“Thus these Acts require a local authority to assess needs, then decide by reference to such an assessment whether the provision of relevant services is called for, and then to make arrangements for the provision of services which have been decided upon as being called for.”
“… to facilitate people’s access to housing of their choice including: • more people receiving personal budgets and Direct Payments to increase their choice and control over where they live and with whom; • local care managers to have increased focus on home ownership and assured tenancies as a model for housing and support; • through person-centred planning, work with people still living with families to establish if that is the person’s preferred option and to instigate plans accordingly.” • more people receiving personal budgets and Direct Payments to increase their choice and control over where they live and with whom; • local care managers to have increased focus on home ownership and assured tenancies as a model for housing and support; • through person-centred planning, work with people still living with families to establish if that is the person’s preferred option and to instigate plans accordingly.”
“States Parties to the present Convention recognise the equal rights of all persons with disabilities to live in the community, with choices equal to others, and shall take effective and appropriate measures to facilitate full enjoyment by persons with disabilities of this right and their full inclusion and participation in the community, including by ensuring that: (a) Persons with disabilities have the opportunity to choose their place of residence and where and with whom they live on an equal basis with others and are not obliged to live in particular living arrangements; (b) Persons with disabilities have access to a range of in-home residential and other community support services, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation from the community; (c) Community services and facilities for the general population are available on an equal basis to persons with disabilities and are responsive to their needs.”
“25. Under a RAS the local authority ascribes a number of points, within a prescribed band, to each of the eligible needs in the particular case. It then calculates the total points and consults a table within the RAS which ascribes an annual sum to the total points…. Crucial to a RAS is a realistic nexus both between the needs and points and between points and costs…. 26. It follows that the sum identified by application of a RAS is not the product of a direct, individual costing of each of the requisite services in the particular case. For that reason the use of a RAS is only the first step in the local authority’s search for the answer to the question, [What is the reasonable cost of securing provision of the services identified as being necessary for the authority to make arrangements for?]….”
“9. For a number of years the [Council] has considered the cost of meeting a person’s eligible assessed non-residential need in the community against a cost of meeting those needs in a residential or nursing home, for those aged over 65. 10. This approach takes the Council’s current banding rates for nursing and residential care, minus the usual personal contribution of£100 per week, and will not normally fund community packages above this level, with a discretionary leeway for exceptional circumstances.”
“… [The Council] proposes to establish a usual maximum expenditure, which will represent the expected maximum weekly expenditure (or ‘indicative allocation of Personal Budget’) on a package of care that would meet assessed agreed eligible need in the community/someone’s home, if that need could be met through a care home placement. In circumstances in which a support plan to meet need and manage risk in the person’s home exceeds the usual maximum expenditure, alternative care arrangements would be considered. This might include offering different ways of meeting need from the service user’s first choice….”
“[The Council] is committed to supporting people to live full and independent lives within their local communities. Where people are eligible for social care support the aim is to support them in a way that reflects their preferences and the outcomes they wish to achieve. However, this needs to be balanced against [the Council’s] responsibilities to make best use of available resources. [The Council] has developed this policy to apply to all adult social care support users including those receiving direct payments so that decision-making in individual cases is fair, equitable and transparent and so that resources are fairly distributed across all who are eligible for support.”
“This [potential saving of£200,000 per year] has been estimated based on the numbers of new and increasing needs. During 2011-12 there were 49 new learning disabilities and physical disabilities service users, with a further 16 people whose needs had increased during the year. The savings are estimated by anticipating an 11% reduction in community based costs for half of the new service users. 11% has been identified as an achievable percentage reduction by analysis of the difference between current community-based service and the average residential and nursing costs for current service users. This has been assumed for only half of cases based on our knowledge of the complexity of need of service users and the challenge of meeting their assessed needs appropriately.”
“1. The proposals suggest that in order to continue to provide services for everyone eligible for services, limits need to be introduced – do you agree or disagree with this principle? 2. Do you agree that this policy should apply to everyone who uses adult social care services funded by [the Council]? 3. Do you agree that we should support people to use other, local and informal support networks to meet their needs? 4. Do you agree with the principle in these proposals that care packages could be supplemented by private means (where available) if the cost exceeds the proposed maximum expenditure threshold?”
“It seems to us that this consultation is flawed as it does not provide sufficient information for consultees to respond to on a range of important topics. There is no indication of the likely number of people that will be affected, or how – specifically – [the Council] intends to navigate these issues. We suggest it may lead to the ‘fettering’ of [the Council’s] discretion in how it discharges its community care duties, and are not reassured by vague assurances that it will depart from the policy in ‘exceptional circumstances’. Most significantly, the policy, once implemented, may result in high levels of unmet need and coercive institutionalisation – both of which bring serious undesirable social, legal and financial consequences. We suggest that the consultation itself is illegal, and that once implemented the policy may lead to further illegality.”
“The cost of a residential home for the individual will only act as a benchmark for comparison with a community care package. Nobody will be forced to live in a residential home as a result of this policy, although some service users may feel it to be more appropriate to do so. It is important to be clear that there may be times when the Council cannot safely meet a person’s needs in the community and it may be that residential care is most appropriate to meet their assessed eligible needs. This decision, however, is based on a best interest assessment for the person concerned where they lack mental capacity.”
“[The Council’s] policy is to apply, subject to exceptional circumstances, a figure that represents the usual maximum expenditure for care packages in the community. The maximum weekly costs to [the Council] will be no more than the net weekly cost to [the Council] of a care home placement that could be commissioned to meet the individual’s assessed eligible needs. … This could mean that insufficient Council funds are available for a package of support preferred by the individual and an alternative will be proposed by the Council. The individual may wish to achieve their preferred method of support by supplementing the Council’s allocated resources through their own private resources, e.g. benefits received and personal assets but the Council must be satisfied that the final support plan meets need and manages risk appropriately. [The draft then refers toarticle 8 of the European Convention on Human Rights .] [The Council] will ensure that maximum independence and privacy is achieved for each individual within the financial limits of the resources available. Exceptional circumstances will be taken into account, e.g. the impact on a person who is in work or on an employment pathway; the impact on wider family if the person has parenting responsibilities; if a person is approaching end of life but not yet eligible for Continuing NHS Care. These are examples and not an exhaustive list of circumstances in which discretion would be used in the application of the policy. … Ultimately, however, [the Council] has to consider how the needs identified in the Personal Assessment could be met in a way which represents the most cost-effective use of resources.”
“This policy will be applied when the assessment process is complete and when full costings of the plan preferred by the service user and of the alternative plan proposed by the Council are available. The potential for the promotion of independence and the use of assisted technology will have been taken into consideration throughout the assessment process. However, Practitioners are expected to explain the policy during the assessment process. Where a proposed support plan exceeds the usual maximum expenditure the first step would be to re-examine the detail of the plan to see if any of the needs can be met in less expensive ways, e.g. with the help of informal support. Where the usual maximum expenditure is exceeded an individual has the right to make up the difference between the Council’s allocated funding and the amount needed to fund their preferred support plan. A third party could also offer to make up the difference in funding needed to deliver the preferred support plan. However, [the Council] must be satisfied that the revised support plan is able to meet agreed needs and appropriately manage risks and such cases would be agreed at the Resource Allocation Panel. Should circumstances change and the individual or third party no longer be able to make up the difference a reassessment would be triggered. This policy will be applied through the decision-making process of the Resource Allocation Panel and the outcome communicated in writing to the individual. Where the home based support plan is not agreed the Practitioner will look at care home placements with the individual and their representatives. Exceptions to this policy will be agreed through the Resource Allocation Panel. Those decisions will be made on an individual basis. Factors that would be taken into account in the exercise of discretion include the potential for further reablement and the eventual reduction of support needed, cultural issues requiring a specialist agency or exceptional family circumstances such as the separation of family members.”
“5. It was noted that application of the policy could result in services being delivered that would not be people’s first choice about the way they receive care. In such circumstances there will be a range of options discussed with service users, including arrangements like shared living, assistive technology and other types of appropriate support to meet assessed eligible needs rather than expectations. This aims to balance available resources with the duty to meet assessed need and to do so in a way that was transparent, equitable and enables the best use of resources. It is expected that this will lead to an agreed positive outcome in most cases. An appeals process will be available if required… 6. The approach for younger adults would be to compare on an individual basis, the costs of meeting their needs in a residential setting against the costs of meeting their needs in the community. This would then allow a discussion about how their needs could be met in the community in a way that was comparable, in cost terms, to residential care. It did not mean that people would be forced into residential care.”
“… [M]y main point I think is to say that we have as a council no wish or power to override people with capacity whose wishes are to remain in their own home. Our primary policy remains to support people in their own home wherever appropriate but in a cost-effective way. One of the other presenters… said to you we think council staff should be able to work with them to get better value for money in a way that both sides are happy with and that I think summarises it absolutely accurately. That is the Council’s wish too. We want to work with people to ensure they can remain leading a good quality of life in their own home but cost effectively.”
“In developing and consulting on the proposed policy the Council has been mindful of the requirements of the [PSED]. A full [EIA] had been completed incorporating the findings of the service user consultation and detailed both the potential positive and negative impacts of the proposed policy. It also outlined mitigating action which the Council would take to limit potential negative impact for service users. In developing the policy the Council had also been mindful of the need to promote equality of opportunity in the provision of support for disabled service users. People affected by the policy would be provided with relevant information in a format which they were able to access and, where necessary, would be able to access support from advocacy services to assist them in understanding and, if required, question the application of the policy in their individual circumstances.”
“Under our proposed policy, if the costs of care in the community exceed the maximum expenditure threshold then (unless there are exceptional circumstances) the person will either have to go into residential care or accept a package of care which is insufficient to meet their needs. Do you agree with this proposal?”
“[The Council’s] policy completely undermines the Government’s commitment to independent living, enshrined in the UN Convention on the Rights of Persons with Disabilities as well as “Valuing people” and “Valuing people Now”. [The Council’s] policy is a distinctly backward step away from the right to live independently in the community and towards people with a learning disability living away from their community in residential care homes”
“[D’s] social worker would sit down with [D], his mother and any advocate and discuss how his support plan could be drafted so that his eligible needs can be met in the community, if this is what [D] wants. One way of achieving this outcome is if [D] shared a flat and support services with another service user. Whilst that may not be [D’s] first choice, such provision would meet [D’s] eligible needs without him having to go into residential care whilst also saving the Council significant sums of money. Such a result ensures that the Council meets its statutory duties whilst using its limited financial resources efficiently.”
“77. … I do not accept that this means that it is for the court to determine whether appropriate weight has been given to the duty. Provided the court is satisfied that there has been a rigorous consideration of the duty, so that there is a proper appreciation of the potential impact of the decision on equality objectives and the desirability of promoting them, then as Dyson LJ in Baker (at [34]) made clear, it is for the decision-maker to decide how much weight should be given to the various factors informing the decision. 78. The concept of ‘due regard’ requires the court to ensure that there has been a proper and conscientious focus on the statutory criteria, but if that is done, the court cannot interfere with the decision simply because it would have given greater weight to the equality implications of the decision than did the decision-maker. In short, the decision-maker must be clear precisely what the equality implications are when he puts them in the balance, and he must recognise the desirability of achieving them, but ultimately it is for him to decide what weight they should be given in the light of all relevant factors. If [the claimant’s] submissions on this point were correct, it would allow unelected judges to review on substantive merits grounds almost all aspects of public decision-making.”
“It was recognised that additional work was required to stimulate the market to create a momentum for change however opportunities did exist to provide an extension to the current range of services available”