Cross Border Placement

A Cross Border Placement describes the placement (into a residential or nursing care home) of a person with eligible Care and Support needs by one Local Authority into a provision located in another country of the UK (England, Wales, Scotland, Northern Ireland). It also applies when a person is placed into a Shared Lives scheme in England by a Local Authority in Wales, Scotland or Northern Ireland.

Cross Border Placements can occur when a person has extremely complex needs and there is no suitable provision in the country of the Local Authority arranging their Care and Support. They can also occur when a move will take the person closer to their family networks for the purpose of promoting their Wellbeing.

As a general rule, people who are placed into a Cross Border Placement remain ordinarily resident in the first Local Authority, meaning the meeting of their eligible needs remains the responsibility of that Authority. This applies regardless of the placement duration.

The Cross Border Placement arrangements are set out in Schedule 1 of the Care Act 2014 and enables local authorities in different countries of the UK to work collaboratively in arranging and managing cross border placements.

Important to know

The 4 countries of the UK developed and agreed the Cross Border Placement provisions together. At their centre are 2 guiding principles:

A person centred Process, focussing on the Wellbeing of the person
Reciprocity and Co-operation

Step 1: Care and Support Planning

As part of the Care and Support Planning process the subject of a placement in another area of the UK may arise. When it does there are key questions that the Local Authority must explore with the person (and their family and professional networks with consent) before pursuing the possibility further:

Would the support network in the area of the proposed new placement improve (or at least maintain) the person's Wellbeing?
What effect might the change of location have on the person's Wellbeing? How well are they likely to adapt to their new surroundings?
Is the person in receipt of any specialist health care? Will the locality of the proposed new placement allow for the satisfactory continuation of this treatment?
Where the person lacks the mental capacity to decide where to live, who is their representative? The representative should be consulted and involved.

The Local Authority must also explain to the person during this step, the implications of a cross border placement in terms of the management of their provision (including the need to share information and potentially delegate key Care and Support functions to the Authority in that area) and the likely choice of provision available.

Step 2: Initial Liaison between First and Second Authority

Once the placement has been agreed in principle and the Authority has identified a potential provider they should immediately contact the Local Authority in whose area the placement will be made to confirm the intention, potential date and provider.

When requested, the 2nd Local Authority should provide the placing Authority with any details regarding the proposed placement, particularly whether there are any concerns about the quality of care or safeguarding.

Important to know

On occasion the 2nd Authority may not be best pleased about the potential placement due to the impact on its own local resources. However, the 2nd Authority is not responsible for commissioning the proposed placement so therefore has no powers to block it. Instead, the guidance stipulates a co-operative approach to resolving any issues before proceeding with the placement.

Important to know

The Local Authority arranging the placement is responsible for doing so in the same way as it would do so if arranging a local placement.

Step 3: Ongoing Management of the Placement

In the same way that the Local Authority is responsible for the management and review of any placement it arranges in its own area, it is also responsible for the management and review of any Cross Border Placement it arranges. This can present many practical difficulties purely because of the distance between the placement and the Local Authority itself. Statutory functions such as Review and Reassessment become more difficult and, if the person has particularly complex needs, regular wellbeing visits and joint work with health professionals local to where the person lives may not be logistically possible.

As such, the Regulations allow the placing Authority to make arrangements in advance for the 2nd Authority to undertake non-statutory day-to-day placement management functions (for example joint work with health, urgent liaison with the placement and the person). A cost for these functions can also be agreed at the discretion of both authorities.

While non-statutory functions can be delegated all statutory functions, such as Review remain the responsibility of the placing Local Authority. Under the Care Act it can request the assistance of the 2nd Authority in gathering information to support this function (including recommending a course of action to be considered by the 1st Authority) but ultimate responsibility rests with the placing Authority.

Step 4: Confirmation of Placement

If the person and their family is not able to arrange transport of the person and their belongings to the new placement then the placing Local Authority should make all the arrangements, including meeting the costs of such if the person does not have the means to pay.

When the placement commences, the placing Local Authority must notify the 2nd Authority in writing and confirm the arrangements that have been agreed previously in relation to the day-to-day management of the placement.

Provider Failure

Should the provider of the placement in which the person is placed fail the 2nd Authority has the power (and depending on the Country, a duty) to intervene and arrange alternative provision (arrangements to recoup costs should be made subsequently).