Carrying out the Review

1. The Timing of a Review

Under Section 27 of the Care Act 2014, the local authority must keep Care and Support / Support Plans under periodic review. This means they must have a system or process in place to ensure that reviews are carried out and monitored in a manner appropriate to the needs and circumstances of the person / carer whose plan it is.

Because every person / carer is different, the Care Act does not specify the frequency in which a Care and Support / Support Plan review must take place. However, the Care and Support statutory guidance does expect the local authority to endeavour to carry out a review as follows:

1. A review of a new service or Care and Support / Support Plan should be carried out within 6-8 weeks of the service/change commencing;
2. A review of an on-going stable Care and Support / Support Plan should take place no less than 12 months after the date of the 6-8 week review, and then no less than once every 12 months after that;
3. Where the person’s / carer's needs or circumstances are likely to change reviews should be arranged as required to monitor the situation and respond to changes in a timely way (thus keeping the plan under review).

Direct Payment Reviews

Reviewing a Direct Payment is not the same as reviewing a Care and Support/Support Plan. Where the person is managing their personal budget through a Direct Payment any reviews of the Direct Payment should normally coincide with the Care and Support/Support Plan review.

For details about the Direct Payment Review see Reviewing a Direct Payment.

2. Different Routes of Review

There are several recognised routes to reviewing a Care and Support Plan/Support Plan.

A Planned Review

Planned reviews are agreed and set as part of the Care and Support Planning process or through general monitoring. Because they are planned, both the Local Authority and the person receiving the Care and Support (or the carer receiving Support) are able to prepare for the Review and information about what to expect from the review can be provided in a timely way.

An Unplanned Review

Unplanned reviews result from a sudden change in need or circumstance, such as the person going into hospital or becoming unwell. As soon as the Local Authority becomes aware of the change and the possibility that the current Care and Support Plan/ Support Plan may need to be revised it should arrange to carry out the review. Because the unplanned review is exactly that, the person/carer will not be as prepared for the review as they would have been had they known it was going to occur. Consequently, consideration should be given to how best to prepare them and any additional support they may need to engage in the review process.

A Requested Review

This is where a person receiving Care and Support, the carer or any other party requests a review of the Care and Support/Support Plan. The Local Authority should consider all requests for a review and has a duty to carry out a review when the request is reasonable. The Care Act expects the Local Authority to have a clear process for considering requests for a review so that decisions are made fairly and consistently.

3. Methods for Carrying out a Review

The review should be:

1. Accessible to the person/carer whose review it is; and
2. Proportionate to the needs being met by the Care and Support Plan/Support Plan.

Often the nature of the review method is determined by the likely outcome of the review process at the time that the review request was made or the Care and Support/ Support Plan was scheduled for general review. In all cases, the review should be performed in a timely manner and reflect the views and wishes of the person/carer about how the review should be carried out.

The Care and Support statutory guidance describes a range of review options that should be available:

1. Self Review;
2. Peer-Led Reviews;
3. Reviews conducted remotely (for example by telephone or email); and
4. Face-to-Face reviews.

Light touch reviews

4. What should be Included in a Review

The review process should be person centred and outcomes-focussed. It should always involve the person and any carer they have.

The following broad elements should be included in all reviews, regardless of the method of review. Wherever possible, the person whose review it is should be aware of these before the review process begins:

1. Have the person/carer's circumstances and/or Care and Support or Support needs changed?
2. What is working in the plan, what is not working, and what might need to change?
3. Have the outcomes identified in the plan been achieved or not?
4. Does the person/carer have new outcomes they want to meet?
5. Could improvements be made to achieve better outcomes?
6. Is the person/carer's personal budget enabling them to meet their needs and the outcomes identified in their plan?
7. Is the current method of managing it still the best one for what they want to achieve (for example, should direct payments be considered)?
8. Is the personal budget still meeting the sufficiency test?
9. Are there any changes in the person/carer's informal and community support networks which might impact negatively or positively on the plan?
10. Have there been any changes to the person/carer's needs or circumstances which might mean they are at risk of abuse or neglect?
11. Is the person, carer, independent advocate or other person involved satisfied with the plan?

5. Reviews When a Person has Substantial Difficulty or Lacks Capacity

Where the person/carer has substantial difficulty in being involved in the review, and there is no appropriate person to facilitate their involvement, they are entitled under the Care Act to independent advocacy.

Where a person with Care and Support needs lacks capacity they may also be eligible to advocacy under the Mental Capacity Act.

For information about the duty to provide independent advocacy and different types of advocacy that may be appropriate during a review see The Duty to Provide an Independent Advocate.

6. Who can Carry out a Review

General Requirements

Although not strictly required, the person carrying out the review of a Care and Support/Support Plan should meet the requirements of a person who carries out an assessment. This is so that the person has the necessary expertise to recognise when a reassessment may be required. In summary, these are that:

1. The person must be competent to carry out the review function of the Local Authority;
2. The person must have the skills, knowledge and competence required to carry out the review based on the person's specific needs (for example the skills to adapt their communication to support a person with a learning disability, or the ability to work confidently alongside other professionals); and
3. The views and wishes of the person/carer about the skills of the person carrying out the review must be taken into regard.

Where the person/carer has a diagnosis of Autism or is Deafblind additional requirements apply. For details of these and information about all of the requirements to be considered when deciding who should carry out a review see Who Should Carry Out the Assessment?

Delegating reviews

The Local Authority retains responsibility for making sure that general reviews are carried out, that any required revisions are made to the Care and Support/Support Plan and that eligible needs continue to be met. However, the Care and Support statutory guidance does allow for the Local Authority to delegate the physical act of review to another party if it considers this to be appropriate. In all cases the Local Authority should still assure itself as to the outcome of the review and operate a sign-off approach. The people that the Local Authority could delegate the review to include:

1. The person receiving the Care and Support/Support;
2. A service provider;
3. Another professional (for example a health professional); and
4. Another Local Authority (for example, when people live in a care home in another Local Authority area).

Where the Local Authority requests another person or agency carry out a review on its behalf that agency or person is generally obliged to co-operate with the request. For information about the duty to co-operate see Co-Operation.