Agenda Item 4 Report to: Date: By: Title of Report: Purpose of Report: Lead Member for Adult Social Care 18 May 2009 Director of Adult Social Care Review of Fair Access to Care Services Bandings within East Sussex for the financial year 2009/10 To enable the Lead Member to consider the proposed application of Fair Access to Care Services (FACS) criteria across all adult social care services.
RECOMMENDATIONS The Lead Member is recommended to: Agree that in considering the Fair Access to Care Services (FACS) framework the eligibility criteria for East Sussex should continue to be drawn under, and inclusive of, the ‘Critical’ and ‘Substantial’ Bands for the financial year 2009/10.
1.
Financial Appraisal
1.1 The Government expects that each Local Authority’s published position in relation to FACS is informed by reference to demand for, and provision of, services, taking into account available resources. As the Guidance makes explicit in considering the relationship between the setting of eligibility criteria and available resources, Councils are expected to review criteria in line with budget setting cycles, and to make any necessary adjustments. 1.2 Below is a table which provides an analysis of the FACS bandings applied to assessed need in the six years since the introduction of FACS in 2003 FACS Band 2003/04 2004/05 2005/06 2006/07 2007/08 2008/9 part Critical Substantial Moderate Low 25% 74% 1% 51% 48% 1% 56% 43% 1% 63% 36% 1% 74% 25% 1% 68% 31% 1% -
1.3 The table demonstrates a move from a position where work with individuals classified with substantial needs was predominant to the present position which illustrates a continued growth in the numbers of people deemed as in ‘Critical’ need 1.4 It is against this backdrop, and mindful of the County Council’s financial position in 2006/7, Cabinet agreed to restrict the criteria to `Critical’ and `Substantial’ and introduce the concept of time as set out in Appendix 1. 2. Background and Supporting Information
2.1 FACS was introduced by Local Authority Circular LAC(2002)13 and provides a framework for determining eligibility for all local authorities in England and Wales, with the aim of ensuring greater transparency for all adult service user groups in understanding the criteria that will be applied to them locally.
2.2 FACS describes four bands of eligibility, Critical, Substantial, Moderate and Low. The bands are based on the level of risk to the independence of the individual if service provision is not made. When considering the higher Critical and Substantial bands Councils are not given any discretion to subdivide or change the language within these bands. 2.3. It is, however, permissible to add to the standard definitions and in 2006/7, with the approval of Cabinet, some additional sentences were added to both the critical and substantial definitions to provide further clarification. These are identified within the framework in Appendix 1 in italics. 2.4 Review activity pertaining to the implementation of FACS in East Sussex has involved contact with local authorities across the South East Region, and the proposals outlined have been drawn in particular from work undertaken by Surrey County Council. Set out below is a an analysis of what has been established as the likely position for each of those Authorities for 2009/10 Surrey Kent West Sussex Brighton and Hove Critical, Substantial Critical, Substantial and Moderate Critical, Substantial and Moderate Critical, Substantial
A Summary of the eligibility criteria for all 150 Local Authorities with Social Services responsibility for 2008/9 is contained in the table below. Critical Critical, Substantial Critical, Substantial and Moderate Critical, Substantial, Moderate and Low 2% 70% 25% 3%
3.
Conclusion and Reason for Recommendation
3.1 For the financial year 2009/10 it is recommended that the County Council continues to draw the eligibility line for all adult social care groups under `Substantial’ 3.2 To maintain clarity and to ensure assessment activity across all adult client groups is undertaken rigorously and equitably it is proposed that the timescales as contained in Appendix 1 are continued. 3.3 This will mean that alongside the factors that national guidance dictates should be considered in determining eligibility ie autonomy, health and safety, the management of daily routines and involvement in family and wider community life, in East Sussex the urgency of the situation that individuals find themselves experiencing will also be a determining factor Those individuals presenting with `Critical’ needs `now or within seven days’ and those people presenting with `Substantial’ needs `now or within six weeks ‘ would, if the proposals are accepted, be eligible for social care support.
KEITH HINKLEY Director of Adult Social Care Contact Officer: Mark Stainton, Assistant Director – Operations Tel No. 01273 481238 BACKGROUND PAPERS: None Local Members: All
Appendix 1 FAIR ACCESS TO CARE SERVICES - ELIGIBILITY FRAMEWORK
Critical (now or within 7 days) – when
• • • • • • • • • Life is, or will be threatened. Significant health problems have developed or will develop. There is or will be a serious risk to the physical safety or self or others There is, or will be, little or no choice and control over vital aspects of the immediate environment. Serious abuse or neglect has occurred or will occur. There is, or will be, an inability to carry out vital personal care or domestic routines. Vital involvement in work, education or learning cannot or will not be sustained. Vital social support systems and relationships cannot or will not be sustained. Vital family and other social roles and responsibilities cannot or will not be undertaken.
Substantial (now or within six weeks) – when
• • • • • • • • Significant health problems have developed or will develop There is or will be a serious risk to the physical safety of self or others There is, or will be, only partial choice and control over the immediate environment. Abuse or neglect has occurred or will occur. There is, or will be, an inability to carry out the majority of personal care or domestic routines. Involvement in many aspects of work, education or learning cannot or will not be sustained. The majority of social support systems and relationships cannot or will not be sustained. The majority of family and other social roles and responsibilities cannot or will not be undertaken.
Moderate (now or within 3 months) – when
• • • • There is, or will be, an inability to carry out several personal care or domestic routines. Involvement in several aspects of work, education or learning cannot or will not be sustained. Several social support systems and relationships cannot or will not be sustained. Several family and other social roles and responsibilities cannot or will not be undertaken.
Low (now or within 6 months) – when
• • • • There is, or will be, an inability to carry out one/two personal care or domestic routines. Involvement in one/two aspects of work, education or learning cannot or will not be sustained. One/two social support systems and relationships cannot or will not be sustained. One/two family and other social roles and responsibilities cannot or will not be undertaken
(Additional sentences in italics agreed by Cabinet on 14/03/06)