The Care and Support Plan

1. What is a Care and Support Plan?

Whenever the Local Authority intends to meet needs under either its duty or powers, Section 24 of the Care Act requires it to prepare a Care and Support Plan.

A Care and Support Plan is a document prepared by the Local Authority which specifies:

  1. The needs identified by the needs assessment;
  2. Which of those needs are eligible ( applying the national eligibility criteria); and
  3. Which needs the Local Authority is going to meet and how it is going to meet them.
Important to know
The Local Authority has a duty to meet eligible needs (apart from needs being met in a care home where the person has financial resource above the upper limit) and a power to meet all other needs.

2. The Information that a Care and Support Plan must contain

Under Section 25 of the Care Act the Local Authority must ensure that a Care and Support Plan contains the following information:

  1. The needs identified by the needs assessment;
  2. Which of these needs meet the national eligibility criteria;
  3. Which needs the Local Authority is going to meet and how it is going to meet them;
  4. The personal budget (see The Personal Budget);
  5. Advice and information about what can be done to meet or reduce the needs in question;
  6. Advice and information about what can be done to prevent or delay the development of needs for Care and Support in the future; and
  7. Where a Direct Payment is to be provided, the needs that are to be met by the Direct Payment and the amount and frequency of the Direct Payment (see Direct Payments).
It can also be useful for the Care and Support Plan to contain further information about the person's Wellbeing and the outcomes they would like the plan to help them to achieve. The Local Authority has a duty to promote Wellbeing and including it within the plan can help them to give proper consideration to how they can do so.

3. Who should be Involved in Preparing a Care and Support Plan

In preparing the Care and Support Plan the Local Authority must involve:

  1. The person for whom it is being prepared;
  2. Any other individual who the person has asked the Local Authority to involve;
  3. Any carer that the person has; and
  4. Where the person lacks capacity any other individual who appears to the Local Authority to be interested in the person's welfare.

Some people will want to be more involved in their plan than others. Some people may wish to actually create their plan, either independently or with the support of another. The Care Act gives the Local Authority the power to authorise the person or anyone else to prepare the plan jointly with it if it considers this appropriate.

Where the Local Authority has authorised the person or other to prepare the Care and Support plan jointly with it, it must facilitate this by providing relevant information about the person.

InvolvingĀ  a person who has substantial difficulty or lacks capacity

Some people will have substantial difficulty being involved in the Care and Support Planning process. Others will lack capacity. The Local Authority has a duty to determine who these people are and to provide independent advocacy to facilitate their involvement. For further information about the advocacy duty, including how to establish substantial difficulty see The Duty to Provide an Independent Advocate.

4. Preparing the Plan

Important to know
The Care and Support Plan 'belongs' to the person it is intended for, with the Local Authority’s role being to ensure the production and sign-off of the plan and that it is appropriate to meet the identified needs to be met.

Ultimately, the guiding principle in the development of the plan is that the process should be person-centred and person-led, in order to meet the needs and achieve the outcomes of the person in ways that work best for them as an individual or as part of a family.

Both the process and the outcomes should be built holistically around people's wishes and feelings, their needs, values and aspirations, irrespective of the extent to which they choose or are able to be actively involved in the process.

During the Care and Support planning process the Local Authority should support the person (and their carer or advocate) to explore:

  1. The range of Care and Support options available to them; and
  2. The methods of managing Care and Support available.

The Indicative Personal Budget

The indicative personal budget amount should be shared with the person, and anybody else involved, at the start of Care and Support planning.

Providing an indicative budget enables the person and their advocate (if they have one), to exercise greater choice and take control over how their Care and Support needs are met. It means knowing, before Care and Support planning begins, an estimate of how much money will be available to meet a person's assessed needs.

The budget will be revised and refined through the process to reach the final personal budget amount. Those involved should be made aware that the budget can go both up and down as a result of the Care and Support planning process.

For information about how the indicative personal budget amount should be calculated see Deciding the Indicative Budget and Personal Budget Amounts.

How to decide the method of managing the Personal Budget

One of the decisions that must be made made when preparing the Care and Support Plan is how the personal budget will be managed.

The person carrying out the Care and Support planning process must be able to provide good, accessible information and advice about the different ways that a personal budget can be managed so that the person can make an informed decision about what would work best for them.

Whatever method of managing the personal budget is agreed the Local Authority must be able to amend this at any point should it no longer be appropriate or desired.

Specifically, the Local Authority is expected to promote the use of Direct Payments, as this provides the maximum level of choice and control. The ability to meet needs by taking a Direct Payment must be clearly explained to the person, so that they can make an informed decision about whether they wish to take this option. This may mean offering the choice of a Direct Payment more than once during the planning process and enabling that choice by providing examples of how others have used direct payments, including via direct peer support from user-led organisations, for example.

For more information about Direct Payments see Direct Payments.

For more information about the different ways that a personal budget can be managed see Managing the Personal Budget.

How to decide the best way to meet needs

The Care Act recognises a wide range of methods for meeting needs and expects the Local Authority to be open to exploring all that appear relevant.

For further information about the range of ways that the Local Authority can meet needs see How needs can be met by the Local Authority.

5. Signing-Off the Care and Support Plan

The Local Authority must take all reasonable steps to reach an agreement with the person for whom the plan is being prepared about how the Local Authority should meet the needs in question and the method of managing the personal budget.

In seeking to ensure that the plan is proportionate to the needs to be met, the Local Authority must have regard to:

  1. The Wellbeing of the person;
  2. The outcomes that the person wishes to achieve in day-to-day life; and
  3. To what extent the Care and Support provision could contribute to the achievement of those outcomes.

If it is not possible to reach an agreement about the Care and Support Plan, the person should be provided with information about the complaints process.

Deciding the Personal Budget Amount

One of the considerations when signing-off the Care and Support Plan is the cost to the Local Authority of the plan. This cost will be the final personal budget amount (before any financial contribution by the person is taken into account).

For information about deciding the personal budget amount see Deciding the Indicative Budget and Personal Budget Amounts.

When the final personal budget amount is agreed, the Local Authority should ensure that the Care and Support plan contains all of the required information relating to it:

  1. The cost to the Local Authority of meeting the eligible needs it is either required to do (under its duty) or decides to do (under its powers);
  2. The amount which, on the basis of the financial assessment, the person must pay towards the cost; and
  3. The amount which the Local Authority is going to contribute towards the cost.

6. Who to give a Copy of the Plan to

The Local Authority must give a copy of the Care and Support Plan to:

  1. The person for whom it has been prepared;
  2. Any other the person has asked the Local Authority to give a copy to; or
  3. Where the person lacks capacity any other person who appears to the Local Authority to be interested in the person's welfare.

7. Combining a Care and Support Plan with another Plan

The Care Act permits the Local Authority to combine a Care and Support Plan with a Support Plan or with any another plan of any kind. However it must only do this when:

  1. The person/carer for whom the plan is being written agrees; or
  2. The person for whom the plan is being written lacks capacity but the Local Authority makes a best interests decision to that effect.
Example:

Clare is receiving services under Section 117 of the Mental Health Act. She is being supported using the Care Programme Approach, and has developed a detailed Care Plan with her care co-ordinator containing all of the following information:

  1. The medical, nursing, psychological and other therapeutic support she will receive;
  2. The action that will be taken to address physical health problems or reduce the likelihood of health inequalities;
  3. The details of how she will be supported to achieve her personal goals;
  4. The support she will get in relation to social needs such as housing, occupation, finances etc;
  5. The support her carer will get; and
  6. Contingency planning should she become unwell.

Clare, her care co-ordinator, her carer and the Local Authority agree that it would be beneficial and appropriate to combine this Care Plan with the Care and Support Plan as much of the information is the same and Clare does not wish to go through a separate planning process with the Local Authority.