The following is a specification for assessment, not a declaration of entitlement. It allows decision-makers to accept, reject or modify each component with reasons.
| Need or outcome | Proposed response | Contingency | Evidence sought |
|---|---|---|---|
| Unpredictable physical episode | Timely trained human response across assessed risk periods | Emergency escalation and recovery protocol | Clinical risk assessment; incident frequency |
| Night trauma symptoms | Trauma-informed night response at the level found necessary | Telephone or in-person escalation as clinically safe | Sleep diary; mental-health assessment |
| Fatigue-related speech loss | Text/AAC accepted; staff communication protocol | Yes/no method and advocate contact | SALT/AAC assessment |
| Personal care | Named tasks by trained, non-family workers if preferred and feasible | Backup staff; clear consent practice | Occupational and care assessment |
| Coercion protection | No sexual or unpaid quid pro quo; safe disclosure pathway | Safeguarding lead and police contact where indicated | Safeguarding enquiry |
| Companionship and regulation | Support continued relationship with dog and agreed grounding plan | Animal-care contingency | Person-centred plan; welfare practicalities |
14.1 Commissioning questions
If the authority rejects continuous support, it should explain the alternative response for each unpredictable risk, its expected response time, who is contractually responsible, what happens when that service is unavailable, and how the person can summon help when unable to speak. If the authority accepts continuous need but proposes a less intensive model, it should show why that model will meet needs safely and reliably.