a duty to meet their eligible needs (as opposed to a power in this authority);
  2. That the Local Authority in which they are ordinarily resident will have a duty to carry out Care and Support/Support planning with the person/carer to determine the best way to meet eligible needs (as opposed to no duty to do so in this authority); and
  3. That the Local Authority in which they are ordinarily resident will have a duty to review and monitor the effectiveness of the support provided to meet eligible needs (as opposed to no duty to do so in this authority).

Ultimately though, the person/carer is legally entitled to have their needs assessed by this Local Authority if they want to. Information gathered during the assessment should be shared with the Local Authority in which they are ordinarily resident so that they can decide with the person/carer how best to meet their non-urgent needs.

Time should not be spent debating whether or not a person/carer is ordinarily resident in the area if this is not clear. The person/carer is entitled to an assessment of need based on an appearance of need, and not whether they are ordinarily resident. To delay the assessment whilst establishing ordinary residence would be unlawful.

The Local Authority should complete the assessment and establish ordinary residence after applying the eligibility criteria.

If the information gathered during a telephone contact suggests the person/carer would benefit from further assessment or intervention a referral should be taken so long as:

  1. The person/carer the referral relates to is making the referral;
  2. The person/carer the referral relates to has given their consent to the referral; or
  3. The person/carer that the referral relates to lacks mental capacity to make a referral and a decision has been made under Best Interests that a referral should be made; or
  4. The person that the referral relates to is at risk of harm from abuse or neglect.

The following information should be included in a referral:

  1. All personal details, including the persons/carers full name (and also preferred name or previous surname), address and preferred contact details, date of birth, national insurance number and NHS number;
  2. The name, relationship and contact details of the person making the referral (if not the person/carer themselves);
  3. When and how the person/carer consented to the referral;
  4. If the person has not consented to the referral, was a mental capacity assessment carried out and is the referral being made under Best Interests;
  5. What the presenting issue is from the person's/carer's perspective and what they would like to happen;
  6. What the presenting issue is from the referrer's point of view (if the referrer is not the person/carer) and what action they may recommend;
  7. What options have been considered with the person/carer to resolve the issue so far, including what support the person/carer has had from family and community networks;
  8. What information and advice has been provided to the person or what information and advice may be required;
  9. What prevention services have been used, considered or may be of benefit;
  10. Any specific communication needs of the person/carer that need to be considered so they can understand and be involved in any adult Care and Support process;
  11. Whether the person/carer is likely to have substantial difficulty in any adult Care and Support process, and if so whether an independent advocate has been considered;
  12. Details of any previous or current Care and Support/Support services (whether the Local Authority is providing them or not);
  13. With the person's/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
  14. Any other information deemed relevant by the person/carer or referrer (if the referrer is not the person/carer).

Sometimes it is clear which service in the Local Authority should receive the referral that has been made. Where this is clear local processes should be followed to transfer the referral to that service.

Sometimes it is less clear which service should receive a referral. For example, if the person/carer's needs could potentially be met by more than one team.

Decision making in this instance should be as simple and consistent as possible. It should involve the person/carer and the potential services with the aim of reaching a shared agreement. Any delays should not negatively impact the person/carer or put them at risk through the delay of any Care and Support/Support needs being met.

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:

  1. The views and wishes of the person/carer about which service/team would best support them must be regarded;
  2. The service/team must possess the skills, knowledge and competence to carry out the anticipated Care and Support functions; and
  3. The service/team must possess the skills, knowledge and competence required to work with the particular person/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.

The service area or team receiving the referral should make effective use of the information gathered thus far and not make the person/ carer (or anyone else previously consulted) repeat information unnecessarily.

Whenever the outcome of a contact or referral is that the person/carer will be involved in any adult Care and Support process (including any assessment, review, reassessment or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person/carer when:

  1. There is no appropriate other person to support and represent them; and
  2. They feel that the person/carer would experience substantial difficulty being fully involved in the Care and Support process without support.

Decisions about the need for advocacy should be made as early as possible because advocacy must be provided before the Care and Support function to be carried out can begin. As such if you know that advocacy will be likely you should discuss this with the person and make a referral at the same time as you transfer the request for a review or reassessment.

See Using Independent Advocacy, which includes guidance on how to establish whether a person needs an advocate, the different advocates that are available and how to make a referral.

The Local Authority has a duty to provide good information around finances at an early stage. This provides people with an understanding from the beginning about how they may be expected to contribute financially towards the cost of any Care and Support/Support they receive so that they can start thinking about and planning how they could use their financial resources flexibly to fund a range of potential care options. You should take any opportunity to provide this information, and should particularly make sure that it has been provided whenever a transfer is made to another service that may result in an assessment, review or reassessment.

See: Specific Requirements on the Provision of the Information and Advice around Finances for guidance on the requirements of the Care Act.

See the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment.

A review is the mechanism by which an existing Care and Support Plan (or Support Plan) is evaluated. This can lead to a revision of the plan or further intervention, such as a reassessment of need.

All review requests should be sent to the allocated worker, or the team responsible for reviewing the Care and Support/Support Plan.

Whenever the outcome of a contact or referral is that the person/carer will be involved in any adult Care and Support process (including any assessment, review, reassessment or safeguarding) the Local Authority has a duty under the Care Act to make an independent advocate available to the person/carer when:

  1. There is no appropriate other person to support and represent them; and
  2. They feel that the person/carer would experience substantial difficulty being fully involved in the Care and Support process without support.

Decisions about the need for advocacy should be made as early as possible because advocacy must be provided before the Care and Support function to be carried out can begin. As such if you know that advocacy will be likely you should discuss this with the person and make a referral at the same time as you transfer the request for a review or reassessment.

See Using Independent Advocacy, which includes guidance on how to establish whether a person needs an advocate, the different advocates that are available and how to make a referral.

The Local Authority has a duty to provide good information around finances at an early stage. This provides people with an understanding from the beginning about how they may be expected to contribute financially towards the cost of any Care and Support/Support they receive so that they can start thinking about and planning how they could use their financial resources flexibly to fund a range of potential care options. You should take any opportunity to provide this information, and should particularly make sure that it has been provided whenever a transfer is made to another service that may result in an assessment, review or reassessment.

See: Specific Requirements on the Provision of the Information and Advice around Finances for guidance on the requirements of the Care Act.

See the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment.

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.

The Local Authority (and anyone representing the Local Authority) has a duty under Section 4 of the Care Act to either provide directly, or provide access to a range of information and advice relating to adult Care and Support, including financial advice. This duty applies equally in respect of all local residents regardless of whether the person with Care and Support needs or carer is known to, lives in, or is already receiving services from the Local Authority.

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.

In addition to our own services, information and advice is available from community and partner organisations. Information about these can be found in the Adult Services section of the Council website which also contains the Adult Social Care Directory.

See: Adult Social Care Hub

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.

You can also see the Financial Assessment and Charging FAQ Response Support Tool for the answers to some frequently asked questions around financial assessment, including questions relating to Disabled Facilities Grants (DFG).

NOTE: This FAQ is based on statutory duties and powers and does not represent Milton Keynes local policy.

When providing information and advice on local charging policy, always refer to the relevant policy. This will be found in the Local Resources section.

There is also information about charging on our Council website.

See: Paying for your Care and Support

Information and advice must be provided in an accessible way so that the person/carer for whom it is intended can best understand and make use of it.

If you feel the person/carer for whom the information and advice is intended will need support to understand it then you should:

  1. Consider whether the person/carer has anyone appropriate who can help them to understand it;
  2. 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
  3. 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 person/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.

Maintaining confidentiality

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 regulations and local policy.

Any unauthorised disclosure of confidential information may result in disciplinary action of individual prosecution under the Data Protection Act 2018.

Protecting information

You should take necessary steps to protect the information that you hold and have access to. For example:

  1. You should ensure that nobody else has access to your electronic information systems (e-mail and IT system);
  2. You should send electronic communication by secure channels (having verified the detail of the recipient);
  3. You should keep records made by hand in a secure place (e.g. notebooks);
  4. You should only discuss information with appropriate people in safe environments.

The rights of the data subject

Under Data Protection legislation (namely the Data Protection Act 2018 and the UK General Data Protection Regulations (UK GDPR) any individual (known legally as the data subject) that the Local Authority holds information about is legally entitled to access the information held about them (known legally as the right of access) unless an exemption to do so applies (see below).

This includes both paper/hard copy information and information held electronically.

If the person lacks capacity

If the data subject lacks capacity to make a request for information under Data Protection legislation and they have a legally authorised representative who deems it in their best interests to request the information it can also be requested by that legally authorised representative and the request should be treated as if it had been made by the data subject.

Carer's access to information about the cared for person

A carer does not have rights to access information about the person they care for unless this information is information that should be provided to them as a matter of course under the Care Act (e.g. copies of the person's assessment or review report).

In all other circumstances information can only be shared if:

  1. The data subject provides consent for it to be shared; or
  2. The data subject lacks capacity to consent but has a legally authorised representative who has consented; or
  3. The data subject lacks capacity to consent, does not have a legally authorised representative but it is the view of the Local Authority that sharing the information would be in their best interests (e.g. to support an assessment by another professional);
  4. None of the exemptions set out in the Data Protection Act apply

The rights of other people

The rights of other people to access information about a data subject are limited. Information can only be provided if:

  1. The data subject provides consent for it to be shared; or
  2. The data subject lacks capacity to consent but has a legally authorised representative who has consented; or
  3. The data subject lacks capacity to consent, does not have a legally authorised representative but it is the view of the Local Authority that sharing the information would be in their best interests (e.g. to support an assessment by another professional);
  4. None of the exemptions set out in the Data Protection Act apply; or
  5. The information is requested under safeguarding and is integral to protecting the person, a child or other vulnerable adult from abuse or neglect.

As permitted under the UK GDPR, the UK Data Protection Act sets out some exemptions to the right of access. These exemptions apply to every information request, with one exception; if disclosure of the information is required by a court order or is necessary for the purpose of or in connection with any legal proceedings it should be provided.

The exemptions are:

  1. If providing the information requested will place the data subject, a child or other adult in (or at risk of) serious harm to their mental or physical health;
  2. If the information is child abuse data, it would not be in the best interests of the data subject;
  3. If a court has ordered the information not to be disclosed;
  4. Where a person with capacity provided the information to you with the expectation it would not be disclosed, or if they expressly indicated this (i.e. they did not consent);
  5. Where the information contains the identity or personal information of another data subject, that other person has capacity and has not consented to their information being shared, and it would not be possible to remove or disguise their data from the information (e.g. by blocking out or removing those details);
  6. Where the information contains the identity or personal information of another data subject, that other person lacks capacity to consent to their information being shared, it is not deemed in their best interests to do so and it would not be possible to remove or disguise their data from the information (e.g. by blocking out or removing those details);
  7. Where disclosure would prevent the detection or investigation of a crime or pose a risk to national security;
  8. The request is deemed 'manifestly unfounded or excessive' (e.g. an identical request has already been received and information has already been provided or denied).

If you are unsure whether an exemption applies you should seek support from a manager, who in turn should seek legal advice as required.

Data subjects should be told what information is collected about them, why and how long it will be kept for.

You should routinely share the following information with the individual it is about (the data subject), whether or not they have requested it:

  1. Copies of any assessment or review reports (including risk assessments, mental capacity assessments and safeguarding reports);
  2. Copies of any Care and Support or other Plans; and
  3. Copies of any meeting minutes in which they were present.

Where the individual has capacity and requests that this information is also shared with another person you should honour this request unless doing so would place the individual, a child or other vulnerable adult at risk of harm from abuse or neglect by that person. Where a request to share information is not honoured you should explain to the individual why the information has not been provided.

If you feel that the information should be shared with another person or organisation in order to benefit the individual (for example a health professional completing an assessment) you should obtain consent to do so.

Where the individual lacks capacity a decision can be made that it is in their best interests for this information to be shared, so long as no exemptions apply.

In all cases

Whenever you are unclear about whether or not to share information you should seek support from a manager, who in turn should seek legal advice as required.

Informal requests by the data subject

If the individual (data subject) has requested information informally relating to them or their case you must decide whether the information can be provided under Data Protection legislation.

It is the expectation in the legislation that wherever possible information is provided to a data subject following an informal request.

Some of the things that should be considered are:

  1. Is the information something that should be shared with the individual as a matter of course?
  2. Would providing the information be a breach of someone else's confidentiality?
  3. Would sharing the information put the individual at risk of harm from abuse or neglect?
  4. Would sharing the information put another adult or child at risk of harm from abuse or neglect?
  5. Do any of the exemptions in the Data Protection Act apply?

Informal requests by others

If the request is being made by a person who is legally authorised to request the information (a Court of Protection appointed Deputy for welfare or someone with Lasting Power of Attorney) the request should be treated as if it had been made by the data subject.

The rights of other people to access information about a data subject are limited. Information can only be provided if:

  1. The data subject provides consent for it to be shared; or
  2. The data subject lacks capacity to consent but has a legally authorised representative who has consented; or
  3. The data subject lacks capacity to consent, does not have a legally authorised representative but it is the view of the Local Authority that sharing the information would be in their best interests (e.g. to support an assessment by another professional); or
  4. The information is requested under safeguarding and is integral to protecting the individual, a child or other vulnerable adult from abuse or neglect.

The person making the request can still make a formal request for the information if an informal request is denied.

Formal requests for information about a data subject

A formal request is a request made in writing. They can be made by anyone.

The outcome of a formal information request should be made within 1 month of the date it was made. Notification in writing should be provided to the person making the request.

If information is to be shared this should also take place within that timeframe, even if the amount of information is significant (e.g. a case file).

Under the Freedom of Information Act anybody may make a formal request in writing (including e-mail) for non-personal information from a public body. This is information that does not relate to a particular individual (data subject).

The Freedom of Information Act specifies that any formal request for information made under the Act must be responded to within 20 days of receipt. The response should confirm:

  1. Whether the information is held by the Local Authority; and
  2. If so, provide the information requested.

Where information about an individual (data subject) is  requested as part of a safeguarding enquiry in order to protect the individual, or another vulnerable adult or child from abuse or neglect (or the risk of abuse or neglect) it should be provided.

This should be provided securely to the person leading the safeguarding enquiry and any concerns that you have about the implications for other vulnerable adults or children as a result of providing the information should be shared and considered by the safeguarding enquiry.

If it is possible to seek consent from the data subject before providing the information you should do so, although information can be provided without consent for the purpose of protecting them (or another adult or child) from abuse or neglect. If the individual does not give consent the information should still be shared if doing so would serve to protect them (or another adult or child) from the risk of abuse and neglect.

You should notify the individual that their information has been shared for the purposes of protecting them (or under safeguarding) from harm unless doing so would place them (or another adult or child) at further risk of harm. In this case you should notify them when it is deemed safe to do so.

You should be clear with the individual from the beginning that in the event of safeguarding information about them may be provided without their consent or immediate knowledge.

Under section 2 of the Care Act the Local Authority has a duty to prevent, reduce or delay the need for care and support.

See: Preventing Needs for Care and Support to read more about the duty to prevent needs for Care and Support, including the types of prevention services recognised by the Care Act, when to provide prevention services and how to charge for prevention services.

There are many kinds of prevention services available. When considering, seeking, or arranging preventative services, this should be:

  • Personalised, responsive and flexible depending on the needs of the person;
  • Creative and focussed on what people want to achieve in their lives;
  • Strengths based- building on what people and their communities can do and promoting new ideas.

All available prevention services in the local area should be explored before undertaking a longer-term intervention.

Information about preventative services provided by our Adult Services can be found in the Local Resources section.

This includes, but is not limited to:

  • Community Alarm;
  • Community Occupational Therapy;
  • Rehabilitation.

In addition to our own services, preventative support is also available from community and partner organisations. Information about these can be found in the Adult Services section of the Council website.

See: Adult Social Care Hub

Last Updated: May 31, 2022

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