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How Needs Can Be Met

1. How needs can be met by the Local Authority

Important to know
'Meeting needs' is an important concept under the Care Act and intentionally moves away from the previous terminology of 'providing services'. It recognises that needs can be met in a variety of ways and that what may meet the needs of one person may not meet the needs of another in a similar situation. The Care Act encourages and expects the Local Authority to take a diverse approach to the meeting of needs.

There are a number of different ways that the Local Authority could decide to meet needs and the Care Act is clear that traditional service led solutions must not be the only option explored.

The following are the examples from Section 8 of the Act showing ways that the Local Authority could meet eligible needs. The list is intentionally not definitive or prescriptive about the exact nature of each method described to allow for a flexible approach to be adopted by the Local Authority:

  1. Information, advice and advocacy;
  2. Care and Support at home or in the community;
  3. Goods and Facilities;
  4. Counselling and other types of social work; and
  5. Accommodation in a care home or in premises of some other type.

When considering how best to meet needs the Local Authority should also have regard to how needs may be met within the person's own resource or local asset base (i.e. beyond the provision, or arrangement, of services by the Authority). For example:

  1. Through universal services;
  2. Through local community groups;
  3. Through informal networks of support;
  4. By other organisations (such as education or health).
Important to know
Any support or services arranged by the Local Authority must be in line with the person's wishes and having regard to the duty to promote individual Wellbeing.

If the Local Authority is aware of any support that the person may be entitled to from another service, organisation or under any legislation other than the Care Act that would meet an identified need it should support the person to access this. For example:

  1. To claim benefits they may be entitled to;
  2. To access health services; and
  3. To access housing support services.

The Local Authority must ensure that it does not arrange services that it is prohibited from arranging under the Act. For details see When the Local Authority may not meet Needs.

Important to know
When considering other means of meeting needs the Local Authority must remember that the duty to meet eligible needs is not discharged just because a person has an entitlement to a different service which could meet those needs, but of which they are not availing themselves. The needs remain 'unmet' (and so the local authority remains under a duty to meet them) until those needs are actually met by the relevant service bring provided or arranged.

In respect to the provision (or arranging of) services, everyone who has needs that the Local Authority intends to meet (either though its duty or powers) will have a personal budget. For information on personal budgets see The Personal Budget.

Personal budgets can be managed in 4 different ways:

  1. By the Local Authority as a managed account;
  2. By a third party as an Individual Service Fund;
  3. By the person or carer as a Direct Payment; or
  4. As a combination of these options.

Each way provides a different level of direct control to the person whose needs are being met about how they are met, with a Direct Payment providing the most autonomy. Wherever possible, the person or carer should be able to choose which method of receiving their personal budget would work best for them.

Regardless of the manner in which the personal budget is being managed, the Local Authority maintains overall responsibility for meeting the eligible needs. This means that should the method being used to manage the personal budget become inappropriate, the Local Authority must arrange one of the alternative methods to ensure the personal budget continues to meet the needs.

2. Brokering Services

Brokerage services may be available in some Local Authority areas and the Care and Support statutory guidance recognises the benefit of Brokerage services for some people and/or where people want to use them.

Brokerage services may be provided internally (by a specific Brokerage service or team in the Local Authority) or externally (through an organisation commissioned specifically for this purpose). Internal brokerage services are normally only available where the Local Authority is going to be meeting needs or arranging services whereas external services may be more widely available to people who arrange their own care.

Brokering involves the Brokerage service:

  1. Identifying potential care providers;
  2. Supporting the person to make a choice about the provider of their care;
  3. Supporting the person to enter into a contract with that provider directly (for example where the person is self funding or using a Direct Payment); or
  4. In the case of an internal brokerage service where the person is not receiving a Direct Payment, entering into a contract with the provider on behalf of the Local Authority.

Where the person has eligible needs, the Local Authority remains responsible for making sure that those needs are being met appropriately. This is regardless of whether services are:

  1. Arranged by the Local Authority; or
  2. Commissioned directly by the Local Authority.
Therefore, effective monitoring of the quality and effectiveness of all services in the local area is important. For further information about how the Local Authority should do this see Commissioning Responsibilities under the Care Act.

3. Individual Service Funds

An individual service fund (or ISF) is one of 3 ways that a personal budget can be managed for the purpose of arranging Care and Support services to meet eligible needs (the other ways are through a Local Authority managed account and through a Direct Payment).

Note: Not all Local Authority areas currently offer ISF’s.

Typically a Care and Support organisation will act as the ISF provider. They will receive the personal budget and either:

  1. Use this to broker appropriate support and services for the person on behalf of the Local Authority, which they then monitor and adapt as required during the personal budget term; or
  2. Provide flexible Care and Support services to the person themselves; or
  3. Provide a combination of both these options.

Where services are arranged by the Local Authority, services that are arranged through an ISF to meet needs should be in line with the person's wishes and have regard to the duty to promote individual Wellbeing.

Example 1:
Marie has a personal budget that is managed by her homecare provider through an ISF. Ordinarily Marie's personal budget provides 12 hours of personal support each week which she uses for personal care, meal preparation and domestic tasks. However, twice a month she likes to go out to a nightclub, which she cannot do without support. Marie has arranged with her homecare provider that twice a month her friend will support her with domestic tasks, meaning that the hours she would have used from her personal budget can be 'banked' and used instead to provide her with the support she needs to go to the nightclub.
Example 2:
Peter has a personal budget that is managed via an ISF by an organisation that the Local Authority has a contract with for this purpose. The organisation provides some of the support that Peter needs directly but has used some of his personal budget to commission social activities that they are not able to provide. The organisation checks that Peter is happy with his social activities and will change them if he is not.

The ISF approach to personal budget management is not currently available in all areas, but where it exists the person with Care and Support needs should be provided with information and advice about how an ISF could benefit them.

Where no ISF offer is available locally, the Care and Support statutory guidance recommends that the Local Authority considers establishing it as an option for people. Additionally, where a person requests an ISF arrangement with a particular provider, this should also be considered, regardless of whether or not the Local Authority has an established a relationship with that specific ISF provider.

4. Pooled Support

Pooled support is mentioned in the Care and Support statutory guidance as one of the ways that the Local Authority can be more flexible about how it provides support and to allow for greater choice and control of the person.

Pooled support is where 2 or more people with Care and Support needs decide to use their combined personal budget to arrange services and support to meet their needs.

Pooled support is more easily achieved when Care and Support is being provided through either a Direct Payment or an ISF.

Example 1:
Ethan, Jake and Haley live in a shared house and receive varying levels of Care and Support from a single provider. Their personal budgets are managed by the provider through an Individual Service Fund. The provider pools their budgets into a combined budget and uses this total budget flexibly. Where hours can be shared they are, and hours that are not used are 'banked'. This means that once each year banked hours can be used to support Jake, Haley and Ethan to have increased support to go on holiday.
Example 2:
6 people who each receive a Direct Payment to support their mental health related Care and Support needs all have an interest in tennis that is unrealised. With their consent the practitioners involved in reviewing the Direct Payments introduce them to each other and they come up with an idea to pool some of their Direct Payments so that they can hire an indoor tennis court every week and meet as a group to play. This supports them all to develop new skills and build social confidence.