Who can get help from Adult Services?

Consultation outcome

Eligibility criteria consultation outcome

A public consultation by Hampshire County Council on a proposal to change the ‘eligibility criteria’ for who can get social care services provided or arranged by the Adult Services Department.

1^st September to 27^th November 2006

Who can get help from Adult Services

‘Eligibility Criteria’ are a set of 4 levels of need, defined by the Government which Hampshire uses to decide who should get help and support. This set of criteria are setailed in the 'Summary of Eligibility Criteria' on page 4.

How we decide who can get help from the Adult Services Department

In order to ensure fair access to public care services, the Department of Health has issued guidance providing a national framework setting out the ‘Eligibility Criteria’ for access to care services provided by local authorities.

These eligibility criteria require Hampshire County Council Adult Services Department to assess and regularly review someone’s ability to live independently and their ongoing need for social care support. Depending on the individual’s assessment of their needs and the eligibility criteria level set by the local authority, the decision is then made whether to provide that person with social care services. A separate financial assessment of the individual's income and savings is then made to establish how much they should contribute.

As well as providing services itself, the Adult Services Department contracts with many local agencies to provide services on its behalf. In addition it signposts individuals towards other sources of help and support that exist in the local community from both public, private and voluntary agencies.

Who gets help now?

At present if someone’s need for help and support fits within either the ‘critical’ or the ‘substantial’ levels, they can expect to receive care services provided or arranged by the Adult Services Department. A separate financial assessment will define their level of contribution to the costs.

What we are consulting about

Because of growing demand and the need to stay within the budget, it is proposed to raise the threshold at which we will provide services from ‘substantial and critical’ to just ‘critical’, so we can continue to provide adequately for those most in need.

In Hampshire, as with most other local authorities in England, the Adult Services Department is currently reviewing the way we deliver social care in order to meet the changing needs of Hampshire residents in the 21^st century.

There are several reasons for this, the main ones being:

The number of people living into old age is rapidly increasing for a whole range of reasons. Older people now represent over 16% of the population and this percentage is increasing all the time with the number of people who reach the age of 85 predicted to double by 2026. More and more people are leading full and active lives, making valuable contributions to their community and family well into their 70s and 80s. However it does mean that very often when people begin to need support and care, these needs can continue for many years.
Major and continuing improvements in health care, nutrition, housing, education and the general rise in the population all impact on the growth in demand for care and support.
The age at which people need care, if ever, is very varied. Many people live active and healthy lives well into their 80s and 90s, while others will need some kind of support from much earlier in life. For example, a child with physical and/or learning disabilities who grows into adulthood, and then becomes a senior citizen, may need more or less care at different times during their lifetime. There is no precise point at which it can be decided that someone needs care, whether from their family, friends, health or social care professionals.

Our duty as an Adult Services Department is to assess individual need as and when it arises in someone’s life. We decide whether to provide services according to the Eligibility Criteria and where each individual is placed on that scale. Almost inevitably, because of changes in the population, resources and other circumstances outside our control, we may have to change the point at which we provide services in order to make certain we can provide for those in the greatest need now and in the future..

Summary of eligibility criteria

Critical

Someone’s need for help is defined as critical if one or more of the following circumstances apply:

life is, or will be, threatened
significant health problems have developed, or will develop
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

Someone’s need for help is substantial if one or more of the following circumstances apply:

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 & Low

The current policy is that people who are in the moderate or low eligibility criteria bands do not receive a service from us.

Consultation process

The consultation period is from 1st September to 27^th November 2006. Please help us make sure others know about this consultation.

This document includes a consultation questionnaire. Additional copies are available by contacting the Helpline on 01962 845469. In mid-November, we are organising several consultation meetings. If you would like to attend one of these, please call the Helpline or go to the consultation website for more information on dates and venues.

Your comments are welcomed and will be taken into account in the Consultation Report, but we are not able to respond on an individual basis. The report to the Executive Member for Social Care, Cllr. Patricia Banks, who will take the final decision on 8th December 2006, will be published at www.hants.gov.uk/decisions/decisions-index/index-mtg-414.html no later that 4th December 2006. If you do not have access to the internet, your local Library and/or Hampshire County Council Information Centres will be pleased to provide you with a copy. You can also call the Helpline on 01962 845469 to obtain a copy.

As you are aware it is a duty for the Department to review the services that each individual receives on a regular basis and this will continue to be the case. If the threshold for access to care is changed, no change will be made to an individual's care without a risk assessment on the impact of such a change. Before any changes are implemented, this will be discussed in detail with an individual and their family.

The Helpline on 01962 845469 is available to take general enquiries, but the staff on that line will not be able to deal with individual queries. They will pass on your questions to the appropriate member of staff.

The eligibility criteria in practice

Critical

Mrs A, aged 83, has dementia and painful leg ulcers for which she is prescribed morphine. Her mobility is variable and she is dependent on others to help her cope with her life. Mrs A was looked after by her husband at home, but sadly he has died and due to her dementia she cannot live alone. There is no-one else to support her and her needs are now assessed as critical. She has been placed in a specialist dementia care residential home where hopefully she can stay for the rest of her life.

Mrs B fell in her sheltered housing flat. She appears confused at times and is no longer coping with feeding and looking after herself. She is incontinent and has been diagnosed as having a urinary infection which could be the cause of her confused state. Working with her GP and other health professionals, her urinary infection is being treated and she is being supported in managing her incontinence. The satisfactory treatment of her urinary infection should reduce her confusion and she will be able to resume her previous routine with the support of the Warden in her sheltered housing.

Mrs B is currently assessed as critical, but with the joint intervention of Adult Services and Health, this could improve to substantial or moderate.

Substantial

Mr D has multiple health problems having had a stroke and having a prolapsed bowel. He is a heavy man and although his wife manages the house, can cook his meals and keep him company, she is unable to help with his personal care. At first, following the stroke his son was able to come twice a day to help him into and out of bed, and attend to his washing, dressing and toileting needs. His needs are assessed as substantial. Services are provided in the morning and evening on the two days the son cannot help.

Mr D's son is facing issues at home and with his work, so will be unable to offer as much support in the future. As a result, Mr D's needs may become critical.

Mr P is 35 years old. He has learning difficulties and lives with his parents. He goes twice a year for a couple of weeks to the local residential unit to give him and his family a break. He used to go to a day centre, but is now in a supported employment programme and any additional support he needs is provided through Direct Payments which his parents help him manage. Mr P and his parents have always coped well and until recently his needs were assessed as moderate. As his parents have got older and their health is not as robust as it was, Mr P's needs are now considered substantial.

How to take part in the consultation

The consultation period is from 1st September 2006 to 27th November 2006. Please help us make sure others know about this consultation. Additional copies of this questionnaire are available by contacting the Helpline on 01962 845469.

You are invited to make you comments know by either:

returning the questionnaire to Freepost SO2077, The Deputy Director of Adult Services (EC Consultation), Trafalgar House, The Castle, Winchester SO23 8UQ. This leaflet has been designed so that you can tear off and return the questionnaire while retaining all the information.
responding to the questions by emailing adult.services.feedback@hants.gov.uk
telephoning 01962 845469 and replying to the questionnaire via the Helpline
returning the questionnaire by fax to 01962 820350
accessing the consultation on our consultation website
in mid-November, we are organising several consultation meetings. If you would like to attend one of these, please call the Helpline or go to the consultation website for more information on dates and venues
alternatively, you may wish to speak or write to your local County Councillor. Their contact details can also be provided by contacting your local library or Hampshire Information Centre.

We are not able to reply to comments individually, but they will be taken into account in the Consultation Report to the Executive Member for Social Care.

If you need this is large print or other formats/languages, please contact the consultation Helpline on 01962 845469.