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Key learning point

A local authority must involve an individual in their key care and support processes of assessment, care and support planning and review, or safeguarding.




Slide 4



Notes

  1. Handout: Substantial difficulty




  1. The Care Act defines four areas in any one of which a substantial difficulty might be found:

  • understanding relevant information

  • retaining information

  • using or weighing up the information

  • communicating their views, wishes and feelings




  1. Many people can be supported to understand relevant information, if it is presented appropriately and if time is taken to explain it. See the information and advice module for more information about accessible information and advice. Some people, however, will not be able to understand relevant information, for example if they have mid-stage or advanced dementia.




  1. If a person is unable to retain information long enough to be able to weigh up options and make decisions, then they are likely to have substantial difficulty in engaging and being involved in the process.




  1. A person must be able to weigh up information, in order to participate fully and express preferences for or choose between options. For example, they need to be able to weigh up the advantages and disadvantages of moving into a care home. If they are unable to do this, they will have substantial difficulty in engaging and being involved in the process.




  1. A person must be able to communicate their views, wishes and feelings - whether by talking, writing signing or any other means - to aid the decision process and to make priorities clear. If they are unable to do this, they will have substantial difficulty in engaging and being involved in the process. For example, some people with mid-stage or advanced dementia, significant learning disabilities, a brain injury or mental ill health may be considered to have substantial difficulty in communicating their views, wishes and feelings. But equally a person with Asperger’s may be so considered, as may a frail older person who does not have a diagnosis but is confused as a result of an infection, or a person who is near the end of their life and appears disengaged from involvement and decision-making. Within this context, it is the person’s ability to communicate their views, wishes and feelings which is fundamental to their involvement rather than the diagnosis or specific condition.







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