In this article, Clare Carter of Avon & Bristol Law Centre advises practitioners on the work of the Law Centre in Community Care Law. Of course, this valuable work is under threat from cuts in funding.
As community care law practitioners we advise and represent a diverse range of the most vulnerable people in our community who need help from social services and/ or the NHS. Whether, and indeed how, any needs are met is subject to such a nebulous and complex mixture of statute and guidance that in 2009 the Law Commission condemned the current legal framework as being ‘inadequate, often incomprehensible and outdated’. (Law Commission 2008 adult Social care: Scoping Report. London p129).
Our clients may, due to age, illness or disability, be in need of practical help from social services to manage their day to day personal care such as washing; dressing; and preparing food; and we, or our relatives may well find ourselves needing that help at some point in our lives. We can help to obtain an assessment or to challenge a refusal or inadequate service decision. Here are some examples of our work:-
Community Care Assessments
Mrs P, aged 84 is registered blind; hard of hearing; and cannot use her hands or mobilise unaided due to rheumatoid arthritis. She had been housebound for 3 years and required assistance with washing; dressing; toileting; transfers; food and drink preparation; walking; reading; operating tv controls; laundry & housework. Having been in receipt of a social services direct payments which allowed her to live in her own home; her needs were reassessed. As a result her support hours were slashed from 28 hours per week to 10 hours per week meaning she would have to go into residential care instead. The decision was so irrational and unreasonable that we threatened the council with Judicial Review proceedings if they did not reconsider the decision. Our client’s needs were reassessed by a different social worker, and her original support package was reinstated in full.
Children in local authority care
K was a vulnerable 17 year old who had been in care since he was 5. The housing authority and social services departments bounced him backwards and forwards between their respective offices for 2 months. Each stated that he ‘wasn’t their problem’. Meanwhile he slept on the streets and in garden sheds.
The Children Act 1989 is clear that our client was entitled to support from social services, ‘to the extent to which [his] welfare required it’ potentially until he was 24. Sadly it took our application for Judicial Review; an Interim Order that he be accommodated and supported pending a full hearing; and a permission hearing; before social services accepted their duty towards him. The outcome – our client received supported accommodation; and a detailed ‘Pathway Plan’ setting out how his needs in relation to housing; education; money/ benefits; social and living skills; family and relationships; and personal safety and health/ wellbeing would be met in the future.
Continuing Health Care Funding
Mr S is a self-employed company director who had early onset dementia causing severe behavioural problems. A stroke had left him unsteady on his feet; doubly incontinent; and unable to communicate. He needed complex 24 hour care, frequently on a 2:1 basis. Social services identified suitable residential care in a nursing home and his wife started paying the weekly charges, in excess of £600 per week. She set about putting their family home on the market to meet the cost.
The family were helped to submit a challenge to the PCT and to social services in respect of the failure to assess Mr S’s needs and entitlements correctly. This led to the Primary Care Trust fully reimbursing all costs already paid by the family and accepting the duty to fund on-going residential care until a change in his needs, or the passing of time, triggered a need to reassess the arrangement.
For more information about our community care work please contact Caroline Miles at email@example.com