Signing Off a Plan and Agreeing a Final Personal Budget

The final plan must:

1. Be appropriate and proportionate to meet the eligible needs of the person/carer;
2. Contain clear outcomes for review purposes; and
3. Represent the best use of available resources (both local services and Local Authority financial resources).

When considering each of the above you must have regard for the person's/carer's Wellbeing and outcomes at all times and be able to demonstrate that you have taken into account their reasonable preferences about how to meet needs when signing off the plan and agreeing the final personal budget.

You should consider all of the evidence and information provided by the social care practitioner during the sign off process. If you require further information from the social care practitioner you should request it before signing off the plan.

Helpful questions to ask during the sign off process include:

1. Has the person/carer been as involved in the plan as they wanted to be (is there evidence that they have been supported by an appropriate person or representative)?
2. Will the plan promote individual Wellbeing?
3. Is it clear from the plan what the person's/carer's outcomes are (and are they realistic)?
4. Is it clear how the plan will support the person/carer to achieve their outcomes (including how any care and support services will contribute to this)?
5. Will the plan promote the person's/carer's independence, choice and control over how their needs are met and outcomes achieved?
6. Does the plan maximise opportunities to prevent, reduce or delay needs?
7. Does the plan demonstrate that a strengths approach to meeting needs has been used (rather than a traditional service led approach)?
8. Do the services/support options explored make best use of available resources (both local services and Local Authority financial resources)?
9. Is the level/intensity of service/support in the plan proportionate to meet the person's/carer's needs and manage risk?
10. Is the type of service/support in the plan appropriate and proportionate to meet the person's/carer's needs (for example, if the service/support is specialist is this level of specialism required)? and
11. Is any contingency plan proportionate to the level of need and risk?

When the method of managing the personal budget (or part of the budget) is to be a Direct Payment there are additional considerations that you must make before signing off the plan. These considerations are in relation to:

1. The appropriateness of a Direct Payment based on the person's/carer's needs and circumstances; and
2. Whether the cost of meeting needs through a Direct Payment represents the most effective use of Local Authority resources.

The appropriateness of a Direct Payment

Before signing off the plan you must be satisfied:

1. That the person who will be receiving the Direct Payment is able to manage it;
2. That the Direct Payment is not going to be used to pay for Care and Support / Support provided by a relative living in the same household as the person (unless there has been prior agreement due to the specific circumstances of the person/carer);
3. That the Direct Payment is not going to be used to meet needs in a care home for more than 4 weeks a year; and
4. From the information available to you that the person with care and support needs/carer is not subject to a requirement, license or order that requires them to undertake drug or alcohol rehabilitation, behaviour therapy or testing.

If you have any concerns about the appropriateness of a Direct Payment you should discuss this with the social care practitioner before signing off the plan. Unless it is clear that the criteria for a Direct Payment has not been met then you should still agree the Direct Payment, but it may be necessary to impose some conditions on the provision and use of a Direct Payment, such as:

1. Prohibiting a named person from providing care;
2. Increasing the frequency of Direct Payment reviews; or
3. Requiring certain information is provided at specific times to ensure effective monitoring of the Direct Payment.

See the Direct Payments Procedure and Guidance (Arranging Support, Services or Equipment) for further guidance.

The cost of a Direct Payment

If the plan proposes a Direct Payment being used to employ one or more personal assistants to meet eligible needs you must take into account any additional costs associated with fulfilling the associated legal requirements of being an employer in any final personal budget amount. These should be clearly recorded on the draft Care and Support Plan.

If the plan does not propose using the Direct Payment to employ a personal assistant, but instead to commission more traditional services you should be satisfied that the person contracting directly with the service through a Direct Payment represents the best use of the financial resources available to the Local Authority. In making a decision about this you must consider:

1. Whether the service could be commissioned directly by the Local Authority at a higher or lower cost than through a Direct Payment;
2. Whether the service would be able to provide the level of flexibility required if commissioned by the Local Authority; and
3. What the implications would be for the person's/carer’s Wellbeing or outcomes if the Local Authority commissioned the service directly.

If the service proposed is a service that the Local Authority could commission in the same way but at a lower cost, you should discuss whether a Direct Payment is still the most appropriate method of managing that element of the personal budget with the social care practitioner before signing off the plan.

The Local Authority is not required to set the amount of the personal budget higher where the cost of an alternative provider arranged via a direct payment is more than the cost to the Local Authority of arranging the same support whilst achieving the same outcomes for the person/carer.  

If the plan is appropriate, proportionate and makes effective use of available resources you should proceed to sign the plan off, determine the final personal budget and notify the social care practitioner of the outcome.

Regardless of whether the  cost of the draft plan is less than, equal to or greater  the cost of the draft plan must be agreed as the final personal budget when

1. You have taken into account the reasonable preferences of the person/carer about how to meet needs;
2. The plan has been deemed appropriate and proportionate to meet needs;
3. The plan has been deemed to make the best use of available resources; and
4. Where a Direct Payment is used you are satisfied that this is appropriate and cost effective.

When the plan is signed off and the final personal budget amount agreed the draft Care and Support / Support Plan must be updated to ensure that it contains all of the required information relating to the personal budget:

1. The cost to the Local Authority of meeting the needs as set out in the plan;
2. The amount which, on the basis of the financial assessment, the person must pay towards the cost (zero for carers); and
3. The amount which the Local Authority is going to contribute towards the cost.

When the plan cannot be signed off

If you have used available evidence and requested any additional information from the social care practitioner but find the plan is:

1. Not appropriate or proportionate; or
2. Does not make effective use of available resources you should not sign it off.

Instead it should be returned to the social care practitioner who submitted it.

When returning a plan you must:

1. Be clear about the reasons that the plan has not been signed off at that time;
2. Suggest steps that the practitioner may take to resolve the issues identified by the sign off process..

When the social care practitioner re-submits the plan it should be considered again.

When the plan is signed off and the final personal budget amount agreed the Care and Support/Support Plan must be updated to ensure that it contains all of the required information relating to the personal budget:

1. The cost to the Local Authority of meeting the needs in the plan;
2. The amount which, on the basis of the financial assessment, the person must pay towards the cost (zero for carers); and
3. The amount which the Local Authority is going to contribute towards the cost.

Sometimes the cost of the total plan will exceed the amount of the personal budget. For example:

1. The person will be residing in residential care that costs more than the personal budget amount with the difference being met through a third party top-up arrangement;
2. The person/carer has included a social activity in their plan;
3. The local ICB have agreed to contribute some of the cost of the plan because of the person's level of health needs (known as joint funding).

Where there is a difference between the total cost of the plan and the personal budget, the amount that anyone else is going to pay should be clearly recorded on the plan.

You should contact the person/carer whose plan it is (or their representative) to let them know that it has been signed off as soon as possible after being notified.

Following the sign off process the person must be given a written record of the Care and Support/ Support Plan.

It is important that the person/carer understands:

1. The Care and Support / Support Plan; and
2. How their personal budget has been decided.

If you are of the view that the person/ carer will experience substantial difficulty understanding the plan then you must make sure that appropriate support is in place, including consideration of the duty to provide an independent advocate.

If an independent advocate is already in place they should be informed when the plan has been provided so they can support the person/ carer to understand it.

Where the planning process was carried out jointly with another organisation to avoid duplication (for example housing or health) a copy of the plan must be made available to the other person that carried it out with you.

In the case of Care and Support plans, a copy should normally be shared in full with any carer unless the person has capacity and has asked you not to share the plan, or to share only part of the plan. In this case you will need to discuss and agree which elements of the plan are to be shared having regard for confidentiality.

In all other cases a copy of the Care and Support Plan can only be shared with the person's consent (or in their best interests if they lack capacity to consent).

If the person consents (or lacks capacity and a best interest decision is made) a copy of the plan should be shared with any service provider who will be responsible for providing Care and Support to the person.

A copy must also be shared with anyone that the person requests you share a copy with, even if they were not involved in the planning process itself.

Support Plans

You can only share the Support Plan if the carer consents.

A copy must also be shared with anyone that the carer requests you share a copy with, even if they were not involved in the planning process itself.

Concerns about a request

Sometimes the person/carer will request a copy of the plan is provided to a person who was not involved in the process You must provide a copy of the plan to anyone that the person/carer requests you to unless:

1. The request was made by a person with Care and Support needs, they lack capacity and you make a decision that sharing would not be in their best interests; or
2. You are concerned that doing so could put the person (or another vulnerable adult or child) at risk of abuse or neglect.

If this situation arises you should seek advice from your line manager and decide whether:

1. To share the record in full as requested;
2. To share the record partially, omitting sections where information could put the person at risk; or
3. To decline to provide a copy of the record (although the person can of course still choose to make a copy available from their own record).

Sometimes the person (or their representative if they lack capacity) /carer may ask for amendments to be made to the Care and Support/ Support Plan. You should:

1. Consider the request;
2. If the person/carer whose Plan it is has not made the request, consult with them (or their representative if they lack capacity); and
3. Review any evidence or information you have which may support or refute the request.

If you reach an agreement with the person/ carer about the need to amend the plan you should do so.

The amended plan will need to be signed off but this should be done in a proportionate way to reflect the level of the changes made to the plan. This may or may not involve a full sign off process.

The amended plan should be circulated to the same people as the original plan, unless the person requests otherwise.

If you are unable to reach an agreement with the person/carer and you feel that an amendment is not required you should not make the amendment. You should be clear about your reasons for not making the amendment and you must make the person aware of their right to complain about your decision.

The draft plan will not have been signed off for one of 2 reasons:

1. It is not appropriate or proportionate; or
2. It does not make effective use of available resources.

The person who has returned the plan to you should have explained the reasons that the plan has not been signed off.

They should have also suggested the steps that you need to take to resolve the issues with the plan before resubmitting it for sign off.

If it is not clear to you what the issue with the plan is then you should:

1. Discuss this with your line manager; or
2. Discuss this with the person who did not sign it off.

When you understand why the plan has not been signed off you should think about the steps that you now need to take.

A request for information

Where a plan has not been signed off because you did not provide sufficient information or evidence to enable a decision to be made, you should consider whether this information is available. If it is available you should provide it and resubmit the plan for sign off.

If the information is not available you should consider how it can be gathered and make arrangements to do so, having full regard for the Caldicott Principles, Data Protection Legislation and local information sharing policies.

A need to revise the plan

Where a plan has not been signed off because there is a particular element that has raised a query you should:

1. Establish whether you have information or evidence that can be submitted to resolve the query;
2. Make arrangements to undertake (or revisit) steps of the Care and Support / Support Planning process as required.

When you have taken the necessary steps and made any amendments to the draft plan it should be resubmitted.

You should notify the person (or their representative)/carer that the plan has not been signed off and the reasons for this at the earliest opportunity.

Where you have been able to provide additional information and resubmit the plan you should confirm to the person/carer the new timeframe for sign off.

Where you are required to undertake (or revisit) steps of the Care and Support/Support Planning process you should agree how best to do so with the person/carer.

The right to complain

If the person (or their representative)/carer is unhappy with the decision not to sign off the plan you must make them aware of their right to complain about the decision.

If the need to meet needs is urgent you may need to arrange interim services to ensure that urgent needs are met during the Care and Support / Support planning sign off process. If this is the case, see: Urgent or Interim Support.