Access to day services

Summary

The requester asked for policies regarding access restrictions to day services for individuals in learning disability community homes and the criteria/charges for various adult social care services. Manx Care responded by providing the full text of the Adult Social Care Services (Charges) (Amendment) Regulations 2024 and a brief eligibility note for Autism Initiatives.

Key Facts

• The response includes the Adult Social Care Services (Charges) (Amendment) Regulations 2024, which came into operation on 15 April 2024.
• Charges for social care services were increased by 5.7% under the new regulations.
• Specific weekly charges for adult care homes providing services for adults with learning disabilities are set at £91.14.
• Eligibility for Autism Initiatives residential services requires the individual to be 18 or over, an Isle of Man resident, and assessed as having an Autistic Spectrum condition with a learning disability.
• The authority confirmed that all requested information was sent, though the response primarily consisted of statutory documents rather than internal staff directives.

Data Disclosed

• 2024-12-09
• 2024-11-19
• 15 April 2024
• 14 February 2024
• £6.51
• £2.59
• £24.50
• £36.68
• £49.07
• £1107.96
• £586.24
• £817.25
• £945.28
• £91.14
• £886.41
• £468.93
• £653.73
• £756.21
• £19.18
• £8.82
• £3.92
• 5.7%
• 18 years
• SD No. 2024/0075
• SD 2023/0097

Original Request

Dear sirs Please provide copies of any staff directive / email or policy in relation to the following: - access of those living in learning disability community homes being restricted to day services eg tall trees, greenfield park etc alongside the rationale for such decision and what meaningful activity now replaces such access - please provide copies of the critera to access the followings services and their charges. Please also include details of any directive, policy determining the number of hours an individual can access such a service and how this is derived. - day services - community homes - supported living - supported employment - any other service commissioned by the department in relation to those with leaning disability and their criteria for access Many thanks -

Data Tables (4)

Full Response Text

Adult Social Care Services (Charges) (Amendment) Regulations 2024 Regulation 1

c SD No. 2024/0075 Page 1

Statutory Document No. 2024/0075 c Social Services Act 2011 ADULT SOCIAL CARE SERVICES (CHARGES) (AMENDMENT) REGULATIONS 2024 Approved by Tynwald:

Coming into Operation: 15 April 2024 The Department of Health and Social Care makes the following Regulations under section 15(1) of the Social Services Act 2011. 1 Title These Regulations are the Adult Social Care Services (Charges) (Amendment) Regulations 2024. 2 Commencement If approved by Tynwald, these Regulations come into operation on 15 April 2024 .1 3 Amendment to Adult Social Care Services (Charges) Regulations 2023 (1) The Adult Social Care Services (Charges) Regulations 20232 are amended as follows. (2) In regulation 5 (non-residential social care services) — (a) in paragraph (1)(a), for “£6.16” substitute «£6.51»; (b) in paragraph (1)(b), for “£2.45”substitute «£2.59»; (c) for paragraph (2) substitute — «(2) A liable person who is — (a) residing in an adult care home of a type described in regulation 6(6); and (b) provided with a non-residential social care service at an adult day care centre,

1 Tynwald approval is required by section 29 of the Social Services Act 2011. 2 SD 2023/0097 Regulation 3 Adult Social Care Services (Charges) (Amendment) Regulations 2024

Page 2 SD No. 2024/0075 c

must pay to the Department the charge of £2.59 for each day the non-residential social care service is provided.»; (d) in paragraph (3)(a), for “£23.24” substitute «£24.50»; (e) in paragraph (3)(b), for “£34.72” substitute «£36.68»; (f) in paragraph (3)(c), for “£46.48” substitute «£49.07». (3) In regulation 6 (residential social care services) — (a) in paragraph (2), for “£1048.18” substitute «£1107.96»; (b) for paragraph (3) substitute — «(3) Subject to paragraphs (4), (5) and (6), a liable person residing in an adult care home which is not a nursing home must pay to the Department a charge of £586.24 per week.»; (c) for paragraph (4) substitute — «(4) Subject to paragraph (5) a liable person residing in an adult care home that provides dementia care services must pay to the Department a charge of £817.25 per week.»; (d) in paragraph (5) for “£894.32” substitute «£945.28»; (e) for paragraph (6) substitute — «(6) A liable person residing at an adult care home that provides care services for adults with learning disabilities must pay to the Department a charge of £91.14 per week.». (4) In regulation 7 (temporary absence from an adult care home) — (a) in paragraph (2)(a), for “£838.53” substitute «£886.41»; (b) in paragraph (2)(b), for “£443.66” substitute «£468.93»; (c) for paragraph (2)(c) substitute — «(c) an adult care home to which regulation 6(4) applies, the charge is £653.73 per week;». (d) in paragraph (2)(d) for “£715.47” substitute «£756.21». (5) In regulation 8 (respite social care services) — (a) in paragraph (1)(a), for “£18.20” substitute «£19.18»; (b) in paragraph (1)(b), for “£8.40” substitute «£8.82»; (c) in paragraph (1)(c), for “£6.16” substitute «£6.51»; (d) in paragraph (1)(d), for “£2.45” substitute «£2.59»; (e) in paragraph (1)(e), for “£3.71” substitute «£3.92». (6) Omit the Schedule (properties charging for residential services only). Adult Social Care Services (Charges) (Amendment) Regulations 2024 Regulation 3

c SD No. 2024/0075 Page 3

MADE 14 FEBRUARY 2024 LAWRIE HOOPER Minister for Health and Social Care

Explanatory Note Adult Social Care Services (Charges) (Amendment) Regulations 2024

Page 4 SD No. 2024/0075 c

EXPLANATORY NOTE (This note is not part of the Regulations) These Regulations amend the Adult Social Care Services (Charges) Regulations 2023 (SD 2023/0097).They increase by 5.7% the charges that are payable for the provision of social care services. The services may be provided in the person’s own home, or in premises arranged by the Department of Health and Social Care. Different charges are applicable for a person temporarily absent from an adult care home, including a nursing home, due to hospital admission and for persons receiving respite care. Regulation 6(4) and 6(6) provides for charges to be payable in respect of a liable person residing in an adult care home which is not a nursing home or a liable person residing in an adult care home that provides dementia care services.

ELIGIBILITY

Autism Initiatives

Residential Services

• 18 years or over • Assessed as having an Autistic Spectrum condition with a learning disability. • Isle of Man resident • Assessed as meeting the Fair access and service eligibility criteria at a ‘critical’ or ‘substantial ‘ banding’. Clause from the specification re: charging:

1. Charging Policy

11.1 The Provider will levy no charges on Service Users for services provided under the contract. 11.2 The Commissioner operates a charging policy in respect of all its services, Service Users will contribute a board and lodging charge direct to the Commissioner in respect of their accommodation.

Autism Initiatives

Day Centre • 18 years or over • Assessed as having an Autistic Spectrum condition with a learning disability. • Isle of Man resident • Assessed as meeting the Fair access and service eligibility criteria at a ‘critical’ or ‘substantial ‘ banding’. The Service is commissioned to deliver a minimum of 60 spaces per week, over 10 sessions and within normal working hours between Mondays - Friday.

Each group session is 3 hours in duration and support a minimum staff ratio of 1 staff member to 3 Service Users.

Clause from the specification re: charging:

11 Charging Policy

11.1 Service Users will be responsible for costs associated with activities undertaken and in
connection with their person centred support plan. 11.2 Where lunch is provided the provider may charge the Service User £4.00 per session (including
lunch) as a contribution to food and utility costs. Where lunch is not provided the provider may
charge the Service User a nominal charge of £1.00 per session towards utility costs. 11.3 The contract price should be net of any income from charging. 11.4 No charges will be levied on Service Users for accessing the staffing element of the Day
Opportunities Service.

Autism Initiatives

Outreach • 18 years or over • Assessed as having an Autistic Spectrum condition with a learning disability. • Isle of Man resident • Assessed as meeting the Fair access and service eligibility criteria at a ‘critical’ or ‘substantial ‘ banding’. • Assessed by Adult Social Care Services or Mental Health Services. Applications will be considered and prioritised by a Resource Allocation Panel chaired by a representative of the Department. The Outreach Service is commissioned to deliver support through a combination of individual 1:1 support and the delivery of social activity groups operating no less than twice weekly.

Individual 1:1 will generally not exceed 3 hours per week and be time limited with an identified review date. Allocation and extension of hours will be determined through an allocation panel process.

Clause from the specification re: charging: 11 Charging Policy 11.1 Service users will be responsible for costs associated with activities undertaken and in connection with their person centred support plan.

11.2 No charges will be levied on Services Users for accessing the staffing element of the Day Opportunities Service.

11.3 Service users will be responsible for costs associated with the provision of day time food, drinks and snacks at the Resource Centre.

Autism Initiatives

Supported Living • 18 years or over • Assessed as having an Autistic Spectrum condition with a learning disability. • Isle of Man resident • Assessed as meeting the Fair access and service eligibility criteria at a ‘critical’ or ‘substantial‘ banding’. Clause from the specification re: charging:

11 Charging Policy

11.1 There will be no charges levied on the Service User for the provision of support commissioned
through this contract.

Please note, that whilst there is no charged levied for the support, Service Users do have lease for their accommodation and pay rent and their expenses.
Praxis Care Glenroyd & Ingledene All placements at Glenroyd & Ingledene are allocated by the Commissioner. Taking account of eligibility criteria and priority, the Commissioner will make nominations for any vacancies as they arise. Clause from the specification re: charging:

1. Charging Policy

10.1 The Provider will levy no charges on Service Users for Services provided under the contract.

10.2 The Commissioner operates a charging policy in respect of all its Services, Service Users of
Glenroyd & Ingledene contributing a board and lodging charge direct to the Commissioner in respect
of their accommodation Praxis Care

Balleyslieh Day Services • 18 years or over. • Assessed as having a learning disability. • Meet the residency requirement of the Social Services Act 2011 to receive a service from Manx Care. • Assessed as meeting the Fair Access and service eligibility criteria.

The charges in line Adult Social Care Service (Charges) Regulations 2024: Adult day care centres (including lunch)
£6.51 Adult day care centres (excluding lunch)
£2.59

These are collected by the Provider.
Crossroads

Social Club day service • 18 years and over • Assessed as having a learning disability

Manx Care Noble’s Hospital, Strang Braddan, Isle of Man IM4 4R (01624) 650 000

Our ref: 4259211 9 December 2024

Dear

We write further to your request, received 19 November 2024, which states:

"Dear sirs

Please provide copies of any staff directive / email or policy in relation to the following:

• access of those living in learning disability community homes being restricted to day services eg tall trees, greenfield park etc alongside the rationale for such decision and what meaningful activity now replaces such access

• please provide copies of the critera to access the followings services and their charges. Please also include details of any directive, policy determining the number of hours an individual can access such a service and how this is derived.

• day services

• community homes
• supported living
• supported employment
• any other service commissioned by the department in relation to those with leaning disability and their criteria for access

Many thanks
-"

Our response to your request is as follows: I have detailed below the information that is being released to you.

Decision on access to Day Services

Please see enclosed letter dated 15 July 2020, sent to service users and families, as well as the below extract from a Day Services Panel meeting, which took place in July 2020:-

• Residential services accessing a traditional building based day services: all present agreed that service users currently living in ALDS/ Praxis residential services should not be offered a building based traditional day services but be offered a community based services and support for accessing activities should be provided by residential staff team. This would:
• Create some urgently needed spaces in traditional building based day services

• provide a building for Praxis day services (service lost building during COVID 19 crisis management and no replacement offered) at Mooragh View Resource centre.
• Eliminate double funding for support for residential service users

The pressures and restrictions necessitated by the Covid-19 pandemic response hastened a review and decision that needed to be made on the day services offering at the time. This decision predated Manx Care, with the reasoning being fairness, equity and meeting the needs of the cohort of service users. This decision has remained in place since the inception of Manx Care due to the need to ensure that all eligible service users have the benefit of enriching activities, as well as remaining within the allocated funding envelope.

Meaningful Activity

Each activity for each service user is subject to the individual’s care plan, any risk assessments, best interests and the preferences and wishes of each individual. Activities are encouraged and facilitated in a way that encourages autonomy, wellbeing, a sense of independence, dignity and positive risk taking balanced with care, support and safety. Activities typically involve 1:1 time with a support worker and / or time spent participating in a range of community activities with staffing support.

Criteria to access services

Referrals to the Adult Learning Disability Social Work Team lead to assessment of a person’s care and support needs. The assessment considers a person’s eligibility for accessing services which are outlined in the Social Services Act 2011. The eligibility includes residency and financial assessment. Care and support needs that are determined as eligible needs, will result in onward referrals to Services (for example, Community Homes, Day Services, Supported Living, Supported Employment etc).

If a person’s needs can be met by Manx Care directly-delivered services, Adult Learning Disability Services will then undertake assessments. Assessments involve ALDS staff observing the person in relevant settings, reviewing care and support records and discussing the person’s needs with parents, carers and other relevant parties to determine whether a suitable placement is available. Where Manx Care cannot meet the person’s needs directly, services will be commissioned.

Charges

A copy of the Adult Social Care (Charges) (Amendment) Regulations 2024 is annexed to this response. The table at Appendix 1 outlines the charges and current policy on commissioned services.

Please quote the reference number 4259211 in any future communications.

Your right to request a review

If you are unhappy with this response to your freedom of information request, you may ask us to carry out an internal review of the response, by completing a complaint form and submitting it electronically or by delivery/post.

An electronic version of our complaint form can be found by going to our website at https://services.gov.im/freedom-of-information/Review . If you would like a paper version of our complaint form to be sent to you by post, please contact me and I will be happy to arrange for this. Your review request should explain why you are dissatisfied with this response, and should be made as soon as practicable. We will respond as soon as the review has been concluded.

If

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