This chapter provides information for multi-agency practitioners in relation to how local agencies must work together, with the aim of preventing, delaying or reducing needs and promoting the wellbeing of adults with care and support needs.
RELATED SECTIONS AND CHAPTERS
- 1. Introduction
- 2. Integrating Care and Support with other Local Services
- 3. Multi Agency Working: Preventing Abuse and Neglect
- 4. Integration and Cooperation: Safeguarding
- 5. Strategic Planning
- 6. Cooperation of Partner Organisations
Under the Care Act 2014, the local authority has a duty to carry out their care and support responsibilities – including carer’s support and prevention services – with the aim of joining up services with those provided by the NHS and other health related services, for example, housing or leisure services.
The duty applies where the local authority considers that integration of services would promote the wellbeing of adults with care and support needs – including carers, contribute to the prevention or delay of developing care needs, or improve the quality of care in the local authority’s area.
2. Integrating Care and Support with other Local Services
There is a requirement that:
- the local authority must carry out its care and support responsibilities with the aim of promoting greater integration with NHS and other health related services;
- the local authority and its relevant partners must cooperate generally in performing their functions related to care and support; and supplementary to this;
- in specific individual cases, the local authority and its partners must cooperate in performing their respective functions relating to care and support and carers wherever they can.
This applies to all the local authority’s care and support functions for adults with needs for care and support and for carers, including:
- preventing needs;
- providing information and advice (see Information and Advice);
- shaping and facilitating the market of service providers;
- safeguarding (see Safeguarding Enquiries);
- cross border placements (see Cross Boundary and Inter-Authority Enquiries);
- transition to adult care and support (see Transition to Adult Care and Support).
The local authority is not solely responsible for promoting integration with the NHS, and this responsibility reflects similar duties placed on NHS England and clinical commissioning groups (CCGs) to promote integration with care and support. There is also an equivalent duty on local authorities to integrate care and support provision with health related services, for example housing.
3. Multi Agency Working: Preventing Abuse and Neglect
See also Preventing Abuse and Neglect
Safeguarding adults from abuse and neglect is a fundamental part of the Care Act 2014. Identification and management of risk is an essential part of any assessment undertaken by a professional working with adults.
As noted above, the local authority must cooperate with its partners, and those partners must also cooperate with the local authority to provide care and support, and safeguard adults.
Relevant partners of the local authority include neighbouring authorities with whom they provide joint shared services and the following agencies or bodies who operate within the local authority’s area including:
- NHS England;
- NHS trusts and NHS foundation trusts;
- Department for Work and Pensions;
- the police;
- probation services.
The local authority must also cooperate with such other agencies or bodies as it considers appropriate in exercising its adult safeguarding functions, including (but not limited to):
- general practitioners;
- NHS hospitals;
- housing, health and care providers.
All agencies should stress the need for preventing abuse and neglect wherever possible. Observant professionals and other staff making early, positive interventions with individuals and families can make a significant difference to their lives; preventing the deterioration of a situation or the breakdown of a support network. It is often when people become increasingly isolated and cut off from families and friends that they become extremely vulnerable to abuse and neglect.
All agencies should implement robust risk management processes in order to prevent concerns escalating to a crisis point and requiring intervention under safeguarding adult procedures.
Partners should ensure that they have the mechanisms in place that enable early identification and assessment of risk, through timely information sharing and multi-agency working. Multi-agency safeguarding hubs may be one model to support this but are not the only one. Policies and strategies for safeguarding adults should include measures to minimise the circumstances, including isolation, which make adults vulnerable to abuse.
See also Safeguarding Case Studies
4. Integration and Cooperation: Safeguarding
Safeguarding requires collaboration between partners in order to create a framework of inter-agency arrangements.
The Care Act 2014 requires that local authorities and their relevant partners must collaborate and work together as set out in the cooperation duties in the Care Act and, in doing so, must, where appropriate, also consider the wishes and feelings of the adult on whose behalf they are working.
Local authorities may cooperate with any other body they consider appropriate where it is relevant to their care and support functions. The lead agency with responsibility for coordinating adult safeguarding arrangements is the local authority, but all the members of the SAB should designate a lead officer. Other agencies should also consider the benefits of having a lead for adult safeguarding (see also Leicester, Leicestershire and Rutland Safeguarding Adults Boards).
5. Strategic Planning
To ensure greater integration of services, the local authority should consider the different mechanisms through which it can promote integration, for example:
- planning: using adult care and support and public health data to understand the profile of the population and the needs of that population, for example, using information from the local Joint Strategic Needs Assessments (JSNA) to consider the wider need of that population in relation to housing (see Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies);
- commissioning: utilising JSNA data, joint commissioning can result in better outcomes for populations in the local area. This may include jointly commissioned advice services covering healthcare and housing, and services like housing related support that can provide a range of preventative interventions alongside care;
- assessment and information and advice: this may include integrating an assessment with information and advice about housing options on where to live, and adaptations to the home, care
- and related finance to help develop a care plan, and understand housing choices reflecting the person’s strengths and capabilities to help achieve their desired outcomes;
- delivery or provision of care and support: this is integrated with an assessment of the home, including general upkeep or scope for aids and adaptations, community equipment of other modifications could reduce the risk to health, help maintain independence or support reablement or recovery.
Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies are, therefore, key means by which local authorities work with CCGs to identify and plan to meet the care and support needs of the local population, including carers.
6. Cooperation of Partner Organisations
Cooperation between partners should be a general principle for all those concerned, and all should understand the reasons why cooperation is important for those people involved. There are five aims of cooperation relevant to care and support, although the purposes of cooperation should not be limited to these matters:
- promoting the wellbeing of adults needing care and support and of carers;
- improving the quality of care and support for adults and support for carers (including the outcomes from such provision);
- smoothing the transition from children’s to adults’ services;
- protecting adults with care and support needs who are currently experiencing or at risk of abuse or neglect;
- identifying lessons to be learned from cases where adults with needs for care and support have experienced serious abuse or neglect.
6.1 Who must cooperate?
The local authority must cooperate with each of its relevant partners, and the partners must also cooperate with the local authority, in relation to relevant functions. There are specific ‘relevant partners’ who have a reciprocal responsibility to cooperate. These are:
- other local authorities within the area (in multi-tier authority areas, this will be a district council);
- any other local authority which would be appropriate to cooperate with in a particular set of circumstances (for example, another authority which is arranging care for a person in the home area);
- NHS bodies in the authority’s area (including the primary care, CCGs, any hospital trusts and NHS England, where it commissions health care locally);
- local offices of the Department for Work and Pensions (such as Job Centre Plus);
- police services in the local authority areas and prisons and probation services in the local area.
There may be other persons or bodies with whom a local authority should cooperate, in particular independent or private sector organisations for example care and support providers, NHS primary health providers, independent hospitals and private registered providers of social housing, the Care Quality Commission and regulators of health and social care professionals.