Actions Following a Reablement Review

In the following circumstances plans should be made to end reablement:

1. It is no longer deemed appropriate through a process of review;
2. All of the outcomes in the Reablement Plan have been achieved; or
3. The person no longer consents to reablement (and has capacity to do so).

Reablement may also no longer be appropriate when:

1. The person has not been able to demonstrate an ability to 'carry over' learning from one day to the next;
2. The person has not been open to being supported in an enabling way; or
3. The person has not demonstrated a desire to become more independent.

Decisions to end reablement (including the timeframe to end reablement) must give regard to:

1. The views of the person about ending reablement;
2. The impact of ending reablement on the person's Wellbeing;
3. The views of any carer about ending reablement; and
4. The views of anyone else consulted or involved in the review process.

The decision about the timeframe to end reablement should take into account:

1. Whether there are any outstanding outcomes to be met by reablement and how long it may take to do so;
2. Whether there were any actions agreed in the review for the reablement service to carry out before ending reablement (for example supporting a person to access a community activity or arrange alternative support);
3. Whether any on-going needs are already being met through an existing Care and Support Plan; and if not
4. How long it may take to carry out the Care and Support processes required to determine the eligibility of needs; or
5. How long it may take to arrange urgent or interim Care and Support; and
6. Whether specific transitional arrangements between reablement and any new service are required.

It may be useful to develop a formal withdrawal plan to monitor outstanding actions and progress towards meeting on-going needs so that reablement ends at an appropriate time.

If, following review it is clear that the person no longer has any appearance of need at all the duty to carry out any further assessment, determine eligibility and meet eligible needs does not apply.

In this situation you must:

1. Explain to the person that they do not have an appearance of need so are not eligible for further assessment or support from the Local Authority at this time;
2. Provide information and advice about what can be done to prevent or reduce the development of needs in the future;
3. Explain what they should do if their needs change;
4. Carry out any outstanding actions agreed at review; and
5. Arrange to end reablement.

All of the above information should be provided in writing when it is originally communicated via telephone.

If the person disagrees

The only ground upon which the Local Authority can lawfully refuse any adult an assessment is where there is no appearance of need. It does not matter whether the appearance of need is likely to prove eligible after any assessment. As such, it is unlikely that many people who request an assessment will be refused.

If the person does not agree with any decision that you have made that they do not have any appearance of need you should discuss this with your line manager to be sure that the decision to refuse an assessment is legally sound.

Note: Under no circumstances must you ignore on-going needs or close the case. The Local Authority has a duty to determine the eligibility of assessed needs and to meet eligible needs and is in a breach of the Care Act if it fails to do so.

If the person has a Care and Support Plan that is meeting all needs there is no further action required, other than notifying the allocated practitioner or service/team responsible for reviewing the plan of the reablement outcome.

If the person has a Care and Support Plan that does not appear to be meeting the person's needs a review of the plan should be carried out.

If the person does not have a Care and Support Plan you will need to determine eligibility and, if eligible carry out a Care and Support Planning process

You can proceed to end reablement when:

1. There are no outstanding actions for the reablement service following the review;
2. The person has been provided with all information and advice required (or that would be beneficial);
3. Steps have been taken to ensure that any eligible on-going needs for Care and Support will be met from the time that reablement ends (either through urgent/interim services or through Care and Support planning).

Bromley Council's Occupational Therapy service can help find solutions to keep people safe and independent in their own homes. The team consists of Occupational Therapists, Occupational Therapy Assistants and Moving and Handling Risk Assessors.

For more information, please see the Occupational Therapy webpages.

Assistive technology refers to Technologies (devices or systems) that maintain or improve independence or reduce risk to wellbeing.

Telecare is the term used to describe the range of equipment that can alert a call centre in a range of circumstances, e.g. if a person falls, leaves their home unexpectedly, or needs assistance. Bromley Carelink service is a 24-hour alarm scheme that helps vulnerable people to remain safely in their own home by enabling them to summon help in an emergency.

For more information, please see the Assistive Technology and Telecare Procedure, and the Carelink and Assistive Technology webpages.

Please see the Local Resources area for more information on setting up Assistive Technology and Telecare in Bromley.

Deaf Plus

Bromley Council commission Deaf Plus to offer a wide range of services to individuals with hearing loss, to develop their potential and promote independence and wellbeing. Services include:

• Information and advice;
• Advocacy;
• The provision of equipment to aid independent living;
• Hearing loss support;
• Training.

For more information about Deaf Plus, or to make a referral, please see their website and contact details below:

Website: www.deafplus.org/advice
Tel: 020 7790 8478
Email: information@deafplus.org

Bromley Technical Officer for people who are deaf, deafened and hard of hearing

A range of assistive technology equipment is also available for people who are deaf, deafened, and hard of hearing from the Bromley Technical Officer, on loan and free of charge. This includes:

• Doorbell alert;
• Personal amplifier;
• Alarm clocks;
• Baby monitor;
• Smoke alarms.

Referrals should be made via the Initial Contact Team.

Kent Association for the Blind

Bromley Council commission Kent Association for the Blind (KAB) to hold the formal register for adults and children who are registered Sight Impaired (Partially Sighted) and Severely Sight Impaired (Blind).

KAB provide a full rehabilitation service for adults with sight impairment to enable people to be as independent as possible. This service includes advice, support, equipment and training in mobility and daily living skills. Social clubs, assistive technology support and awareness training are also available.

To make a referral to KAD for Sight Impairment (or Deafblind) assessment, please complete a Contact or OT Referral Form.

For more information about KAB, or to make a referral, please see their website and contact details below:

KAB website: www.kab.org.uk
Simply Connect directory (for local KAB information): bromley.simplyconnect.uk

Tel: 0208 464 8406
Email: rehab.bromley@kab.org.uk
Address: Community House, South Street, Bromley, Kent, BR1 1RH, United Kingdom

If, as part of any conversation you have with a person or their family you become concerned that a vulnerable adult or a child is experiencing, or at risk of abuse or neglect you must respond appropriately.

See Safeguarding Adults, which also includes information about how to raise a children's safeguarding concern.

If you are concerned that an adult or child is in imminent danger from abuse or neglect, or that a criminal act has taken place you should contact the police by dialling 999.

Where the safeguarding is in respect of the person receiving reablement a decision will need to be made about the need to pause the reablement process to allow a safeguarding enquiry to take place.

There are 2 possible options:

1. The reablement process continues alongside any safeguarding process; or
2. Reablement is paused with no on-going intervention by the person whilst a safeguarding process takes place.

Any decision should involve the reablement service, the person who will be carrying out any safeguarding process, the person with Care and Support needs (or their representative) and any carer.

You must consider any appropriate action required to authorise deprivations of liberty whenever:

1. The person lacks capacity to make decisions about the Care and Support provided to them; and
2. You feel the level of restriction being imposed on the person is depriving them of their liberty; or
3. You feel the level of restriction required to meet their care and support needs following assessment is likely to deprive them of their liberty.

See: Recognising and Responding to Deprivations of Liberty.