Purpose of this form
Who can use the Review Process Form
How to use the Review Process Form
Part 1 - Monitor Event Outcome
Part 2 - Review Details
Part 3 - Other Review Details
Part 4 - Review Outcome
Part 5 - Moving the Client back into Monitoring and Setting up the Next Review
Part 6 - Disability Registration
Part 7 - Changes to CareFirst Details
Part 8 - Care Plan/Service Details
Purpose of this form
This form is used every time a Review takes place. It is used to record the progress of the review, its outcome, and changes to the client's care plan, service details, eligible needs and person details.
A review must take place for all clients / carers with ongoing services at least once every twelve months. However, if the client has a change of presenting need that needs to be re-assessed before the planned review date, this re-assessment must be sufficiently robust to constitute a review.
The form can also be used to record additional specialist work for Personally Care Managed (PCM) cases and for sensory assessment work on existing Help Desk or PCM care managed cases. In such circumstances, the case will not move into a Review event, and not all sections on the form need to be completed. Separate guidance has been provided for these situations.
You can also use Part 1 of the SS3(P) to close a case, or to transfer a case between teams.
Who can use the Review Process Form?
The SS3(P) is used by all care management staff (Referral Co-ordinators, review care managers, Help Desk workers or Personal Care Management workers).
The form may be completed and input in stages, or completed at the end of a review process.
How to use the Review Process Form
It is not always necessary to complete the entire form, only those parts which apply to the current situation
The first section of the form indicates the case's current Monitoring event.
The Outcome of the Monitoring event will reflect what is to happen next. The appropriate Outcome should be ticked, with the corresponding reason.
The End Date is when a planned review is allocated to a worker, or for an unplanned review, the date of the Referral Outcome on the relevant form.
Note: For a planned review, a worker must be available to be allocated for the Review. If there is no worker available, the case must stay in the Monitoring event until a worker is available, even if the review is over-due.
For an unplanned review/reassessment, a re-referral must be recorded on CareFirst with the outcome of 'Review'.
Allocating the Review Event
If moving into a planned review, allocate to the worker who will undertake the review.
If moving into an unplanned review, the Review event can be allocated to a worker if there one available to undertake the work. If there is no worker available, allocate the Review to the Team and add a Waiting List activity.
The Review Start Date is the same as the End Date used in Part 1. Tick the appropriate Priority box.
The allocated review worker must check the client's Ethnicity status on CareFirst. If the ethnicity information is either missing or is shown as 'XX Not Stated', this must be followed up during the review.
Review Activity
If the existing Review activity (Desktop or Face to Face) is currently allocated to the Team, allocate it to the responsible worker on the SS3(P). The activity will need to be re-assigned on CareFirst.
During the review process, the need for other specialist assessments may be identified. These can be added to the form and allocated to a worker (or a waiting list activity added if needed). The Review event should remain allocated to the original reviewing worker.
Complete the appropriate row if a Waiting List activity is needed, a Desktop Review moves to a Face to Face Review, or a specialist assessment is needed.
Note:If a case has an existing Desktop Review activity, and needs to move to a Face to Face level, always mark (and input) the Desktop Review activity as 'Complete', as some form of review/reassessment at this level would have to have been completed to identify the need for a Face to Face review.
The activity details to be completed are:
| Allocated to: | Complete name or system number of the worker. |
| Date requested: | Date the piece of work was requested A new activity may be requested at any time throughout the review process. Note: A requested date is not needed when allocating an existing Desktop or Face to Face review activity from a team to a worker, as this date is already on CareFirst. Do not change this date. |
| Date required | This is the date by when the piece of work should be completed. This will activate the 'traffic light' information on the assigned worker's desktop, where any Assessment activity assigned to them will show as Green, Black (becoming due) or Red (overdue). This date must take into account risk, presenting needs and quality standard requirements. Once input, this date must never be changed (see the section on Waiting List activities on the following page). Note: A required date is not needed when allocating an existing Desktop or Face to Face review activity from a team to a worker, as this date is already on CareFirst. Do not change this date. |
| Input by | This is for Business Resources / Review Care Managers to initial and date to indicate that the activity has been added onto the system (or re-assigned to an allocated worker). |
Completed/ | The worker allocated to undertake the activity completes this confirm that the review / assessment has been completed and Date: (C) or abandoned (A) and the date. Input Note: If the review activity is marked as 'Abandoned' on the SS3(P) because it did not happen, it may not need to be input as 'Abandoned' on CareFirst. Refer to the Note about cancelled reviews on page 7 for further details. |
| Input by | This is for Business Resources / Review Care Managers to initial and date to indicate that the system has been updated. |
Waiting List Activity
If there is no appropriate worker available to carry out the type of review/re-assessment required, open a Waiting List activity to the designated Practice Manager.
When a Waiting List activity becomes due, or an appropriate worker is available, the Waiting List activity is marked as C (Completed), and the type of review or specialist assessment is allocated to the available worker in the Activities section on the appropriate line. For inputting purposes, when the Review activity is assigned to the available worker, the Review event also needs to be assigned to the worker on the system.
Note: If a Waiting List activity is no longer required (because the client no longer needs - or wants - to be reviewed or reassessed), mark the Waiting List activity as 'Abandoned'.
In exceptional circumstances, a Waiting List activity's required by date can be extended. Note this in the same 'Date required' space on the SS3(P) using a different colour pen. The responsible Manager should initial this. Also indicate the CareFirst input in a different colour. A Waiting List activity is the only Activity that may be amended in this way.
Specialist Assessments
Workers completing a specialist assessment who operate from the same office as the person responsible for the review can share the same SS3(P). A separate SS3(P) can be used by any "off site" workers.
Case Files should remain within the relevant Care Management team office. The main SS3(P) should remain attached to the front of the case file (on site) or stay together with copies of any assessment documentation (taken off site) until all work has been authorised and input to the system.
Note:There must be discussion and agreement between the workers completing the review and other specialist assessments about who will be responsible for completing the Care Plan (this will usually be the worker undertaking the review). If the worker completing a specialist assessment makes care plan or service recommendations to the reviewing worker, the details must be added to the relevant SS3(P) and outlined on an SS2(a) or SS6.
When the required level of review activity has been completed (or abandoned), the review outcome can be recorded. It is not necessary to wait for a specialist assessment to be completed before moving onto Parts 3 and 4.
Assessment Activity Reassigned
Complete the 'Assessment Activity reassigned to' if an activity needs to be re-allocated to a different worker. Pass the SS3(P) to Business Resources to update the system before passing it to the new worker.
When the main review/re-assessment process has been completed, if there is a need for the case to be personally care managed, record the PCM worker's name.
Ethnic Origin
If the client's existing ethnicity information on CareFirst is either missing or 'XX Not Stated', the reviewing worker needs to indicate the client's ethnicity details (or 'Declined to Answer'). The review worker also needs to identify who provided the ethnicity information (including if 'Declined to Answer'). For example, 'Self' (if the client), 'Partner' (if the spouse or partner), 'Advocate' or 'Parent'.
If ethnicity details are already recorded on CareFirst, leave this part of the form blank.
Carers Assessment
The worker completing the form must tick the appropriate box to indicate whether a Carers assessment ('Joint' or 'Separate' assessment) has been completed or not ('No').
If a joint assessment has been completed, the details of the carer (including Name, Title, Address, Contact Telephone Number, Age or Date or Birth) must be recorded in Part 8 (Any Other Changes). Business Resources staff will tick the 'Done' box when the carer has been recorded as a 'Party' to the client's assessment.
If a separate carer assessment is required (or has been completed), complete an SS91 Carer Contact Form. If the worker has completed the separate Carers assessment, also complete an SS1(APC) Adult Protection / Carer Process Form to record the carer's assessment. Tick into the 'Done' box to confirm the necessary form(s) have been completed.
Adult Protection Assessment
The worker completing the form must tick the appropriate box ('Yes' or 'No') to indicate if there are any Adult Protection concerns.
If 'Yes', complete an SS1(SAP) (or an SS1 for a Learning Disability client) so that a new referral for the adult protection concerns can be recorded. If the worker has completed the adult protection assessment work, also complete an SS1(P)APC, so that an Adult Protection Assessment event can be recorded. Tick into the 'Done' box to confirm the necessary form(s) have been completed.
Eligibility
The worker completing the FACS Eligibility Checklist (SS14) must add their name and the date the assessment was completed on the SS3(P). Business Resources staff will use these details and the actual SS14 Checklist to record Eligibility Criteria on CareFirst.
If there is an existing Time Limited Services activity on CareFirst, tick into the appropriate box ('Yes' or 'No') to indicate whether this is still needed or not.
When the review process is completed (or abandoned), tick one Outcome and a corresponding Reason.
| Monitor Service | Use this when the client is going to carry on receiving ongoing services, and will require the same level of care management (Monitoring event type). This is regardless of whether the review resulted in a change to the client's care plan or not. If the client requires a different level of care management (Monitoring type) following the completed review, use the outcome of 'Transfer' (see below). If the review process has been abandoned, use the outcome of 'Cancelled' (see below). |
| Close / NFA | Use this when the client is no longer going to receive services (for example, they are no longer eligible or have declined all ongoing service provision) or because the client has died during the review process. If a client is going to stop having services, but these are withdrawn over a period of time, the Review event must stay open until all services have ended. |
| Transferred | Use this when the client switches between teams or moves from one case type (level of care management) to another. |
| Cancelled | Use this when the review process has not been completed, for example, because of a change in circumstances (such as the client going into hospital or moving away). If the client is still receiving ongoing services, a next Monitoring event is required in Part 5 of the form |
Part 5: Moving the Client back into Monitoring and Setting Up the Next Review
Following a Review, if the client is eligible and is going to carry on receiving ongoing services, a new Monitor event and review activity need to be set up.
Note: When the Review outcome is 'Cancelled':
The type of Monitoring event reflects the level of care management received.
If Monitor Personal Care Management (PCM) is selected, the named care manager must be identified. For the remaining Help Desk options (Monitor CC and Monitor SCM), add the responsible team. Business Resources staff will record the event's start date and provisional priority on CareFirst using the same details as the Review outcome.
Time Limited Services Check or Review Activity
Time Limited Services - For clients receiving new social care services as part of a hospital discharge package, these services must be "time limited" to a maximum of six weeks (refer to the separate Time Limited Services guidance). A Time Limited Services (TLS) activity must be recorded on the SS3(P).
The 'Date requested' is the same date as the start of the Monitoring event, and the 'Date required' can be up to a maximum of six weeks.
Review Activity - All clients (receiving either ongoing services or a combination of ongoing and time limited services) must have a review activity recorded. This identifies when the client's next review (not a monitoring check) will take place. The 'Review Date' cannot be more than 52 weeks on from the Monitor start date.
Indicate who will undertake the review (this can be a named worker or a team) and whether the review will be a Desktop or Face to Face review. (Refer to separate guidance for criteria for these two review types.)
Part 6: Disability Registration
Completing this section will always result in Disability Registration, and therefore this must be discussed with the client. Refer to separate guidance regarding definitions of the disability categories and who is able to request registration.
The worker who completed the review / assessment should add their name and tick the appropriate box.
A Secondary Disability Registration can be recorded if appropriate. The worker needs to write the appropriate category details and their name, as the assessing worker.
Part 7: Changes to CareFirst Details
Risk Assessment
The only risks being recorded on CareFirst are those that are High or Moderate and have a bearing on the safety of staff/service providers when visiting the client and/or their home.
Any risks identified from the re-referral or any previous assessment must be confirmed or removed following the review. The relevant risk is ticked, plus a ‘C’ or an ‘N’ to show whether this is confirmation of - or a newly identified - risk, or an ‘R’ if the risk is being removed (either due to error or as it is no longer valid). Also, record the date this decision was reached and what document (Risk Assessment Form / Management Plan) it is evidenced on.
Any Other Changes or Additional Admin Tasks Required
Due to a lack of space on the SS3(P), the reviewing / specialist worker should add any other changes to the client's personal or case details on an SS4(a) and attach it to the SS3(P). Each change or task will need an effective date.
This includes details such as changes to address (for example, if the client is moving into a home for long term residential or nursing care), a change to the living alone status, new telephone / contact numbers, new important family members or other contacts (for example, emergency contact / spare key holder), or change of GP.
It is the responsibility of all staff to ensure that accurate records are maintained.
Part 8: Care Plan / Service Details
Care Plan Details
The details needed on the SS3(P) are those that CareFirst requires for any service provision (including one-off service provision). This section needs to be completed as well as the client's actual care plan (normally the SS2), even if there is no change to the current care plan.
Note:The only exception to this is that Part 8 does not need to be completed if the Review Outcome (Part 4) is 'Cancelled'.
Select the Existing Care Plan Outcome by ticking the appropriate box.
Note: If there is any form of service provision, the outcome is New / Revised Care Plan. The Cancelled / Closed option is used for case closure - as the client has died, moved away, is no longer eligible or the services are no longer required.
Tick one box to indicate the Care Plan Goal:
| Support to Remain at Home Safely | If the client is going to have services such :as Domiciliary, Day Care, Meals, Equipment or an Adaptation or respite care (residential or nursing). |
| Provide Rehab or Reablement: | If a client is going to a unit for rehab or reablement |
| Provide 24hr care in Alternate Setting | If the client is going into long term residential or :nursing care. |
| Copied to the Client? | Tick into the 'Yes' box to indicate that a copy of the care plan has (or will be) provided to the client (or their representative). Tick into the 'No' box and complete a short note as to why this is the case if the care plan is not going to be provided to the client (or their representative). |
| Responsibility for the Care Plan | Tick the relevant box to indicate who will be :responsible for the Care Plan. This reflects thecase type. Use Team for Help Desk (CC), the Personal Care Manager or Self (Client) for Self Care Management cases. |
New, Continuing or Ending Services
List any new, continuing or ending services. The services to be provided are chosen from a restricted list of services on CareFirst. Add the overall service type, such as:
| Equipment / Adaptations Day Care Domiciliary Care Meals Residential/Nursing Care | Respite Residential/Nursing Care Short Term Residential/Reablement Professional Services Transport |
For Equipment / Adaptation or Professional Services, add on the SS3(P) the type of equipment or adaptation or professional service provided (as these can be input by Business Resources staff from this form).
Direct Payments is noted on the form as one of the service types. If Direct Payments is not appropriate for the client, annotate N/A (not applicable) against it. If the client is eligible for but declined Direct Payments, tick the 'Service Declined' box so that this can be recorded on CareFirst.
Note: Direct Payments is not the only service that can be recorded as declined, but this service type is picked up for reporting purposes.
For all other service types, add on the SS3(P) the overall service description (for example, Day Care or Domiciliary). The full service details (the provider or the number of units) are not required. (These are input via from the Service Contract Forms - SS618 / SS619 - by Finance staff.)
For new services, the Proposed Start Date is the date the service is due or intended to start.
The Fully Provisioned date is:
For continuing services, just add the type on the SS3(P) with 'Continuing' next to it.
For services that are ending, include an end date.
Authorisation
The SS3(P) does not need to be authorised prior to final computer input.
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