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Admissions and Commencement of Service in Domiciliary Support (Wales) Policy

Policy Statement

This policy sets out:

• how this domiciliary support service handles referrals of people who are considering using our service
• how to make sure that everyone is satisfied that the service will meet their needs
• how to organise the start of service so that the individual concerned will be satisfied that we can meet their needs and achieve the outcomes they seek.

We consider that the success of our care service will be in making the correct decisions and taking appropriate action at the start. To ensure this, we have developed our pre-admission and commencement of service procedures in line with the requirements of Regulation 14: Suitability of Service of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017.

Regulation 14 requires {{org_field_name}} to have an “admissions and commencement of the service policy and procedure”, which includes reference to:

• arrangements for confirming that they can or cannot provide a suitable service
• details about the consultation process involved and the information to be considered
• the assessment processes (including for emergency admissions), including who will undertake the assessment
• the circumstances where a service will not be provided
• the arrangements for start of service.

{{org_field_name}} has a suite of policies that meet these requirements for domiciliary support, including:

• Needs Assessment
• Information Provision for Prospective Service Users
• Information for People Receiving Domiciliary Support: Range of Services
• Responding to Requests for Service
• Self-funding and Direct Payments Arrangements
• Contracts and Agreements and Termination of Service.

The service’s approach to its referrals and admissions is also consistent with the Social Services and Well-being (Wales) Act 2014.

Policy on Referrals and Admissions

Referrals and applications*

*The sources of a domestic support service’s referrals and applications will vary according to its Statement of Purpose as required for registration with the CIW and local factors.

Referrals from people following local authority/health services assessment — The service provider could receive enquiries or applications from or on behalf of people:

1. whose care and support needs have been assessed by their local authority and relevant health services
2. who have met eligibility criteria for receiving this kind of service
3. who have a personal plan that indicates that domiciliary support will be the best way of meeting their needs
4. who have agreed that the local authority should arrange or is instrumental in organising their care and support
5. who could be receiving local authority funding to meet their care needs.

Such applications will usually be made to care providers that have been contracted or commissioned by a local authority in line with its specifications by being on an approved list or direct contract. Such applications might also be made for people needing care and/or continuing nursing care following discharge from hospital. Local procedures will apply in these different circumstances.

In the event of any referral by these means, {{org_field_name}} manager will give an immediate reaction on the service’s capacity and suitability, timescales for commencement of service, and if appropriate, request information from their needs assessment, which should enable the service to assess its capacity to meet the person’s needs.

If the referral appears suitable, the service will then ask for the full written needs assessment (if not already supplied). For its part, the service will provide any information requested or needed by the applicant, and a meeting with the person who is considering using its service, preferably in the form of a visit to the person’s home with the local authority social worker/relative/friend and/or lawful representative — as appropriate being present. If for any reason a pre-service visit is impractical, other methods of discussing with the individual and their representatives might be used.

Referrals made independently of the local authority — A person who intends to pay for their own care and support might not have had a full needs assessment by their local authority although, in line with the Social Services and Well-being (Wales) Act 2014, they are entitled to one.

Where the individual prefers not to have their needs assessed by the local authority and is acting independently of it, the service provider will employ a qualified person to carry out its own needs assessment equivalent to that provided by the local authority. The assessment will meet the criteria set out in Regulation 18: Provider Assessment of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017.

A key aim of the initial stage in all cases is to make sure that the service provider is fully aware of the person’s needs and has the resources to meet them. The service will decide about providing the service in principle based on this assessment and terms and conditions and/or a contract can then be agreed.

Procedures Following a Decision to Consider Providing a Service

1. Pre-service assessments — Where a pre-service assessment is required in a person’s own home, the manager or team dealing with the application will:
   a. check that it has all available information from the referral to enable it to proceed, including such matters as the urgency of the need for service and that it lies within the service’s scope
   b. arrange with the person concerned and/or person(s) who are lawfully representing that person dates and times for the assessment visit(s)
   c. check that the person is giving their consent to the assessment/has been given through a best interests assessment in line with Mental Capacity Act 2005 requirements
   d. check if there are any safety risks to the people carrying out the assessment and put appropriate measures in place if there are, for example, for assessor and/or the person who is considering using the service to be supported throughout the assessment
   e. check if there are any specific requirements to enable the assessment to be carried out, eg if the person has communication difficulties
   f. check the assessment on completion that it is sufficiently comprehensive including risk assessments to enable both parties take informed decisions about the proposed care and support arrangements
   g. check if any agreed personal plan is with the consent of the person or if the person cannot give their informed consent that any decision taken meets the requirements of the Mental Capacity Act 2005
   h. make sure that if the person is being deprived of their liberty because of any restrictions decided in the personal plan, these decisions are fully authorised in line with current requirements, and their human rights are being protected.
2. Pre-service visits — We will try to give people as full and honest an impression of the services as possible. They will have the chance to discuss with the manager and other appropriate staff the proposed arrangements to ensure that they are acceptable.
3. Meeting needs — In line with its registration requirements, the service provider must be satisfied that it has the capacity to meet the needs of any who is looking to use its services before they agree to receiving the service. We will discuss this issue with the individual, and their relatives/lawful representative/local authority social worker as appropriate, and if it is necessary to decline to provide the service, we will frankly tell them the reasons. We believe that clarity at this stage can avoid a much more painful breakdown of the arrangements later.
4. Trial service — We will offer people the opportunity to review and to terminate the service at the end of the first month if they are not satisfied with it. (If applicable and written into the person’s contract.)
5. Start of service — If everyone is satisfied that what we have to offer is the right step, we will arrange a start date for the service and proceed to meet the requirements of their personal plan.
6. Emergency Referrals — We recognise that situations sometimes arise which make rapid decisions necessary. In these instances, we apply the procedures governing planned referrals and gather and supply all necessary information as soon as practically possible in line with the service regulations.
7. Mental capacity — The service assumes that prospective users will give their written consent to their receipt of service. Where the person is unable to give their formal consent because of lack of mental capacity, the service will ensure that all due Mental Capacity Act 2005 processes have been followed and will ascertain if there will be any deprivation of liberty that requires safeguarding.
8. Provider assessment — The service will proceed by carrying out its own assessment in line with the requirements of Regulation 18 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017.

Training

All staff receive training in line with their roles and responsibilities in the handling of referrals and pre-service procedures.

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