CQC Quality Statements
Theme 3 – How the local authority ensures safety in the system: Safe systems, pathways and transitions
We statement
We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between services.
What people expect
When I move between services, settings or areas, there is a plan for what happens next and who will do what, and all the practical arrangements are in place.
I feel safe and supported to understand and manage any risks.
ADDITIONAL INFORMATION
Sensory Services (opens in Trafford Council website)
CONTENTS
1. Introduction
Local authorities must keep a register of people who are sight impaired (partially sighted) and severely sight impaired (blind).
Registration is voluntary, however individuals should be encouraged to consent to being registered as it may assist them in accessing other relevant support services and benefits. People who agree to be registered may be entitled to some benefits, for example, an increase in personal tax allowance, a reduction in the cost of a TV licence, a free bus pass and parking concessions under the Blue Badge Scheme.
Access to care and support is not dependent upon registration, and those with eligible needs for care and support should continue to receive services regardless of whether they wish to be registered.
Local authorities should work with health services and local voluntary organisations to identify those who may benefit from registration.
Registration data can also be used to help local authorities with planning the delivery of relevant support services
2. Registration
If the person consents to registration they will be included on the local authority’s register and be provided with a registration card. The register can also be used by the local authority to ensure that accessible information about services is provided to the person, for example to ask if they require support to participate in electoral events.
3. The Certificate of Vision Impairment
The Certificate of Vision Impairment (CVI) formally certifies someone as being sight impaired or as severely sight impaired. Where the person has given their consent, the hospital should send a copy of the CVI to the local authority. However, people in receipt of a CVI should not be added to the local authority register until they have given their specific consent for registration.
Local authorities may take the date of certification given on the CVI as the effective date of registration. If the adult has not given their consent for their name to be added to the register of sight impaired adults, they should still be offered a needs assessment.
The CVI is an important source of information for local authorities in relation to their registration duties. The local authority should satisfy themselves that the CVI is completed correctly and it contains valid signatures as required (currently the consultant ophthalmologist and the patient). Both electronic versions and paper copies of CVIs can be accepted for registration.
3.1 Certification
The CVI is issued by a consultant ophthalmologist to certify the patient as sight impaired or severely sight impaired. The Certificate of Vision Impairment: Explanatory Notes for Consultant Ophthalmologists and Hospital Eye Clinic Staff (gov.uk) contains guidance on who should be certified as severely sight impaired and sight impaired.
Certification is not the final stage, but often it is the point when people begin to accept the severity of their sight loss and feel ready to access to practical and emotional support.
It is expected that NHS services will keep the completed certificate, signed by the consultant and the patient, for their records. Where the patient has given their consent, a copy of the certificate should be sent to the relevant local authority and the patient’s GP within five working days of its completion. The ‘Certificate of Vision Impairment Explanatory Notes for Consultant Ophthalmologists and Hospital Eye Clinic Staff’ provides information on this.
3.2 Transferring and retaining the CVI
The CVIs should be kept until the person moves to another area or dies. In the event of a person’s death, the local authority should keep the CVI for at least six years as it may be necessary for tax purposes to establish if a deceased person was registered with a local authority.
3.3 Making contact
Within two weeks of receiving the CVI, the local authority should make contact with the person to discuss their inclusion on the local authority register (with the person’s informed consent) and offer them a registration card. Where there is an appearance of need for care and support, local authorities must arrange an assessment of their needs in a timely manner.
To maximise the ability of people who have sight impairment to be involved in their own care and decision making, they should have access to information and advice in an accessible format so that they can adapt to their situation as quickly as possible and obtain any aids and support that will help them to maximise their independence.
4. Continuity of Care
When a person moves home and goes to live in another local authority area (see Continuity of Care chapter), the first local authority should ensure that their care and support needs will continue to be met during their move. The process requires the original authority to provide the authority the person is moving to with relevant information to support the move. This could include a copy of the person’s care and support plan, their latest assessment, a copy of their CVI and any other documentation the second authority requests. The second authority should add the person to their register (if they give their consent for this), and the former authority should remove that person’s name to avoid duplication.
5. Care Planning
Royal National Institute for Blind People (RNIB) have developed resources to help social care professionals support people with sight loss.
Following completion of a needs assessment, the local authority must prepare a care and support plan for everyone with eligible needs (or other needs it chooses to meet). Where someone has sight loss, this should be recorded in the care and support plan (see Care and Support Planning chapter).
Local authorities should consider securing specialist qualified rehabilitation and assessment provision to ensure that the needs of people with sight loss are correctly identified and their independence maximised. Certain aspects of independence training with severely sight impaired and sight impaired people require careful risk management and should only be undertaken by professionals with relevant experience and training. This type of rehabilitation should be provided to the person for a period appropriate to meet their needs, and this will help the person to gain new skills, for example, training to use a white cane.
Rehabilitation for sight impaired people is a specific form of reablement and is not limited to the usual six week period for rehabilitation as this could take longer.
