Reviewing

Good practice examples

Why reviewing is important

How to manage reviewing better

Good practice examples

Salford - Linking individual reviews and contracting

Why reviewing is important

Reviews should be seen as an ongoing process for ensuring the most appropriate services are being delivered to those in most need.

It is particularly important to carry out an initial review of services since people mainly present to social services at a point of crisis in their lives when their needs are greatest and as a result require a 'crisis' level service. Reviewing the situation after an initial period is likely to lead at least to a reduction in service to 'maintenance' level.

The SSI Annual Report (England) of 2002 "Improving Services for Older People…Policy into Practice" comments critically on Reviewing practices: 'nationally, nearly one-third of adults did not receive their scheduled review in 2000/01'.

The impact of poor reviewing on managing resources is that:

• People continue to receive services they no longer require, which creates dependency and additional costs to the authority
• People do not receive services they do require, which puts them in potentially unsafe situations
• Accurate information on service provision is not available for internal use or to meet national requirements
• Accurate information on cost is not available, with implications for current and future budgets (See also section on Financial Planning)
• Planning and commissioning decisions are made without accurate information on demand being available

Much still remains to be done. Less than half the service users in England who were due a review received one in 2001/02. Click here to see where your authority stands nationally.

Department of Health guidance for English authorities in 'Fair Access to Care Services' required that from April 2003

and that by April 2004

"the circumstances of all service users in receipt of services on 7 April 2003 should have been reviewed at least once"

The same requirements are set out for Welsh authorities in "Creating a Unified and Fair System for Assessing and Managing Care in Wales", but with deadlines of October 2002 and October 2003 respectively.

How to manage reviewing better

• Record and update assessment and care plan information regularly, particularly in relation to in-house services. Care plan information is often only a historic record showing what care managers originally asked for and not what is actually being provided
• Carry out reviews at appropriate time intervals
• Ensure care manager-led case reviews are carried out once cases begin to receive long-term support. Reviews which are provider led may focus on services received rather than on a holistic review of current need
• Make sure there is direct contact or involvement of service users and carers in reviews
• Use electronic systems to keep track of reviews.

GOOD PRACTICE TIPS

How to manage reviewing Set up an independent review process either through: establishing review teams or specialist posts within care management teams or retaining the function within mainstream care management and allocating a proportion of cases for 'review only' to all or some care managers, but setting tight performance targets for completion to ensure priority within the more active caseload. Ensure reviews are regular holistic, concentrate on current need, minimise dependency and are focused on outcomes Ensure service users and their carers are fully involved in the review process Ensure reviews identify if the service user still meets the eligibility criteria Ensure reviews identify if needs have changed and consider other services beyond those that are currently provided Ensure that the necessary changes to services are subsequently made and recorded Use reviews as part of individual and departmental performance management to identify whether the required outcomes have been achieved and targets met Review services as well as individuals. Quality assurance checks on internal provider services and contract monitoring and quality assurance checks on external providers should be built into a regular and systematic process which includes care managers, service users and carers Salford Good practice: Linking individual reviews and contracting