Know your rights
Confidentiality statement
We are committed to delivering high quality services while protecting your personal information and data. Only those who need to see your records to provide you with services are allowed to see them.
Learn more about how we use your data, keep it safe and your rights to access your records:
The Care Act 2014
The Care Act 2014 replaced 60 years of legislation in social care. It places a number of duties on the council including:
- promoting wellbeing
- preventing the need for care and support by promoting independence
- providing information and advice.
Check the Care Act Statutory guidance
Wellbeing
Local authorities must promote an individual’s wellbeing when carrying out their care and support duties. Sometimes this is referred to as ‘the wellbeing principle’. It is a guiding principle that puts wellbeing at the heart of care and support.
Wellbeing is a broad concept and all areas of wellbeing are equally important, including:
- Personal dignity
- Protection from abuse and neglect
- Control by the individual over their day-to-day life
- Participation in work, education, training or recreation
- Suitability of the person’s living accommodation
- The individual’s contribution to society
- Social and economic wellbeing
- Domestic, family and personal domains
- Physical, mental and emotional wellbeing
Wellbeing applies to all areas of life. This is why our approach is to understand all your views and circumstances. We will always check how our assessment on your eligible needs can have an impact on your wellbeing.
Prevention
One of the main aims of the Care Act is to prevent the need for care and support. This means ensuring we have a healthy care and support system that promotes wellbeing and independence and is not only reactive to people who reach a crisis point.
Prevention and early intervention help us to support and help people retain or regain their skills and confidence. It stops need or delays deterioration wherever possible.
Our responsibilities for prevention apply to all adults and include:
- People who do not have any current needs for care and support
- Adults with needs for care and support, whether their needs are eligible and/or met by the local authority or not
- Carers, including those who may be about to take on a caring role or who do not have any current needs for support, and those with needs for support which may not be being met by the local authority or other organisations
‘Prevention’ or ‘preventative’ measures can cover many different types of support, services, facilities, or other resources. When looking at the best way to perform our responsibilities, we always consider all options and how different approaches could support the needs of local communities.
Signposting and information
Information and advice is vital to help people, carers and families take control of, and/or make well-informed choices about their care and support. It promotes wellbeing by increasing their ability to exercise choice and control. Good information and advice also plays a vital role in preventing or delaying the need for care and support.
It is our duty to provide effective information and advice that is accessible and tailored to a variety of diverse audiences.
Care and support needs assessments
There are three stages to your care and support needs assessment, which helps us to consider if you are eligible for support.
Learn about the assessment process and National eligibility criteria
The Mental Capacity Act 2005
The Mental Capacity Act (MCA) 2005 applies to everyone involved in the care, treatment and support of people aged 16 and over living in England and Wales who are unable to make all or some decisions for themselves. It is designed to protect and restore power to vulnerable people who lack capacity.
All professionals have a duty to comply with the Mental Capacity Act Code of Practice. An MCA assessment can be completed by any person who has been trained in how to complete one.
The Act’s five statutory principles are the benchmark and must underpin all activities and decisions carried out in relation to the Act:
- The person must be presumed to have capacity unless it is established that they lack capacity
- The person is not to be treated as unable to make a decision unless all practicable steps have been taken without success
- The person is not to be treated as unable to make a decision merely because they make an unwise decision
- An act done, or decision made on behalf of a person who lacks capacity must be done or made in their best interests
- Before the act is done or the decision made regard must be had to whether the purpose for which it is needed can be effectively achieved in a way that is less restrictive of the person’s rights and freedom of action.
The code of practice sets out a number of things a social care practitioner should do when trying to work out the best interests of a person:
- Encourage and support the person’s participation
- Get to know what would be important to the person if they were making the decision for themselves
- Explore the person’s views, beliefs and values now and in the past
- Act in a non-discriminatory manner
- Consider if the person might regain capacity
- Consult other relevant people such as anyone named as someone to be consulted, close relatives or friends, any attorney or deputy
- Continue to respect the person’s privacy regardless of their mental capacity
- Respect and promote the person’s rights
An independent mental capacity advocate (IMCA) must be instructed, and then consulted, for people lacking capacity who have no one else to support them (other than paid staff), whenever:
- an NHS body is proposing to provide serious medical treatment
- an NHS body or local authority is proposing to arrange accommodation (or a change of accommodation) in hospital or a care home
- the person will stay in hospital longer than 28 days
- they will stay in the care home for more than eight weeks.
Deprivation of Liberty Safeguards
What is Deprivation of Liberty Safeguards (DoLS)?
The Mental Capacity Act DoLS apply to anyone aged 18 and over and
- suffers from a mental disorder or disability of the mind – such as dementia or profound learning disability
- lacks the capacity to give informed consent to the arrangements made for their care and/or treatment
- for whom deprivation of liberty (within the meaning of the Article 5 of the ECHR) is considered after an independent assessment to be necessary in their best interest to protect them from harm.
There is no simple definition of deprivation of liberty. Ultimately, this is a legal issue and would be determined by the courts.
There is guidance to help staff and institutions assess if the steps they are taking deprive a person of their freedoms. DoLS give assessors the authority to make recommendations, and supervisory bodies the authority to deprive people of freedoms if it is in their best interests.
DoLS focus on people in hospitals or care homes without the ability to give their consent. People in these circumstances need to be looked after with care and treatment schedules that may deprive them of some or all of their freedoms.
The deprivation of a person’s liberty is a serious matter and should not happen unless it is absolutely necessary. These safeguards have been created to ensure any decision to deprive someone of their liberty is made following defined processes and in consultation with specific authorities.
DoLS in the community
For people living at home, supported living or somewhere other than care homes or hospitals, a DoL must be authorised by the Court of Protection unlike DoLS in hospitals or care homes (as explained above).
The same guidance applies to social care practitioners to assess and evidence their recommendations.
Personal budgets
The personal budget is the total amount of money we pay for all the care and support you need to meet your eligible needs.
Your personal budget depends on the outcome of your initial assessment or the review of your current support plan. It is calculated based on:
- the type of support you require to meet your needs
- the support you decide to receive to meet your needs
- the cost of care and support you will receive to meet your needs.
A financial assessment will say if you need to pay in full or a contribution for your care; this information will be considered when calculating your personal budget and it will be explained in your support plan.
How can I use my personal budget?
During the support planning process, you can decide how you want to use your personal budget:
Managed by the council
Adult social care will help you organise your care and support through our existing care providers contracted by the council, and we will pay them for their care directly.
Combination of direct payments and council managed services
We want to give you as much freedom as possible to decide how you meet your eligible needs. You have the option for full control over some of your personal budget, while adult social care can arrange and organise other care and pay for it directly.
Direct payments
Direct payments are cash payments made to people who have been assessed as needing social care services from us.
Having a Direct Payment means you have more freedom, choice and control to arrange your own services or support according to your needs.
If you already receive support from us and want to apply for a direct payment for your social care needs, contact team responsible to review your support plan (contact details in your support plan).
Who can get a direct payment?
You can receive direct payments if you are 16 years or over, and been assessed by us as in need of social care services.
Carers who need social care may also be entitled to a direct payment.
What can I use direct payments for?
You can use direct payments to pay for goods and services identified in your support plan.
There isn't a specific list of goods or services which you can buy to meet your needs.
One of the benefits of using direct payments is that you have the chance to choose less traditional services. For example, you might choose to use your direct payment for support with:
- personal care
- getting out and about in the community
- maximising your independence and well being
- employing a personal assistant
Rules and options I should know about
There are a few rules around direct payments. These set out how an amount is calculated, how direct payments can be used, and how they are monitored once it's set up.
Direct payments cannot be used to:
- employ a relative or partner who lives in your home (unless under exceptional circumstances)
- purchase permanent residential care (but eligible for short breaks as part of your assessed care needs)
More information
If you get council-funded support and are interested in getting a Direct Payment,
contact the staff member or team who last set up or reviewed your support. If you are unsure where to start, contact our Direct Payment Support Service on:
Tel: 020 7364 4166 (weekdays 9am to 5pm)
Email: dp.support@towerhamlets.gov.uk
Support for people receiving direct payments
You can get support to manage your direct payment including:
- support to set up your payments
- ongoing help to manage your money and using it in effective ways
- employing your own personal assistant. You can get help to recruit the right person and understand your responsibilities as an employer.
- Paying a care agency, day centre or other provider for their services.
- Getting support from us (the council), somewhere else, or you can do a bit of both.
The important thing is that the support you choose gives you the help you need.
Employing a personal assistant (PA)
Becoming an employer for the first time can be daunting. We have a Direct Payment Support Service to help direct payment users to get started, and provide support and advice when they need it.
The support service provides you useful information, including:
- employing a Personal Assistant
- employment law (sick pay, holiday pay, maternity leave)
- recruiting staff (advertising and interviewing; contract of employment, etc.)
- employers’ responsibilities e.g., national insurance, liability insurances, health and safety.
Continuing health care
NHS Continuing Health Care (CHC) is a free care service package provided to adults with long-term complex health needs due to a disability, accident or illness. This care is provided outside hospitals, for example at home or in a nursing home.
We will explain how it works and plan, with your consent, to have a CHC assessment if the social care practitioner believes you may be eligible. This assessment can be initiated by a health professional too.
A CHC assessment can happen at any time including:
- during your initial assessment
- during a review of your needs and support plan.
Learn more about NHS Continuing Health Care
There is a national framework to decide who is eligible for NHS CHC. Anyone who meets the criteria is eligible, regardless of their income or capital.
People who are eligible may receive the personal health budget money they need via a direct payment.
Who is eligible?
These services are for people who have what is known as a 'primary health need’, including:
To know if you’re eligible for NHS CHC, the first step is to complete a CHC checklist. This document will determine whether a full assessment is required.
A full assessment called a decision support tool must be completed by a multidisciplinary team (normally a nurse and a social worker). You will be fully involved in the assessment process and can include a family member or a friend for support if you prefer. The assessment will look at:
- how complex your needs are
- how intense your needs can be
- how unpredictable your needs are, including any risks to your health if the right care is not provided at the right time
- what help you need
Eligibility depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change your eligibility for NHS CHC may change.
How can I access these services?
If you feel that you, a family member or someone you care for may be eligible for NHS CHC, please contact either one of the following for an assessment:
Contact details for CHC teams in the North East London area
If you are not eligible for CHC but in a care home with nursing , you may be entitled to NHS-funded nursing care.
NHS CHC fast-track
When the health of an adult is rapidly deteriorating or the person is entering a terminal phase, they may be eligible for NHS CHC fast-track. It allows for a decision about their eligibility to be done within 24 hours - enabling care to start as soon as possible. CHC Fast-Track can happen in various settings like hospitals, a hospice or at home.
A clinician must make a recommendation for CHC Fast-Track.
Find out more