Responsible Officer - Sally Slade
e-mail - sally.slade@devon.gov.uk
Date of Issue:  Revised November 2005

Time Limited Services

Contents

1. When to use Time Limited Services
2. Information to be given to Service Users, Carers and Service Providers about Time Limited Services
3. Ending Time Limited Services
4. .Outcomes from Monitoring
5. Changes in Circumstances

1. When to use Time Limited Services

When an assessment indicates the need for non-residential services, Time Limited Services must be used for hospital discharge situations and can be used for people living in their own homes.  

If the client's needs are particularly complex or unpredictable, it is not mandatory to use the Time Limited Services approach for community based assessments for people living in their own homes.

The Time Limited Services approach must be applied to both acute and community hospital discharge situations.

When Social Services either arrange or provide Community Care Services, following either a community or hospital based assessment, any services using the Time Limited Services approach must be time limited to a maximum of six weeks.    

• For all new service users, all non-residential services can be time limited.  
• For all existing service users, any new type of non-residential service added to the person's existing care package can be time limited.  Changes to the level of existing services are not affected.

Any services arranged must meet the FACS criteria.

Service users will be financially assessed for all relevant services.

Time Limited Services do not apply where it has been agreed that the person should move long term into a care home (residential or nursing).

Note:The SS1(P) and the SS3(P) have a Time Limited Service activity tick box.  This allows the Time Limited Service process to be recorded on CareFirst (see the latest version of CareFirst Guidance Note 030).

2.  Information to be given to Service Users, Carers and Service Providers about Time Limited Services

From the outset, the service user / carer / service provider must be advised of the end date for any services.  This includes new current services for an existing care managed client following a hospital stay.

For all Time Limited Services the care plan must clearly state:

• The service end date.
  
• The need for service users / carers / service providers to notify Social Services if there are concerns about the services stopping at least ten working days before the end date for the services where there is no planned monitoring of the care plan (see Section 3 below).
  
• Where there is a need to monitor the care plan prior to the services ending (see Section 3) the date must be set out in the care plan.  
  
• Contact details to be used by the service user / carer / service provider if there are concerns about the services stopping.  Depending on the locally agreed process, this can be the assessing worker, a named care manager, the Hospital Link worker, the Hospital Discharge team or the Locality Help Desk.  
• If it is necessary for a worker to undertake a planned Time Limited Services check with the service user, this worker must be identified in the care plan.  This can be the assessing worker, a Hospital Link worker, a named care manager or Help Desk worker.  Whatever local process is agreed, the contact person must remain constant throughout.

The agreed approach must form part of the Local implementation plan for reviews.

The new or revised care plan must be sent to the service user / carer / service provider as soon as the services are agreed.  

Any Individual Service Contract (SS618) for a new or existing client's Time  Limited Service must specify the service end date and be sent to the service provider(s) as soon as the service is agreed.  It should clearly be marked as "Time Limited Service".  

Social Services will not fund any services provided after the pre-determined end date on the service contract and care plan.  The care plan must specify this for service users / carers / service providers.  

Note: Service users / carers / service providers must contact Social Services at any time if there are significant issues regarding the care plan.

3. Ending Time Limited Services

There are two options for ending time limited services, the approach used determined by the individual situation as described on the next page.

Option One

The service user / carer / advocate has been assessed as able to contact Social Services if there are concerns about the services stopping.

It is anticipated that the majority of service users (70%) receiving TLS will be able to manage with these contact arrangements either individually or with appropriate support from carer / family / advocate.  

In these circumstances, the services will end at the pre-determined date and there will be no monitoring of the care plan unless there is a request to do so from the service user / carer / service provider.

Where there is no contact from the service user / carer / service provider prior to the service end date:  

• The services will stop at the specified end date.
  
• Social Services will not pay for any services provided after the pre-determined end date for the service.
  
• No monitoring or review of the situation will be required.
  
• The case must be closed on CareFirst.
  • For cases with only a Time Limited Services activity, close this on an SS3(P) (Parts 1 and 8) and an SS13.
  •   For cases which have other ongoing services, abandon the Time Limited Services activity on an SS6.

If prior to the service end date the service user, carer or service provider contacts Social Services with concerns about the services stopping, follow the guidance in Section 4.

Option Two

The service user / carer has been assessed as unable to contact Social Services, either individually or with appropriate support, if there are concerns about the services stopping.  This may be due to communication difficulties or a person with dementia living alone with no carer / family support.  In these circumstances, a date to monitor the care plan should be agreed and written into the care plan.

• The monitoring worker must diary a monitoring of the situation ten working days prior to the service end date.  This can also be recorded on CareFirst as an activity.
  
• The level and type of monitoring will be determined by the individual’s situation (using the guidance set out in the appendices of the Differentiated Approach policy), so may be by telephone, written or face to face.
• The monitoring work will not be recorded as a review.

The services will end at the pre-determined date unless the monitoring evidences the need for services either on an ongoing or time limited basis (see Section 4).

4. Outcomes from Monitoring

Where monitoring of the care plan is required, this and its outcome should be recorded on the SS6 (Monitoring and/or Assessment Summary Form).  Following the monitoring, there are three possible outcomes:

One:  The person is not eligible for either an extension for time limited services, or any ongoing support.  

• The service user / carer / service provider must be notified of the outcome.
• The case will close on the original pre-determined service end date.

Two:The person remains eligible and there is a need for a short term extension of the existing care plan and service contract to cover adjustments to the level and type of services that can be managed on the basis of the initial assessment and FACS checklist.  There should only be one short term extension to a maximum of a further six weeks.

• The service user / carer / service provider must be notified of the outcome.  The service contract must be extended using an SS618(a).  The new end date for the extended services must be specified on the SS6 and SS618(a).
• The contact details for the service user / carer / service provider should remain the same as on the original care plan.
  
• Business Resources and Finance must be informed of the new extended end date.    

Three:  Due to the ongoing risks arising from the service user’s needs and / or the complexity of the care plan and services, the person is eligible for ongoing support.

• The service user / carer / service provider must be notified of the outcome.  A FACS checklist, a revised care plan and an SS618(a) must be completed.  
• Following this outcome, normal care management processes will be followed.
  
• Business Resources and Finance must be informed of the new care management arrangements, including the review type and date - see the latest Practice Guidance for the Revised Review Process.       

5.Changes in Circumstances

If there is contact from the service user / carer / service provider about a change in circumstances or a new need that cannot be managed as part of the original assessment, then the review process set out in the latest version of the Practice Guidance for the Revised Review Process should be followed.

Note: Any exceptions to the Time Limited Services process need the Locality Operations Manager's agreement.