Guidance on the prioritisation and timeliness of the delivery of adult social care under the Care Act easements Local authority ASC departments will be well practised in responding to emergencies, where there is an incident or provider failure that results in the need to provide rapid support. On occasion, they may have to prioritise the delivery of such support to ensure those most in need and at highest risk receive this support as a priority. This guidance must be read in conjunction with the ethical framework for adult social care. The current challenge that local authorities face with COVID-19 means that prioritisation may need to be considered over a longer period with rapidly changing scenarios. This guide has been produced to provide a helpful tool for ASC when considering how to prioritise care and support should the local authority have decided that it needs to operate under the Care Act easements. It is vital that professional judgement and oversight is used, as this document will not provide answers about prioritisation in all scenarios. It aims to help delivery of care and support in a risk-informed way, ensuring everyone, where possible, gets the care and support they require, but that those most in need are prioritised first. Social care is a locally delivered and led service developed on the detailed understanding of individuals and their families and advocates, communities and cultures. Social workers, occupational therapists, and nurses form the core professional group therefore have clear professional responsibilities and accountabilities. Local professional leaders such as PSWs and principal occupational therapists will be key in ensuring this guidance is applied and understood. The skill of these professionals should be used to help develop, agree and review locally agreed processes that would be informed by this guidance. Understanding local care needs and prioritisation Base principle Most local authorities will have mapped all existing known packages for complexity and need and should where possible have also mapped the care and support needs of those that self-fund. It is important that mapping at this stage considers the complexity, risk and level of need within the care package and not just the current delivery. This should allow for a better understanding of the risk should there be an impact on care delivery. This includes considering unpaid carers. This will ensure local authority knowledge of an individual informs any prioritisation work needed, should the situation require it. Local authorities may want to ‘RAG-rate’ their packages and have them split between high, moderate and low (or similar terminology). It is likely that many will have a mixed care package. They should note these but work on the most essential element of care for mapping purposes. Prioritisation If operating under the Care Act easements, local authorities may need to prioritise packages of care and support. In the first instance local authorities would consider those care packages which are already mapped and noted as high and moderate. Prioritising individual care may be fluid, as risk and need levels may fluctuate. New information such as unpaid carer involvement or whether people have now become unwell with COVID-19 will need to be considered. DHSC does not propose to advise local areas on how to prioritise as methods of prioritisation will be unique to each area. The Department also recognises that there will already be well established methods of prioritising in most areas. As set out in the guidance and ethical framework for adult social care, local authorities must retain an approach to working with individuals and carers in a personalised and effective way, ensuring they are engaged in this process as much as possible. Local authorities should take into account all elements of a person’s life that may impact on their needs and their personal circumstances. These circumstances can include social issues such as domestic abuse, financial issues and the vital support of unpaid carers which may not be appropriate or sustainable as a single support in this current climate. Local authorities should also understand what resources, assets/offers the person has at their disposal,
including knowledge of and access to forms of community and neighbourhood support.