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CQC Quality Statement

Theme 1 – Working with People: Supporting people to live healthier lives

Royal Borough of Greenwich statement

We support people to manage their health and wellbeing so they can maximise their independence, choice and control. We support them to live healthier lives and where possible, reduce future needs for care and support.

What people expect

I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally. I am supported to plan ahead for important changes in my life that I can anticipate.

KEY POINTS

  • Under the Care Act, the local authority is responsible for setting up and maintaining – including review – information and advice services relating to care and support.
  • All adults – including carers – in the local authority area, who need information and advice about care and support, must be able to access the service.
  • The local authority must ensure that the information provided is of good quality, easily accessible and relevant.
  • The local authority should take opportunities to provide or signpost people to advice and information when people in need of care and support are in contact.

1. Introduction

Having access to good quality information and advice is very important to enabling people, carers and families to take control of, and make well informed choices about their care and support and how they will fund it. Not only does information and advice help to promote people’s wellbeing by increasing their ability to exercise choice and control, it is also a vital part of preventing or delaying people’s need for care and support.

Royal Borough of Greenwich Council has a legal duty to: ‘establish and maintain a service for providing people in its area with information and advice relating to care and support for adults and support for carers’ (Section 4, Care Act 2014).

It has an active and critical role in the provision of information and advice and must take an active role. To fulfil its duty, Royal Borough of Greenwich is likely to need to go further than providing information and advice directly (though direct provision will be important) by working to ensure the coherence, sufficiency, availability and accessibility of information and advice relating to care and support across the Royal Borough of Greenwich area. Importantly, this duty relates to the whole population of the Royal Borough of Greenwich area, not just those with care and support needs or who are in some other way already known to the system.

It is important to be clear that the duty to establish and maintain an information and advice service is distinct from the duty to meet eligible needs (see Eligibility): this is true for both people with care and support needs and their carers. While a person’s eligible needs may be met by the provision of information and advice, this will be an individual response following a needs or carers assessment. Royal Borough of Greenwich cannot fulfil its universal information and advice duty simply by meeting eligible needs, nor would information and advice always be an appropriate way of meeting eligible needs.

Royal Borough of Greenwich must ensure that information and advice services established cover more than just basic information about care and support and cover a wide range of care and support related areas. The service should also address prevention of care and support needs, finances, health, housing, employment, what to do in cases of abuse or neglect of an person and any other areas where required.

Royal Borough of Greenwich should consider who are the people it is communicating with on a case by case basis, and signpost them towards the types of information and / or advice that may be particularly relevant to them.

Royal Borough of Greenwich must also provide independent advocacy to assist a person’s involvement in the care and support assessment, planning and review processes where they would otherwise have substantial difficulty in understanding, retaining or using information given to them, or in communicating their views, wishes or feelings and where there is nobody else who can offer this support (see Independent Advocacy).

2. Terms Used

The Care and Support Statutory Guidance uses a number of different terms, which are included in this chapter.

‘information’ means the communication of knowledge and facts about care and support.

‘Advice’ means helping a person to identify choices and / or providing an opinion or recommendation regarding a course of action in relation to care and support.

‘Advocacy’ means supporting a person to understand information, express their needs and wishes, secure their rights, represent their interests and obtain the care and support they need.

The term ‘financial information and advice’ includes a broad range of services to  help people plan, prepare and pay for their care costs.

‘Independent’ financial information or advice means services independent of the Royal Borough of Greenwich. It also refers to ‘regulated’ financial advice which means advice from an organisation which is regulated by the Financial Conduct Authority (FCA) which can include individual recommendations about specific financial products.

Royal Borough of Greenwich should ensure that people are able to access all of these types of financial information and advice to help them plan and pay for their care.

 

3. The Duty to Establish and Maintain a Service

Under the Care Act, Royal Borough of Greenwich must establish and maintain a service for providing people in its area with information and advice relating to care and support for people and support for carers. This should be done in conjunction with partner organisations and be informed by local Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies (see also Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies). The information and advice service must cover the needs of all its population, not just those who are in receipt of Royal Borough of Greenwich funded care or support.

Royal Borough of Greenwich is also responsible for ensuring appropriate quality assurance and review of the service. This should include feedback from local people who use it, to make sure that the service learns from people’s experiences and continuously improves.

4. Who are the Information and Advice Services for?

Royal Borough of Greenwich is responsible for ensuring that all people including carers in its area with a need for information and advice about care and support are able to access the service.

People (carers included) who are likely to need information and advice may include:

  • people wanting to plan for their future care and support needs;
  • people who may develop care and support needs, or whose current care and support needs may increase. Under the Care Act, Royal Borough of Greenwich is expected to take action to prevent, delay and / or reduce the care and support needs for these people (see Preventing, Reducing or Delaying Needs chapter);
  • people who have not contacted Royal Borough of Greenwich for assessment but are likely to be in need of care and support. Royal Borough of Greenwich is expected to take steps to identify such people and encourage them to come forward for an assessment of their needs (see Preventing, Reducing or Delaying Needs chapter);
  • people who become known to Royal Borough of Greenwich (through referral, including self-referral), at first contact where an assessment of their needs is being considered (see Assessment chapter);
  • people who are assessed by Royal Borough of Greenwich as currently being in need of care and support. Advice and information must be offered to these people irrespective of whether they have been assessed as having eligible needs which Royal Borough of Greenwich must meet;
  • people who have eligible needs for care and support which Royal Borough of Greenwich is currently meeting (whether Royal Borough of Greenwich is paying for some, all or none of the costs of meeting those needs (see Care and Support Planning chapter);
  • people whose care and support or support plans are being reviewed (see Review of Care and Support Plans chapter);
  • family members and carers of people with care and support needs, (or those who are likely to develop care and support needs). Royal Borough of Greenwich is expected to have regard to the importance of identifying carers and take action to reduce their needs for support (see Assessment chapter);
  • people who are subject to adult safeguarding concerns (see Adult Safeguarding chapter);
  • people who may benefit from financial information and advice on matters concerning care and support. Royal Borough of Greenwich must consider the importance of identifying these people, to help them understand the financial costs of their care and support and access independent financial information and advice including from regulated financial advisers (see Financial Information and Advice chapter), and;
  • care and support staff who have contact with and provide information and advice as part of their jobs.

4.1 Carers

Royal Borough of Greenwich must recognise and respond to specific requirements that carers have for both general and personal information and advice. A carer’s need for information and advice may be separate from information and advice for the person for whom they are caring. Their needs may be covered together, in a similar way to Royal Borough of Greenwich combining an assessment of a person needing care and support with a carer’s assessment (see Assessments – Carers chapter), but may be more appropriately considered separately. This may include information and advice on:

  • breaks from caring;
  • the health and wellbeing of carers themselves;
  • caring and advice on wider family relationships;
  • carers’ financial and legal issues;
  • caring and employment;
  • caring and education; and,
  • a carer’s need for advocacy.

5. Quality of Information and Advice

Royal Borough of Greenwich must ensure that there is an accessible information and advice service that meets the needs of its population. Information and advice must be open to everyone who would benefit from it.

Royal Borough of Greenwich should ensure that information supplied is clear, meaning it can be understood and acted upon by the person receiving it.

It should be accurate, up to date and consistent with other sources of information and advice. Staff providing information and advice within Royal Borough of Greenwich and other frontline staff should be aware of accessibility issues and be appropriately trained (see Section 8, Accesibility of Information and Advice).

All reasonable efforts should be taken to ensure that information and advice provided meets the adult’s requirements, is comprehensive and is given at an early stage. Royal Borough of Greenwich make sure that all relevant information is available to people for them to make the best informed decision in their particular circumstances.  Leaving out or withholding of information is not acceptable.

There will be some circumstances where impartial information and advice are particularly important and Royal Borough of Greenwich should consider when this may be best provided by an independent organisation, rather than by Royal Borough of Greenwich itself. This is particularly likely to be the case when people need advice about how and whether to question or challenge the decisions of Royal Borough of Greenwich.

6. Content

Royal Borough of Greenwich must ensure that information and advice is provided on:

  • how the local care and support system works locally – about how the system works. This includes what the ‘process’ may involve and the judgements that may need to be made; specific information on what the assessment process, eligibility, and review stages are, how to complain or make a formal appeal to the authority, what this involves and when independent advocacy should be provided. It also includes wider information and advice to support individual wellbeing; the charging arrangements for care and support costs; how a person might plan for their future care and support needs and how to pay for them, including provision for the possibility that they may not have capacity to make decisions for themselves in the future;
  • how to access the care and support available locally – where, how and with whom to make contact, including information on how and where to request an assessment of needs, a review or to complain or appeal against a decision;
  • the choice of types of care and support, and the choice of care providers available in the local area – including prevention and reablement services and wider services that support wellbeing. Where possible this should include the likely costs to the person of the care and support services available to them. Information on different types of service or support that allow people personal control over their care and support for example, details of Independent Service Funds and direct payments should be included;
  • how to access independent financial advice on matters relating to care and support – including the extent of their personal responsibilities to pay for care and support, their rights to statutory financial and other support, locally and nationally, so that they understand what care and support they are entitled to from Royal Borough of Greenwich or other statutory providers. Details of the information and advice people may wish to consider when making financial decisions about care so that they can make best use of their financial resources and are able to plan for their personal costs of care whether immediately or in the future;
  • how to raise concerns about the safety or wellbeing of a person with care and support needs and also consider how to do the same for a carer with support needs.

Depending on local circumstances, the service should also include, but not be limited to, information and advice on:

  • available housing and housing related support options for those with care and support needs;
  • effective treatment and support for health conditions, including Continuing Health Care arrangements;
  • availability and quality of health services;
  • availability of services that may help people remain independent for longer such as home improvement agencies, handyperson or maintenance services;
  • availability of befriending services and other services to prevent social isolation;
  • availability of intermediate care entitlements such as aids and adaptations;
  • eligibility and applying for disability benefits and other types of benefits;
  • availability of employment support for disabled people;
  • children’s social care services and transition from children’s services to adult care and support services;
  • availability of carers’ services and benefits;
  • sources of independent information, advice and advocacy;
  • the Court of Protection, power of attorney and becoming a deputy;
  • the need to plan for future care costs;
  • practical help with planning to meet future or current care costs;
  • accessible ways and support to help people understand the different types of abuse and its prevention.

7. Opportunities to Provide Information and Advice

Royal Borough of Greenwich has a number of direct opportunities to provide or signpost people to advice and information when people in need of care and support come into contact with them. These include:

  • at first point of contact with Royal Borough of Greenwich;
  • as part of a needs or carer’s assessment, including joint Continuing Healthcare assessments;
  • during a period of reablement;
  • around and following financial assessment;
  • when considering a financial commitment such as a deferred payment agreement or top‑up agreement;
  • during or following an adult safeguarding enquiry;
  • when considering take up of a personal budget and / or direct payment;
  • during the care and support planning process;
  • during the review of a person’s care and support plan;
  • when a person may be considering a move to another local authority area;
  • at points in transition, for example when people needing care or carers under 18 become adults and the systems for support may change.

Royal Borough of Greenwich and its partners must also use the wider opportunities to provide targeted information and advice at key points in people’s contact with the care and support, health and other local services. These may be at key ‘trigger points’ during a person’s life such as:

  • contact with other Royal Borough of Greenwich services;
  • bereavement;
  • hospital entry and / or discharge;
  • diagnosis of health conditions – such as dementia, stroke or an acquired impairment for example;
  • consideration or review of Continuing Healthcare arrangements;
  • take up of power of attorney;
  • applications to the Court of Protection;
  • application for, or review of, disability benefits such as Attendance Allowance, Personal Independence Payments, and for Carer’s Allowance;
  • access to work interviews;
  • contact with local support groups, charities, or user-led organisations including carers’ groups and disabled person’s organisations;
  • contact with or use of private care and support services, including home care;
  • change or loss of housing;
  • contact with the criminal justice system;
  • admission to or release from prison;
  • ‘guidance guarantee’ in the Pensions Act 2014;
  • retirement.

8. Accessibility of Information and Advice

Royal Borough of Greenwich should ensure that products and materials (in all formats) are as accessible as possible for all potential users. Websites should meet specific standards such as the Web Content Accessibility Guidelines and guidance set out in Making Your Service Accessible (UK Government).

Printed products should be produced to appropriate guidelines with important materials available in easy read, large print and languages other than English. Telephone services or face to face services should also be available to people who do not have access to the internet or who need services to be delivered in another way to meet their specific needs. Local authorities should particularly be aware of the needs of individuals with complex but relatively rare conditions, such as deafblindness and those with hidden disabilities (see Working with Adults with Hidden Disabilities chapter).

Under the Equality Act 2010, reasonable adjustments should be made to ensure that disabled people have equal access to information and advice services. Reasonable adjustments could include the provision of information in a range of accessible formats or the provision of help with communication support. When a person contacts the information or advice service, they should be asked what the best way for information is to be given to them and how they prefer to communicate.

Information and advice should be available in a range of formats including:

  • face to face contact;
  • use of social and professional contacts;
  • community settings;
  • advice and advocacy services;
  • telephone;
  • mass communications, and targeted use of leaflets, posters and so on (for example in GP surgeries);
  • use of ‘free’ media such as newspaper, local radio stations, social media;
  • Royal Borough of Greenwich’s own and other appropriate internet websites, including support for the self-assessment of needs;
  • third party internet content and applications;
  • email.

Some groups in need of information and advice about care and support may have particular requirements. These may include:

  • people with sensory impairments, such as visual impairment, deafblind and hearing impaired;
  • people who do not have English as a first language;
  • people who are socially isolated;
  • people whose disabilities limit their physical mobility;
  • people with learning disabilities;
  • people with mental health problems.

Some people, including those with dementia, may benefit from an independent person to help them to access or avail themselves of necessary information and advice. From the point of first contact with or referral to Royal Borough of Greenwich, the provision of independent advocacy to support involvement in assessment, planning and reviews should be undertaken (see Independent Advocacy chapter).

9. Adult Safeguarding

Royal Borough of Greenwich and its partners have a duty to help people with care and support needs, and who may be at risk of abuse or neglect as a result of thir needs, keep safe. But this does not prevent them making their own choices and having control over their lives. Everyone should understand the importance of safeguarding and help keep people safe (see Adult Safeguarding).

Royal Borough of Greenwich must provide information and advice about how to raise concerns about the safety or wellbeing of a person who has care and support needs. It should also support public knowledge and awareness of different types of abuse and neglect and how to support people to keep safe.

The information and advice provided must also cover who to tell when there are concerns about abuse or neglect and what will happen when such concerns are raised, including information on how the Royal Greenwich Safeguarding Adults Board works.

10. Complaints

Anyone who is not satisfied with a decision made by Royal Borough of Greenwich can make a complaint about that decision and have that complaint dealt with by Royal Borough of Greenwich. Royal Borough of Greenwich’s arrangements must make sure that those who make complaints receive, as far as reasonably practicable, assistance to enable them to understand the complaints procedure or advice on where to obtain such assistance. See Complaints.

11. National Organisations

Where appropriate, Royal Borough of Greenwich should signpost or refer people to national sources of information and advice where these are recognised as the most useful source. Examples might include:

Some national providers offer free access to tools, resources and information that can be integrated into Royal Borough of Greenwich websites or delivered in paper format.

Referral or signposting to national sources however should only occur where deemed to be in the person’s best interests.

12. Further Reading

12.1 Relevant chapters

Financial Information and Advice

Promoting Wellbeing

Preventing, Reducing or Delaying Needs

12.2 Relevant information

Chapter 3, Information and Advice, Care and Support Statutory Guidance (Department of Health and Social Care)

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