Considering the value of supporting information
Useful supporting information will help you understand an individual’s needs so you can make a determination about their entitlement to assistance.
You will not need additional supporting information for every application and the type of supporting information available will differ from client to client. This will depend on the individual’s condition, needs and circumstances.
You should not expect:
- to be able to get the same pieces of supporting information from every individual
- that the value of that information will be the same in every case
Additionally, it is not possible to be prescriptive about the minimum requirements for a piece of supporting information to be considered valuable, because it will depend on the specific circumstances.
You should consider the factors outlined in this section when deciding:
- how valuable a piece of supporting information is
- whether more information is needed to make a robust decision i.e. if the information you have is not valuable
Factors to consider
When deciding whether a piece of supporting information is valuable you should consider:
- who it’s from
- the period of time it relates to
- the content
When considering a piece of supporting information you should:
- Consider all the information you have within context
- Use other decision making tools if you are unsure how to interpret it, such as a case discussion
Who the information is from
You should consider if the source:
- knows the individual and understands the impact their condition or disability has on their life
- offers insight into the individual’s condition or disability as a result of their role in the individual’s life
- is involved in the individual’s treatment or care regularly
You should be satisfied that the provider of information can be reasonably expected to have an insight into the individual’s life. There is no definitive list of the nature of the way in which someone providing supporting information should know the individual.
If they are providing supporting information it is reasonable to assume that they have the insight required to provide it, unless you have reason to think otherwise.
For example, it is reasonable to assume that an 11 year old’s primary school teacher has a good level of understanding about the individual’s life. But if you know that the individual is now in secondary school and hasn’t seen that teacher since they left primary school 10 months ago, you’re likely to view the information as less valuable. This is because the individual’s needs may have changed from when the teacher last saw the individual 10 months ago.
This is because how regularly someone sees the individual may impact how valuable a piece of supporting information is. This does not mean that the source has to see the individual or the impacts of their condition at a given regularity to be considered valuable. Rather that you should consider whether it is more likely than not that the source of supporting information will be able to offer insights into the individual’s condition or disability based on how often they see the individual.
This will differ from case to case. It should also be considered in regards to whether the individual’s needs are likely to have changed in the time since the source saw them, or if their condition remains fairly consistent.
There may alternatively be details in the information itself which de-value the perspective of the person providing it. For example it may be clear that the person has simply observed from afar, rather than being directly involved in the individual’s life.
There are specific details required from people providing supporting information as a professional. You should use the Gathering supporting information chapter to help you identify a professional.
The period of time the information relates to
How up-to-date a piece of supporting information needs to be in order to be considered valuable will differ from case to case.
This applies to both the confirmation from a professional and additional supporting information.
The key consideration is whether or not the information is relevant to the period the application or award review relates to. That does not necessarily mean the information needs to be recent. However, you must be able to make a reasonable assumption that it is relevant to the circumstances existing at the time the application or award review relates to.
The two main factors influencing how close in time the supporting information needs to be to the application are:
- the nature of the individual’s disability or health condition
- the individual’s age
Individuals who have a disability or condition which is likely to remain consistent in the way it impacts them may have supporting information which is still relevant after many years.
Only if an individual’s condition is likely to have changed in a way that may impact their needs since the date of the supporting information might there be a reason to obtain more recent information. That may be especially the case for individuals who have become newly disabled following a significant illness or injury, such as having had brain damage or having a limb amputated following a major trauma. In these instances it’s probable that the individual’s needs in the year immediately after the event might change to a greater or lesser extent after that point.
The age of the individual is also relevant to how current the supporting information needs to be. For conditions which require careful management and strict adherence to treatment regimes, mental health conditions, diabetes or epilepsy for example,
It’s likely that individual’s may need more support as children than they will a as they age toward adulthood. In which case, information from when an individual was 12 may be relevant to their needs at 16, but may be less valuable when they are 18.
You should also consider any age related and environmental factors that could lead to changes in the individual’s needs. For example, some conditions may be worsened by stress and so children of exam age may experience a worsening of the symptoms, or have increased needs, during this period of their life. In which case, information for an individual who is sitting their GCSEs at 16 may be less valuable if it is from when they were 13 and not sitting exams. You should make use of other decision-making tools, such as medical guidance and case discussions, to understand how age may impact an individual’s needs and whether this would impact the age of supporting information you require.
When deciding whether dated information is still relevant, you should consider the individual’s current needs and decide whether it is more likely than not that their needs have changed since the date of their supporting information.
It is the date of the supporting information that is being explored here, not the content of the supporting information.
You may conclude that that supporting information was dated from a time relevant to the application or review but the information it provides is inconsistent with other information you have gathered. In this case, the supporting information is relevant but there is an inconsistency.
You should also ensure that the supporting information supports the backwards and forwards test. Supporting information meets the backwards test if it relates to needs the individual has had for at least 13 weeks before the date of application and you can conclude that it is more likely than not that the individual has had the stated condition or needs for all days of those 13 weeks.
If you’re unsure if the information is current enough to help you, you should use other decision making tools, such as medical guidance or requesting a case discussion.
Example: when older supporting information may still be valuable
Hannah is 12 and has recently moved to Scotland with her parent. She was diagnosed with ADHD when she was 8 years old. Her parent has submitted supporting information from four years ago that confirms her diagnosis and functional ability.
The case manager establishes that:
- ADHD is a lifelong condition
- Hannah’s needs are consistent with her condition and how it affects her
The case manager concludes that her supporting information is still relevant. They use this supporting information to support their decision regarding which rates of the care and mobility component would be appropriate for Hannah as well as the length of review period to set.
Example: when older supporting information may not still be valuable
Tyler is 6 years old and has glue ear. His parents submit supporting information from his school that details his problems hearing and concentrating. This supporting information is over 2 years old. As the case manager is not familiar with the condition, they request a case discussion with a practitioner.
The case manager then establishes that:
- glue ear is a condition that can fluctuate over time, where a child may experience periods of no symptoms or needs, and can clear up on its own in 3 months
- Tyler’s needs may have changed since the date of his supporting information
The case manager concludes that, as Tyler’s condition can fluctuate, his supporting information is not relevant. In Tyler’s case, the case manager must gather additional supporting information about Tyler’s current level of need. Given what they established from their case discussion, this information should be from within the past three months.
Telling the person responsible for an individual's CDP award that they might need to provide new supporting information at the next review within the review period justification
When justifying your review period decision, you might identify that the supporting information currently provided will be out of date and not of the same value at the time the individual’s next review is set for. In these circumstances, it may be appropriate to set out within their review period justification that new supporting information might need to be provided at the next review.
The aim here is not to 'verify' what the person might tell us in their review form and you should always consider whether the existing supporting information will continue to be relevant by the time of the individual’s next review.
This should always be approached from a position of:
- supporting the person responsible for the CDP award to engage with the individual’s scheduled review
- ensuring the next case manager is more likely to have up front the information they need from the individual to make a robust review decision.
There will be times when asking for new supporting information would not be appropriate, as the information provided will continue to remain relevant or up to date. In these circumstances, the next case manager would use the appropriate decision making tools if needed to establish the individual’s new level of need at review.
Example 1: The case manager explains an individual will likely need to provide new supporting information at their next review
John is 6 years old and has glue ear. The case manager familiarised themselves with John’s application and supporting information. His parents submit supporting information from his school that details John requiring attention for a significant portion of the day in connection with his bodily functions of hearing, concentrating and communicating.
The supporting information was dated within 3 months of John’s application. As the case manager was not familiar with the condition, they requested a case discussion with a practitioner.
The case discussion confirms that glue ear is a condition that can fluctuate over time, where a child may experience periods of no symptoms or needs, and can clear up on its own in 3 months. The practitioner notes that the supporting information with the application form was dated within 3 months, this would be relevant and of value for the initial determination. The practitioner shares that John’s needs are likely to change in the more immediate term.
The case manager has demonstrated a clear understanding of how John’s needs compare to those of a child of the same age and has awarded John the lowest rate of the Care Component. They also set an exceptional review period of 1 year, based on:
- medical guidance and a case discussion with a practitioner indicating that the glue ear can clear up in 3 months
- John's parents noting that he has recently had grommets fitted to help with draining fluid from his eardrums. Approved medical guidance suggest grommets will fall out within 6 to 12 months which the case manager considers to be an appropriate point to review John's award.
The case manager concludes that, as John’s condition can fluctuate and may have cleared up in time for his next review, his supporting information will not be of the same value when his scheduled review occurs.
The case manager sets out in John’s determination letter that his award will be reviewed in one year as there is a likelihood that his circumstances will change following treatment and the expected recovery time for John’s condition. The case manager also says in John’s determination letter that it is likely new supporting information will need to be provided, and that an update on his needs relating to hearing, communicating and concentrating would be needed. This is so that John’s needs at the time of his next review can be fully understood.
Example 2: The case manager making a current decision does not ask for the individual to provide new supporting information at their next review
Jason is 9 years old and experienced complications at birth, resulting in a lack of oxygen to his brain. Following medical assessments, he was diagnosed with cerebral palsy. The case manager familiarised themselves with Jason’s application and supporting information.
Jason experiences periods of both stiffness and floppiness, along with developmental delays. Jason is awaiting an assessment to determine if he has a learning disability. As a result of his condition, he requires assistance with his care needs, including using the toilet, dressing and washing. Jason can manage to eat and drink by himself most of time, as long as he has access to his aids (non-spill bowl with guard, adapted cutlery and non-spill cup).
Jason goes to bed at 7pm, his parents change his position before they go to bed about 10.30 pm. He is described as being a great sleeper and rarely wakes throughout the night, even when his parents help him change position.
Jason cannot walk independently and uses a wheelchair when outside of his home, and specialist equipment for seating at home and in school.
The case manager has demonstrated a clear understanding of how Jason’s needs compare to those of a child of the same age and has awarded the middle rate of the care component and the higher rate mobility component.
In reviewing Jason’s application and supporting information, including input from his consultant, the case manager considered that his needs may change as he grows. Taking into account his current age and confirmation that his care plan is due to be reviewed at age 12, it was deemed appropriate to review his CDP award at that point, in three years’ time.
The case manager considers the supporting information provided for Jason. It confirms his condition, cerebral palsy, which is a lifelong condition which will remain despite any treatment to manage symptoms. Although the supporting information will not be recent at the time of review, it will remain relevant to Jason’s circumstances at review. Therefore, the case manager does not ask for any new supporting information to be provided at Jason’s review.
This means at the next review, when the case manager familiarises themselves with Jason’s review form and existing information provided, they will see that confirmation from a professional has already been provided for Jason’s cerebral palsy. They can use this when considering the detail provided on whether Jason’s needs have changed, or remain the same.
The content of the supporting information
When thinking about value, consider if the information:
- includes additional detail not provided on the application or review form
- relates to the individual’s experience of their condition rather than general information about that condition
- is broadly consistent with the information in the application or review form, or there is a reasonable explanation for any inconsistencies
Make sure you fully understand any specialist language or terminology used. This is so you can correctly interpret the information.
If you need to check what something means, use other decision-making tools such as medical guidance or a case discussion.
Do not treat supporting information from abroad any differently. If you need to request translations, see accessibility guidance.
The supporting information provides additional information
You may conclude that a piece of supporting information is valuable if it contains additional details not provided in the application or review form.
You should not automatically disregard additional information that is relevant if it is inconsistent with other information. You should consider whether there is a reasonable explanation for the inconsistency. If there is no reasonable explanation, you should follow the guidance on inconsistencies below.
The supporting information relates to the individual's experience of their condition
Supporting information is valuable where it is an account of how the condition impacts the individual on a day-to-day basis or provides details on their needs.
Supporting information may offer lots of additional detail about the condition in general. For example, information from a factsheet, a leaflet or a medical website. However, this is not valuable as it does not give you any insight into how that condition impacts the individual or their needs.
The same piece of information is valuable whether the source has seen what they are reporting for themselves or it is something they have been told.
Where supporting information indicates that what they are reporting is not something they have seen themselves but is something the individual has told them, you should not treat this information any differently.
Treating the information differently could disadvantage individuals who do not have contacts who regularly see their day-to-day needs.
You should continue to take a trust-based approach to this information, as always.
Medical professionals are unlikely to see the individual at any great length when they do see the individual. There are also some aspects of an individual’s care that it is unreasonable to expect certain professionals to see for themselves, such as night time toilet needs.
As a result, their insights on certain needs may only come from what the individual has told them.
Differences in describing levels of need
Some sources of supporting information will have a point of reference that impacts how they describe an individual’s needs. The way in which people they regularly come into contact with are impacted by their condition, the nature of the conditions the people they see often have, and the prognoses they are used to discussing will all impact their perspective. You should consider the source and the context when reviewing supporting information.
For example, a GP might describe an individual’s condition as ‘well-controlled’. They might choose that term because they know their condition has the potential to be very difficult to treat with medication and could routinely become very severe.
A condition being well controlled does not necessarily mean that the individual will not have any care or mobility needs. It may simply mean that the way they are impacted by their condition is consistent. The GP may use ‘well-controlled’ to indicate a range of circumstances, including that the individual:
- is prescribed treatment for their condition and consistently takes it as directed
- has a condition which does not impact on them currently
- has a condition which is stable and consistently impacts them in the same way
An alternative example is a teacher at a special school whose pupils have a variety of conditions and needs (some physical, some neurological, some both). They might describe a pupil who requires less one-on-one support than other pupils as ‘capable of working independently’. That may be the case when compared to the needs of the other pupils, but it does not necessarily mean the child requires no support, or more support than the average child their age. It simply means they require less supervision than the other children who attend that school.
It is important to remember that all subjective terms, such as mild, stable, well behaved, easily managed, require a judgement to be made by the person using them. They should not be seen as definitive and the wider context in which they are made must be considered.