Fair Exclusion from Care Services part 1 – with a social work hat

Four bands

If FACS is unfamiliar territory, an acronym too far, it goes like this: an assessment of an adult’s needs for care services categorises those needs into one of four bands, critical, substantial, moderate or low. Central government defines the bands, local authorities determine which bands they can afford to meet.

The process and the definitions are set out in statutory guidance, affectionately known as FACS. For a reminder of how great your needs have to be to be deemed ‘substantial’, there is a useful summary here.

Rationing and cuts

What is very clear in the Harrow case, is what the court is not saying. It is not saying that Harrow cannot take resources into account. And since ‘taking resources into account’ is a euphemism for rationing and cuts, it isn’t saying that Harrow can’t ration and cut. Nor is it saying that it is inherently unreasonable to exclude people with substantial needs from services.

The practical consequences of turning away those with substantial needs may be more far reaching than is immediately apparent. Here are some of the possibly less apparent ones:

First, consider the impact on service users. In a world in which only critical needs are eligible, preventative and support services will become only a distant memory. Will there be social services for people with moderate learning difficulties, people whose need for mental health services fluctuates, elderly people seeking aids and adaptations?

Social work impact

Second, consider the impact on services. How many of the residual services still directly provided by social services authorities are provided primarily to people assessed as having substantial needs? Day Centres? Respite Services? Meals on Wheels? Will these services even continue to be viable, or will they simply close?

Finally, the impact on social workers. Government guidance says that when needs are ineligible, councils should consider “providing alternative services as part of community development, “Supporting People”, health promotion or other wider initiatives”.

The logical conclusion is that social workers will not be involved in these processes. Indeed, since a social work assessment is hardly a requirement or precursor to receiving these, social workers may not even be involved in assessments. The future for adult services social workers will simply be to ensure Fair Exclusion from Care Services.

Allan Norman is Principal Social Worker & Solicitor at Celtic Knot , an independent law firm and social work practice.