Assessment and Care Management
Assessment and Care Management perform a wide range of functions, including:
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Initial Referral
The service is the first point of contact for people who may require social care support. If necessary people will be signposted to non-statutory services or refer to the social work/occupational therapy services when appropriate.
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Integrated Discharge
Co-ordinates the safe discharge of people following hospital admission. The service works collaboratively with health practitioners to ensure that people are supported to return to their own homes or alternative living situations. People who require longer term interventions will be referred to other support services
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Initial Assessment
Provides short term social work interventions following screening by the Initial Referral. Situations may involve out of borough hospital referrals, carers assessments, crisis situations relating to the carers or cared for person and those situations which meet social care eligibility criteria but are not appropriate for referral to other teams.
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Emergency Response
Responds to requests for social care intervention out of office hours. The type of situations referred may be breakdown in care arrangements, safeguarding issues and family crises. Depending on the complexity and severity of the situations referrals may be made to other agencies or social work teams
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Community Social Work
The service, supports individuals who have low level care needs maintain their independence by utilising resources within their own community. People will be provided with access to services which include health, welfare benefits, housing, leisure, education/skills development and employment.
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Occupational Therapy
Provides therapy based assessments for people adjusting to life following accident, injury, acquired disability or age related conditions. This may include allocation of independent living equipment and major housing adaptations.
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Sensory Support
Provides a range of services for hearing impaired/deaf/deaf-blind/blind and visually impaired people. This includes assessments, rehabilitation plans, identifying appropriate equipment, referring to other services, providing low level housing related support and creating support plans following funding approval.
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Reprovision
Provides support for adults with a learning disability. The focus is on increasing the quality of life for people in residential and nursing care by reassessing needs and relocating individuals back into the community supported living situations wherever possible.
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Complex
Provides support to individuals with a learning or physically disability who require a period of in-depth intervention due to their high level of support needs. This includes those young individuals going through transition into adulthood and those that require intervention in relation to a history of offending behaviour.
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Review
Reviews individual support plans to evaluate if the person’s outcomes have changed and if they continue to meet the eligibility criteria for social care funded services. The outcome of the review may result in a reduction, increase or cessation of funding.
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Community Mental Health
Works in partnership with Dudley & Walsall Mental Health Partnership NHS Trust to provide an integrated range of health and social care services to children and adults, including older people, who have experienced mental ill-health. Programmes include community recovery, day/residential placements, hospital referrals, substance dependency and assessments relating to mental capacity.
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Safeguarding
The service is responsible, in collaboration with partner agencies, for the response to reported adult safeguarding concerns for vulnerable adults. It investigates, risk assesses and when appropriate, takes action to protect the victim and prevent the perpetrator from causing further harm
The majority of people involved in providing these services work within regulated professions which require registration with the HCPC for social workers and occupational therapists. A common theme is therefore the requirement for Continuous Professional Development, and an evidenced record of learning and resultant outcomes.
