Issues that affect access to services

Question 1

What issues affect access to services?

Answer 1

Referral
Assessment
Eligibility Criteria
Barriers

Question 2

What are the 3 types of referral?

Answer 2

Self referral
Third Party referral
Professional referral

Question 3

What is self-referral?

Answer 3

when a person contacts a care provider personally, by letter, email, phone call, making an appointment or attending a care setting or surgery and
requesting help

Question 4

What services can be accessed through self-referral?

Answer 4

• Access to the primary healthcare services, such as doctors, dentists and opticians.
• Many social care services for children and adults are accessed by self-referral.

Question 5

What is third party referral?

Answer 5

when a friend, neighbour or relative contacts a health
or care service on another person’s behalf.

Question 6

Give an example of third party referral

Answer 6

For example, a neighbour may ringthe social services department on behalf of a frail elderly person to request care support, or a relative concerned about the general health of a person with Down’s
syndrome may contact the GP.

Question 7

What services can be accessed through third party referral?

Answer 7

These referrals are usually to services that are
accessible through self-referral.

Question 8

What is professional referral?

Answer 8

when a health or care professional contacts another
service provider to request support for a service user.

Question 9

Give an example of professional referral

Answer 9

a GP referring a service user to a hospital consultant, or a head teacher referring a child with learning difficulties to an educational psychologist, or a social worker contacting the domiciliary care services for a client with disabilities.

Question 10

Give some negatives of self-referral

Answer 10

• you can’t self refer yourself for mental health
• people who can’t read or write or speak english may have trouble
• elderly + children may have issues using phones or emails
• not seen as important bc you weren’t referred by a doctor

Question 11

Give some negatives of third party referral

Answer 11

• may be an unwanted referral
• communication / language barriers
• might not know much about you or your medical history

Question 12

What assessment do local authorities have a duty to carry out if someone has trouble looking after themself without additional help?

Answer 12

Community care assessment

Question 13

What is the community care assessment?

Answer 13

professional assessment of care needs provided by a local authority
adult social services department, which also provides help and advice in
accessing services to best meet the service user’s need.

Question 14

Who is responsible for the community care assessment?

Answer 14

The adult social services department is usually responsible for this, and it would normally be a social worker who completes such an assessment.

Question 15

Why might someone need an assessment? What might the service user need?

Answer 15

▸ reassurance and information about local or national organisations that could help
▸▸ simple devices that can help the client to live independently, such as aids to open
tins or jars, or equipment to help them use their bath
▸▸ a higher level of care, such as domiciliary care, or they may need residential care.

Question 16

Who has a right to a carer’s assessment?

Answer 16

If a client is supported in their home by family, friends or neighbours, these carers also have a right to a carer’s assessment to see whether they need support to carry out their caring activities. These unpaid carers are often called informal carers to distinguish them from professional care staff, or representatives of charitable groups.

Question 17

Define carer’s assessment

Answer 17

assessment of the needs of informal carers providing support for a vulnerable person, such as a person with a physical disability, a person
with a mental health need or a frail older person.

Question 18

What sets out carers’ legal rights for assessment and support?

Answer 18

The Care Act 2014

Question 19

What should happen when an assessment is completed?

Answer 19

Service user or carer must be provided with a written copy of the report outlining the needs identified and the action agreed.

Question 20

Give some negatives of the community care assessment

Answer 20

• social workers might be discriminatory e.g. to people with aids
• long waiting list
• social workers might not provide an accurate assessment
• might not give info about local organisations that could help e.g. alcohol support groups

Question 21

Give some negatives of carer’s assessment

Answer 21

• Carer might not use money to support service user
• Government might not give funding
  -informal carer might dismiss needs (their own or service user’s?)

Question 22

What 2 criteria must a person meet in order to be entitled to care and support from the local authority?

Answer 22

1. a physical and/or mental impairment or illness, plus
2. an inability to achieve at least two of the following daily activities (called outcomes):

This is also known as National Eligibility Criteria

Question 23

List the daily activities someone must be unable to achieve to receive care and support from the LA

Answer 23

▸ prepare and eat food
▸▸ wash themselves or their clothes
▸▸ manage their toilet needs
▸▸ dress appropriately, especially in cold weather
▸▸ move around their home easily
▸▸ keep their house safe and clean
▸▸ maintain family or other close relationships, in order to avoid social isolation
▸▸ access work, training, education or volunteering
▸▸ use local facilities, including shops, recreational facilities and other services
▸▸ carry out caring responsibilities, including caring for their children
▸▸ meet the outcomes likely to affect their health and wellbeing.

a person only needs to be unable to achieve 2 of these

Question 24

What is the National Eligibility Criteria?

Answer 24

criteria applied to decide whether a service user is entitled to support from the local authority social services department.

Question 25

What happens if a person meets the National Eligibility Criteria?

Answer 25

the local authority has a duty to make sure the identified needs are met.

Question 26

Give some issues with the eligibility criteria

Answer 26

• some people have ‘invisible disabilities’ which might stop them from getting help
• financial assessment might be inaccurate
• budget could be stolen if someone has control of it

Question 27

Describe how care is paid for?

Answer 27

The local authority carries out a financial assessment which
will take into account the service user’s regular income and their savings.

Question 28

What does the financial assessment do?

Answer 28

The financial assessment will decide whether the service user must contribute to the cost of care and if so how much they will contribute.

Question 29

What do most service users receive if they are eligible?

Answer 29

Personal budget/direct payment

Question 30

What is a personal budget / direct payment?

Answer 30

a cash payment made directly to the service user so that they may pay for identified and necessary care services to be provided.

Question 31

Who are direct payments available to?

Answer 31

These payments are available to all client groups across the UK, including older people, people with physical and learning disabilities and carers. People with disabilities normally receive a personal budget to allow them to purchase care services from people or companies of their own choice. The local authority, however, still has a duty to ensure that service users’ care needs are met.

Question 32

List some of the barriers to accessing services

Answer 32

• language
• financial
• communication
• scarce resources
• inconvenient location of the service

Question 33

Explain how language can be a barrier to accessing a service

Answer 33

• if English is not a service user’s first language and there is no
  interpreter available
• the service user is hearing-impaired and there is no signer
  available to support communication

Question 34

Explain financial barriers in accessing services

Answer 34

• the cost and difficulty in providing care for children or other
  dependants while a service user attends a care setting
• the potential loss of wages

Question 35

Explain how communication can be a barrier to accessing services

Answer 35

• service users feeling unable to communicate easily with
  care providers and other service users, because they feel discriminated against or that there is prejudice against them, or that there are negative stereotypes associated with their community e.g. travellers
• not having a translator / miscommunication
• speech impairments e.g. non-verbal

Question 36

How can scarce resources affect access to services?

Answer 36

• long waiting times for hospital appointments or treatment
• lack of beds available in hospitals or appropriate residential care settings
• restricted opening times or specialist resources not easily available

Question 37

How can inconvenient location affect access to services?

Answer 37

• if the service user has to rely on public transport which could be unreliable
• the cost of travelling may be a barrier as financial help for travel is not always available

Question 38

Give some negatives of professional referral

Answer 38

• long waiting time
• can be biased
• referrals can be cancelled last minute

Question 39

Give some issues with the eligibility criteria

Answer 39

• some people have ‘invisible disabilities’ which might stop them from getting help
• financial assessment might be inaccurate
• budget could be stolen if someone has control of it