Adult Social Care Assessment Guidelines

The  new guidelines for the conduct of Adult Social Care  Assessment, the “Prioritising need in the context of Putting People First: A whole system approach to eligibility for social care Guidance on Eligibility Criteria for Adult Social Care“, must be followed by all local authorities in the conduct of these assessments.

Paragraph 107  provide for the possibility to complain should a service user be unhappy with the conduct of the assessment. When the local complaints process is exhausted, the service user may complaint to the Local Government Ombudsman, or as he is now called the “Local Government and Social Care Ombudsman.” 

F had indeed completed the local complaints process and ended up lodging a complaint with  the LGO, as addressed on the LGO page.

However, there is NO mention of who is responsible for the oversight of the conduct of these assessments and independent external audit of  local authorities’  compliance with the Guidelines.  We could NOT find any information relating to this element of assessment.    This would suggest that local authorities can conduct assessments in a fashion completely suitable to  their agenda.  In order words, assessments could be fixed to suit a particular situation, without  any fear of eventual audit and possible retribution, as none of these exist.

Serious questions exist with the interpretation of paragraph 54, which lists the four Grades: Critical, Substantial, Moderate and Low.  It would appear that each local authority can interpret these as they feel fit.  Therefore, inconsistencies may/do exist and the decision of grading may be a matter of a “postcode lottery”,  devoid of any consistency in social care provision.

One of the conditions of the ‘Critical‘ grading to be satisfied is  if “life is, or will be threatened and significant health problems have developed or will develop...” 

Who is to assess these elements?  A Social Worker, who has no medical qualifications and is expected to assume the role of God, to venture and hazard a guess “when significant health problems will develop?”  Today, next week, next year, when?  This is vague, that, frankly, any member of the human race will in theory qualify for this definition, as eventually, whenever, we will suffer ill health, of some sort.

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Care and Support Plan Review

First of all, let’s establish what service(s) F receives from RBKC:

Since his discharge from hospital in  June 2000, he was  provided with the services of a “domestic carer/cleaner”,  as explained on early events page.

He was provided with these service because of his physical/sensory impairment and NOT because he is HIV+.   The same service would be provided to other service users, irrespective of their HIV status.

Ms Daintith’s tries to give the impression in her letter to F dated 2nd March 2012 that “As you are not receiving a service from us at present, that F was ONLY receiving  the  services of a “domestic carer”.  This is an  a wrong assumption, which Ms Daintith dreamt up, to suit the situation. 

In fact,  F is also in receipt of other “services”, among them assured  tenancy on his accommodation and the maintenance of it.   He also receives Housing and Council Tax Benefit,  Freedom Pass and a Taxi Card.  He can also avail himself of other community services.     FOI Request to RBKC confirmed that these would be considered as “services”.

Social Services are obliged to carry out regular  “Care and Support Plan Reviews” with their service users,   to review their satisfaction, or not,  with the service(s) provided,  as shown on  a Review dated 5th February 2009 – “what are the objectives of the care package.”

These were also carried out by F’s Social Workers between mid-2000 and October 2010.

Although these Reviews provide a space for the service users’ signature, confirming veracity of the information, F was NEVER given the opportunity to do so.  In fact, he was NEVER even given a copy of the Review for his information.   

Therefore, he was NOT at ALL aware what information was actually recorded on these Reviews, which, it is assumed,  resulted from handwritten notes made by the various Social Workers whilst interviewing F about his satisfaction with the “service”.  It MUST be remembered that these interviews are carried out in an atmosphere of CONFIDENTIALITY and therefore requiring to be treated as CONFIDENTIAL.

On 14th May 2011 F asked RBKC for copies of all of his assessment and Care Plan Reviews, which he received on 6th June 2011.

   He found that NOT A SINGLE document was reviewed and signed by him, confirming the veracity and correctness of the information.

He found that, had be been given the opportunity to review these Reviews, he would have NEVER agreed for details of his HIV+  diagnosis and details of its progress to be recorded and eventually made available to whomever.

On review, it came to light that information on these Reviews was either incorrect or incomplete.  It appears that  they  reflect the views of various Social Workers, none of whom had qualifications to deal with service users suffering from sensory/physical impairments, to arrive at a credible opinion, rather than F’s view. 

An example of this inventiveness  is Ms Desmond Owusu’s Care Plan Review  when he visited F on 18th March 2010, the same day Ms Baillie told F that henceforth he will be responsible for the entire cost of his care.  There was no explanation or justification for this decision.  All spaces, which should perhaps should relevant amounts, were blank.

As  Mr Owusu’s visit became irrelevant, particularly  when he suggested to F that he could help him with how to manage his money, F told him leave, which he did a few minutes later.  Yet, he was  able to “create” a Review on 26th March 2010.

In respect of signed Reviews, we asked a few local authorities, who confirmed that all service users are given a copy of their Review.  They are either requested to sign and return the Review, with relevant amendments, if any, or inform the local authority to correct the Review.

Anyway, in ALL CASES, the service  users are given a copy for their records.  THIS WAS NOT THE CASE with  F’s Reviews.  It can be assumed that the practice of NOT  giving a copy to the  service users is widespread and indeed very convenient.  It would be naive to assume that  Ms Baillie was NOT aware of this heinous  practice.

Disclosed HIV relevant information

NOTE: Had RBKC complied with F’s May 2010  amendment to his Information Sharing Agreement and what was in fact a NOTICE in line with paragraph 10  of the DPA, this page would not exist, as there would NOT have been any HIV relevant information to disclose, as it  would have all been removed in May 2010RBKC was not even entitled to ask for HIV relevant information, as confirmed by the Department of Health, let alone record it and make it available to any Tom, Dick, Harry and itinerant bottle washer, without consent

On 18th December 2011, the LGO told F that he had received  from RBKC copies of ‘Care Plan Reviews’ dating back to 2000. The LGO confirmed on 12th January 2012 that he did not ask for these Reviews, as they would be irrelevant to his investigation.

As F had already asked for and received on 6th June 2011, copies of his ‘Care Plan Reviews‘, he became concerned about the content of these Reviews.

It was these, NOT asked for by the LGOCare Plan Reviews which contain not only confirmation of F’s HIV+ status, but also details of the conditions progress, as shown on the “worst” example, completed on 5th February 2009.

What is most upsetting and highly irregular, is that this information was given to the LGO as a result of  Ms Parker’s personal whim,  during a lapse of sanity,  rather than any valid legal reason to do so. 

In her justification dated 22nd February 2012, Ms Parker claimed, as discussed on the disclosure of information page,  that the disclosure was in accordance with paragraph 29 of the Local Government Act 1972, claiming that the LGO had the “powers of the High Court” to compel RBKC to disclose F’s HIV related information.

This statement is INCORRECT.  Paragraph 29 of the LGA 1972 deals with a completely different matter.  Ms Parker should have quoted  the 1974 version of the Act.

However, as F’s HIV related information was  disclosed, the handling of this specific data is protected by the NHS Statutory Restriction on data handling.

Anyway, paragraph 29-(7) of the 1974 Act provides an exemption.

Ms Parker states that the LGO “…asked for a copy of all your “assessment documentation” so that she  could properly consider your complaint.”

Yet, she adds that “Copies of your assessments and care plans were therefore provided.”   However, the LGO told F on 12th January 2012, that he would never ask for the care plans, as they would be irrelevant to his investigation.” 

However, RBKC could not provide justification for sending  LGO 17 pages of F domestic carers/cleaner’s   details of HMRC bonus for the online declaration of his income tax return.  This exchange of emails was due to HMRC error in depositing the bonus into the Direct Payment account, rather than F’s personal account.  This matter was eventually resolved.

 Sadly, this confirms  Ms Parker’s confusion, resulting in an unique event in English legal history: the disclosure of person’s HIV status without the person’s CONSENT.

These documents and information on  them, ended up in what is nothing but a ‘PUBLIC DOMAIN’.   Nobody knows how many copies of these documents, but most importantly, the INFORMATION contained on them are floating around not ONLY RBKC, but also the LGO.  When, in fact, all of this information should have been deleted in compliance with F’s May 2010 Amendment to his Information Sharing Agreement, which RBKC chose to ignore in its entirety.

According to the Department  of Health’s statement dated  26th June 2016, “local authorities  are not entitled to ask for, or routinely receive, an individual’s  confidential medical records, including information about a person’s HIV status”, as discussed on the Collection page 

Had F not asked RBKC for copies of the documents sent to the LGO, he would have NEVER discovered  the handwritten, incomplete, inaccurate, unverified and unsigned assessment document, the ASAQ, allegedly used during F’s assessment process.  

Although RBKC were obliged to tell F that his highly confidential personal and medical information had been disclosed without his consent, this did not happen.   F found that 146 confidential documents were sent to the LGO, not even without his knowledge.   

Furthermore, this confirmed that RBKC chose to completely ignore F’s May 2010 Amendment to his Information Sharing Agreement, which is very clear about not only the disclosure, but also the deletion of F’s HIV relevant information, which RBKC were NOT entitled to have in the   first place, as the Department of Health statement.

 

 

 

 

 

Contact Us – by Webform

Some organisations and others use  a relative newcomer to the means of contacting them – the WEBFORM.

When submitting a Freedom of Information Request to a Government department, the submission is governed by the Freedom of Information Act 2000.

Paragraph  8 – 2- (c) states that  sender should have a copy of his FOI, “capable of being used for subsequent reference.”

However,  when the sender uses the WEBFORM of submitting his FOI,  he encounters  a fundamental problem:

When he completes the ‘webform’, and presses the ‘Submit’ button, the message is sent.  However, at that specific time, he is left with NOTHING to prove that he had actually sent anything at all, Unlike the conventional method of an  outgoing email message, a COPY IS NOT AUTOMATICALLY  placed in the sender’s  OUTBOX.

Therefore, the sender has NO proof  that he had sent anything at all, should be need to follow up on the message or use a copy of it for whatever purposes.

As the recipient of the message is in NO way obliged to confirm the receipt, the sender has no leg to stand on.

We are of the opinion that sender, whoever he may be, should be able to a legally valid copy of his message, sent to to whomever.

DHSC – Contact Us

The only means member of the public may contact the DHSC is via its ‘webform’.

Although the sender may select the topic of his communication, the webform for this submission is same for all.

Information handling is governed by the Data Protection Act and  any requests for information, FOIs, by the Freedom of Information Act 2000.

Paragraph  8 – 2- (c) states that  sender should have a copy of his FOI, “capable of being used for subsequent reference.”

When the sender completes the ‘webform’, and presses the ‘Submit’ button, the message is sent to the DHSC.  However, at that specific time, the sender has NOTHING to prove that he had sent anything at all, therefore  the message is at odds with para 8-2(c).

The DHSC is in NO way obliged to confirm the receipt of the message.  It is obliged to comply with telling the sender if the information is held by the authority and if any fee is due to be levied.

The DHSC has installed relatively recently  almost an instant response system,  sending the individual  a copy of his message.

 

Post Operative domestic help

NOTE:  This event is included on this Blog, as it can be fairly assumed that the unnecessary, unwarranted distress and anxiety  caused by the unauthorised disclosure of his HIV+  status, exacerbated  F’s general health, as referred to in Dr Walsh’s letter, dated  5th February 2014

Update 22nd May 2019:  Ms Cheng, RBKC’s Reablement Team Manager  wrote to F, trying to justify the difference between the “Reablement” and “domestic help” part of the recovery process.  It is clear that she is confused and poorly advised  what F’s “Post-Operation_help” is all about.  She keeps repeating that F was due “Reablement” sessions.  This is not so.    He should have been offered  the “domestic help”, as the Reablement, is provided by the NHS, at its cost and takes place at the Porchester Leisure Centre.  This was thoroughly explained to Ms Cheng in F’s reply.   In the same reply, F sent the requested invoices from the Care Agency, as RBKC has agreed, as gesture of “good will” to reimburse him for these costs.  This will be challenged later on.

During their “Pre-Operation Assessment”, “Pre-Op”, those who are to undergo a  Heart Surgery, are given  the Guy’s and St Thomas leaflet  “Going Home after Your Heart Surgery“. 

Page 19 recommends  that in order to achieve speedy healing of the breastbone,  which was cut apart during his operation and a speedy recovery from the operation as  a whole, the patient should  NOT participate in even mildly strenuous activity.

Although the patient is asked, during the “Pre-Op” assessment,  whether he will have domestic help available for this short period of time, it appears that  the “Pre-Op” department does NOT make any arrangements, should this not be the case, to ensure smooth transfer home after the operation.  It is left to the patient to make the necessary arrangement. 

The patient  has to apply for this temporary service  to his Council’s social services, in what is called a “self-referral”.   This in itself may be quite a hard thing to do, particularly if he is elderly, disabled, or whatever, where he finds this to be a daunting task.  

Therefore, this service, if needed,  should be agreed BEFORE the operation.

Before F went  for his Open Heart operation on 11th November 2018,  he asked RBKC about the current temporary domestic care arrangements for Borough Residents, who  had an ‘Open Heart‘ operation. 

When on 21st November 2018, F did not receive any news from neither the Hospital, nor RBKC’s Social Services, about the status of his request for this help, he sent a  status  enquiry to PALS  at the Hammersmith Hospital.

On 22nd November 2018, Ms Justina, assuming to be a Social Worker at the Hammersmith Hospital, called F and told him to call RBKC Social Services and ‘self-refer’ himself, as it was a private matter.  We do not agree with this statement.

 Later on 22nd November 2018,  RBKC  phoned F and carried out a short assessment.  It became clear that the person who spoke to F had NO idea about this specific unique one-of situation.

He was asked  about ‘information sharing’ and whether he had any ‘other existing medical conditions.’  F refused to give any details, as they were irrelevant to the application. 

At the end of the short assessment,  by whomever, F was informed that RBKC would NOT provide merelydomestic help‘ as F did NOT have any PERSONAL care needs. 

When asked, RBKC refused to confirm this in writing, why this would be so, This is reflected in their reply, when on 22nd November 2018,  RBKC only  sent him a list of  agencies. 

This letter, as it is incomplete, is at odds with a precedent set by the Appeal ruling in Savva v RBKC, which states that letter  should be self-contained,  fully explaining the matter, without referring to anything else.

The mere fact that F had  undergone the Pre-Op assessment and is waiting for his operation, should be adequate justification  to entitlement to this specific service.   

F  found that his temporary post-operative domestic care should have been provided by RBKC, if asked for,  irrespective whether he received PERSONAL CARE OR NOT

In order to ensure that the patients  receive the recommended DOMESTIC CARE, the  “Pre-Op” team  should  record on patient’s file that a  reliable help to assist him with his every day chores, for about six weeks, will be available.

For those living alone, or unable to arrange for this short term service,  the “Pre-op” team  should issue instructions   to  the patient’s Council social services to arrange, in principle,  for this short term service.  Dates and scope of the service to be decided later.

This would remove the possible difficulty that may emerge on the discharge date, when it may become  clear that the necessary help is NOT in place.  The individual may have to remain in hospital for undefined time,  BLOCKING the much needed BED.  This should be of a specific concern, if the individual is elderly, frail, or just appears unable to cope.

It is of paramount importance that a satisfactory  outcome of  what is a major surgery, in F’s case costing about £30,000,  is achieved.  Otherwise,  it could be seriously  compromised  by Council’s  refusal to provide the temporary help, in F’s case costing about £ 400.00

On 28th March 2019, he wrote to Ms Jordan Griffith-Brown of RBKC’s Social Services, on the matter. Let’s see what the NHS London and the Department of Health and Social Care have to say in this matter.

It is sad that such a confusion exists at RBKC over such an important short-term social services facility.   This becomes even more serious, when  it is considered that those who undergo this kind of an operation, are  often elderly and by the nature of the conditions, quite frail.  Individuals may end up in undesirable, even dangerous situation, relating to  their post-operative care.

The Bottom line:  We feel that the “Pre-Operation Assessment” process should ensure that the temporary domestic help of about six weeks is  clearly arranged at this stage, rather than leaving it until the operation time.  

The patient’s local authority  should be instructed of this service, so that arrangements  could be put in place;  and if needed, the necessary funding arrangements made.  

The patient’s file should clearly reflect the fact that he DOES or DOES NOT require this short term service.  It  is much easier to cancel the provision, rather than run around on the day of discharge, trying to make these arrangements, when it may become evident that care agencies may NOT have spare manpower to arrange this at short notice.

This will ensure that arrangements are in hand and will “kick in” when the patient is discharged from hospital.  Thus, preventing any possible “bed blocking”, resulting from the failure to arrange the home help.

 

 

 

 

 

 

 

Attempt to shut us up

When F realised that the ‘acquisition‘ of his HIV related information, was as serious a matter as its ‘disclosure‘, be asked in 2013 for the Blog to be taken out of  the ‘public domain’.  

The intent was to amended it,  including information after relevant enquiries were made relating  to its acquisition.

Suddenly, out of the blue, on 26th February 2015, F received a letter from Mr Vimal Sarna, HF&F solicitor, issued at the request of the Director of Adult Social Services, who was at that time, Ms Stella Baillie.

The letter told F that distress and anxiety was caused to the Director by the Blog.

Knowing that the Blog was taken out the circulation long ago, in 2013, on 27th February 2015, F asked for links/evidence of this Blog.

On 2nd March 2015, Mr Varna confirmed the Blog’s removed.  It was NOT removed as a result of his vacuous threat of a Court action, but way back in  2013, to amend it.

On 4th March 2015, F replied to Mr Varna, which did not elicit a reply of any sort. It confirmed the stupidity of this specific action.

On 5th March 2015, F informed RBKC’s Chief Executive about  Social Workers’ legal obligations to their clients, just  in case these facts  have evaporated from his memory, should they ever been there in the first place.

Nothing more was ever heard  from  these colourful individuals.

 

Legal matters

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Full text is available here:WORDPRESS BLOG Legal responsibilities

Signatures on documents

When F received copies of his  never seen before Care Plan Reviews and the October 2010 Assessment, he found that NONE were signed by him.

F asked Mr Leak why  F was NOT asked to verify and sign the ASAQ.  He was told that as a Social Worker was present, it was NOT necessary for  F to sign it,  confirming  veracity of his answers. This would suggest that other individuals were also NOT asked to verify and sign their ASAQ’s. 

This might also suggest that not only F’s ASAQ  but  that  of others may have been competed whenever, by whomever and wherever, without  the assessed individual being aware.  The ASAQ  scored to reflect the desired outcome/total.

F asked the Disability Law Advice centre about this matter.  He was told that unverified  and UNSIGNED  assessment document IS NOT WORTH THE PAPER IT IS WRITTEN ON AND SHOULD HAVE NEVER BEEN USED IN AN ASSESSMENT PROCESS, as it is unsafe and unreliable.

As F could not find any information,  on 29th July 2014, he asked senior Professor in Law about this point.

Professor Chalmer’s reply  is interesting.  It is clear that RBKC by not asking anyone to sign their  documents, expose themselves to criticism and inability to prove that the documents were completed in the individual’s presence.

Mr Leak may have been right, but the caveat here is that,  as long as the document remains UNSIGNED, BOTH parties MUST be SATISFIED with the answers.  However, as soon as either party disputes them, the documents becomes legally unsafe, as there is NO proof that the service user had seen the document, let alone agreed with its content.

This situation is avoided, by simply NOT giving the service user a copy of the Review.  Job done.

He sent a number of FOI Requests to local authorities, regarding the necessity for a signature of the Care Plan Reviews.   From the replies received, the one from Waltham Forest on  16th July 2015  is a typical reply.  It states that the service users  get two copies of their Reviews; they are asked to sign one, confirming veracity of the information.

 

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