The Care Act 2014

Joanne Clement1 October 2014

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Introduction

Most of Act comes into force - April 2015

Funding reform - April 2016

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1: General Duties

Key principle: Individual Well-being

General duty to promote individual’s well-being

LA must “have regard”

Individual best placed to judge individual’s well being

Individual’s views, wishes, feelings beliefs

Individual participating as fully as possible

Preventing and delaying need for care and support

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1. General Duties

No mention of independent living in the Act

BUT draft guidance says

“The wellbeing principle is intended to cover the key components of independent living in the UN Convention on the Rights of People with Disabilities”

Supporting people to live as independently as possible, for as long as possible, is “a guiding principle of the Care Act”

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1: General Duties

LAs must provide information and advice

Includes financial information and advice

Duty on public bodies to co-operate

Integration of care and support with health services and housing

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2: Assessment

Assessment for adults and carers

Appears to a local authority person may have needs for care and support

Assess needs and desired outcomes

Training

No experience of condition, must consult expert

Specialist assessors for people who are deafblind

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2: Assessment

Adult can refuse assessment

UNLESS

Lack capacity and would be in his best interests

Experiencing, or at risk of, abuse or neglect

Independent advocacy – substantial difficulty in being involved and no one to act on person’s behalf

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3: National Eligibility Framework

First national eligibility framework

End to the post-code lottery

Minimum threshold not maximum – power to meet needs below national threshold

Impact of needs on the person’s well being

Draft regulations published June 2014 – Govt says equivalent to substantial

Outcomes v activities?

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3: National Eligibility Framework

Lots of room for interpretation

Physical or mental impairment or illness

As a result, unable to achieve a particular outcome

As a consequence, “significant impact” on adult’s well being

Outcomes – basic care activities; maintaining relationships; work / training / education or volunteering; accessing community facilities; caring responsibilities for a child

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3: National Eligibility Framework

Basic care activities

Eating and drinking Maintaining personal hygiene Toileting Getting up and dressed Getting around home Preparing meals Cleaning and maintaining home

Also National Eligibility threshold for carer’s needs

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4: Charging

Power to charge for services

No major changes – clarifying the law

Cap on care costs

Prevents local authorities from charging if total costs accrued in meeting eligible needs exceeds the cap

£72,000 after state retirement age. Lower below it

Not include daily living costs

More consultation on care cap

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4: Charging

Calculating the costs for the cap

LA itself meets needs: costs to LA, specified in personal budget OR

Another LA met needs cost to that other LA, specified in personal budget OR

Self-financing: what cost to LA would have been if LA had met eligible needs, specified in personal budget. NOTIONAL cost, not actual cost

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5: Meeting Needs

Duty to meet adult’s eligible needs

- Ordinarily resident

- Needs not being met by carer

- Accrued costs not exceed the cap

- No charge for meeting needs or three conditions met

Condition (1): Resources below financial limit

Condition (2): Resources above limit, but LA asked to provide

Condition (3) : Lacks capacity to arrange themselves

Duty to meet if accrued costs exceed care cap

Power to meet needs

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5: Meeting Needs

Duty to support carers if needs meet eligibility criteria (similar caveats on costs)

Ways to meet needs - providing accommodation, - Care and support at home- Counselling or social work- advice

LA itself provide service; arranging for another person to provide service; making direct payments

Care and support plan – linked to outcomes

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5: Meeting Needs

Personal Budget

- cost to LA of meeting eligible needs - Adult contribution and daily living costs- Amount LA must pay- Any other public funds

Independent personal budget

- privately arranged - notional cost - what cost to LA would be - minus daily living costs - ensure those privately paying not reach the cap more quickly

The “Care Account” – accrued costs

Direct Payments

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6: Safeguarding Adults

LA duty protect adults from abuse and neglect

Safeguarding Adult Boards

Safeguarding enquiries if suspect adult with care and support needs is suffering or at risk of abuse or neglect

Independent advocates

No power of entry

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7: Market Shaping

LA must promote efficient and effective operation of market

Variety of providers

Variety of high quality services – 15 minute care visits?

Aware of current and likely future demand and supply. Sufficiency assessment?

Sustainability of the market: fees? Regard to actual cost of care

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8: Moving between LA areas

Can you take care package with you if you move? No, but better than before

Genuine intention to move - home LA provide information; receiving authority must assess

Receiving authority has duty to provide from day 1. If not completed assessment, must comply with home LA package

Assessment / cost of provision different – provide written explanation of the difference

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9: Outsourcing

LA can outsource almost all social services functions to third party

Only exception: promoting integration and co-operation and safeguarding functions

Third party can take decisions for the LA

LA remains liable for third party actions (not criminal offences)

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10: Human Rights Act

Extending scope of HRA to private care providers

Not cover entirely private arrangements

Regulated by CQC

Providing care and support arranged or funded by LAs

Residential and non residential

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11: Appeals v Judicial Review

Power to set up appeals against LA decisions

Challenge LA decisions “without resorting to judicial review”

Short on detail

“Element of independence” from LA – “some LA representation”

Another consultation on appeals

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