Care Act 2014 Overview

What is the Care Act?

• The most significant reform of social care legislation in more than 60 years

• A single modern law that makes it clear what kind of social care people should expect

• Takes into account:• Dilnot Commission’s Report into the funding of care • Francis Inquiry into failings at the Mid Staffordshire NHS

Foundation Trust

The Care Act replaces many previous laws

National Assistance Act 1948: established the welfare state and abolished the Poor Laws

1948 1960… 1970…

Chronically Sick and Disabled Persons Act 1970: reforms to key entitlements to community services

NHS and Community Care Act 1990: first major set of reforms, including first right to assessments and start of commissioner/ provider split.

1980… 1990… 2000… 2010…

Carers (Recognition and Services) Act 1995: the first Act to recognise carers

Community Care (Direct Payments) Act 1996: new powers to make direct payments

Carers and Disabled Children Act 2000: extending direct payments to carers

Health and Social Care Act 2001: updates on direct payments

Why is the Care Act necessary?

Demands on the system•Care and support affects large numbers of people•Three-quarters of people aged 65 will need care and support in their later years

Financial pressures•Councils are facing significant and increasing demand •Nationally, adult social care spending has fallen by around 8.5% from 2011/12 to end of 2013/14

What is the Care Act trying to achieve?

• Make care and support clearer and fairer• Promote people’s wellbeing• Enable people to prevent and delay the need for care

and support• Put people in control of their lives so they can realise

their potential• Develop integration with health and other partners

General duties

Duty to promote wellbeing•Concept of wellbeing central to the Care Act•Need to consider physical, mental and emotional well-being•Influences the way all functions are carried out in relation to individuals•Assumption that the individual is best placed to judge their own wellbeing•Importance of achieving a balance between individual’s wellbeing and that of any carer

General duties

Duty to prevent, reduce, and delay needs• Applies equally to those not receiving services and their carers• Three general approaches aimed at:

• individuals who have no current health or care and support needs• individuals who have an increased risk of developing needs• minimising the effect of disability or deterioration for people with complex

care and support needs• Working with independent, community and voluntary services key to prevent

people’s needs escalating

General duties

Duty to provide information and advice• Local authorities will need to ensure that information is provided so that the public

can:• know how the care and support system works• access services that help prevent care needs from becoming more serious• make informed choices about care and support• know how to access independent financial advice• raise concerns about the safety or wellbeing of an adult

• Financial information and advice even more important given funding reform from 2016

General duties

Duty to shape the local market• Local authorities required to promote diversity and quality of

local services so there is a range of high quality providers for people to choose from

• Commissioning focussed on outcomes and promoting wellbeing• Need to foster an effective care and support workforce• Pay at least the minimum wage

First contact and identifying needs

Eligibility• New national minimum eligibility threshold ensures more

consistency• Based on “significant impact on wellbeing” - considered

equivalent to current ‘substantial needs’ criteria

Carers

Carers• New rights to support for Carers• Carers put on same footing as those they care for• Carers supported to maintain their caring role for longer

First contact and identifying needs

Independent advocates• Duty to provide an independent advocate where someone has

substantial difficulty being involved in the process and there is no one to act on their behalf

• Applies to care planning process - assessment, planning, review - safeguarding enquiries and appeals

Integration and partnership working

Duty to promote integration and duty to cooperate• Greater integration between Adult Social Care, Health and

Housing to improve outcomes for people• Commitment to make joined-up health and care the norm by

2018

New relationships

Self-funders •Local authorities will need to establish a closer relationship with people who self-fund their care as:

• there is a legal obligation to promote the health and wellbeing of the entire population;

• if self-funders are not well informed about preventative support services and care options this may result in the earlier loss of independence;

• once the funding reforms are introduced, self-funders who are eligible for support will want to register their spend on care with their local authority to start their care account.

Funding Reform 2016/17

• Current system for paying is based on laws written over 65 years ago

• Developed at a time when few people lived into their 70s and fewer needed care and support

• Life expectancy is now 80 and rising• People more likely to need more care and support and

need it for longer

Funding Reform 2016/17

Cap on Care Costs

•Limit on the costs of care for eligible care and support needs•Cost per week is the amount that it would cost the person’s local authority to meet their needs if they were eligible•Does not include the costs of daily living•Cap on care costs set at £72,000

Funding Reform 2016/17

Cap on Care Costs

•When a person reaches the cap the local authority will pay a contribution towards the person’s care fees to cover the cost of care•Person will have to pay only a set amount for their daily living costs - £230 per week

Funding Reform 2016/17

Means test

•Current rules – if a person has less than £23,250 in assets they will receive means-tested help.•New system – people in a care home with less than £118,000 in assets will qualify for means tested help with their care costs

Funding Reform 2016/17

Working Age Adults

•People who develop eligible care and support needs below the age of 25 will have a zero cap for life•Those who develop a care and support needs from the age of 25, the cap will be set at £72,000

Funding Reform 2016/17

Appeals

•New Appeals system•People able to more easily challenge decisions about their care•Sits alongside existing complaints system and option of going to the Local Government Ombudsman.

What does this mean for partners and care organisations?

• Need to respond to the wellbeing principle• Greater local authority involvement with self-funders• Greater local authority involvement in services focused

on prevention• Greater local authority focus on promoting diversity

and quality in the market

What’s happening in Derby?

• Because of all the work we have done to introduce self-directed support and personalisation, we already complied in many areas

• Carried out self assessment - identified gaps and developed projects to meet the requirements of the act

• Completed financial models to estimate the additional cost of implementing the Care Act in Derby

Timetable

• April 2015 – Part 1 - Majority of Care Act came into force

• Summer 2015 – Receive confirmation of direction of travel for Part 2 following election

• October 2015 – Receive final guidance and regulations for Part 2

• April 2016 – Part 2 - Funding reforms come into effect

Adult Social Care Restructure

Aims of restructure - implemented in April 2014•Improve the availability of advice and information•Focus on community support and early intervention•Promote self directed support for people with eligible needs and their carers•Make financial savings

Adult Social Care Restructure

Objectives•Reduce hand-offs•Develop Local Area Co-ordination•Improve efficiencies in the Enablement service•Reduce duplication through clearer locality links with community matrons•Improve outcomes in specialist mental health settings•Improve self directed support through more customers support planning for themselves•Review safeguarding

Review of Adult Social Care Restructure

Have partnerships with other organisations improved?•Has locality working led to more joint working and a more integrated approach to the delivery of health and social care in communities?•Does the current structure support hospital discharge more effectively?•Have the specialist teams created any improvement in the integration of their services with other partners?•How can partners work more effectively together to prevent, reduce or delay social care needs?

Questions

• What’s working well?• What needs to change?• What would work better?

Opportunities for Feedback

Workshop •Friday 29 May•10 am – 12.30 pm•Derbyshire Healthcare Foundation Trust, St James House, St Mary’s Wharf, Mansfield Road, Derby DE1 3AD •email Jodie Smith if you would like to attendEmail•Send your feedback on what is working/what is not working by 5pm on Thursday 28 May to Jodie.smith@derby.gov.uk

More information

• Olwen Wilson, Programme Manager, Derby City Council

• Email: olwen.wilson@derby.gov.uk• Telephone: 01332 642742• www.derby.gov.uk/careact