Care Act Q&A Event

Monday 18th May, 6-7.30pm

What the Care Act means for you from

April 2015

Jerome DouglasCare Act Implementation Manager

The Care Act - A result of a number of separate Government commitments around social care

• A full review of adults’ legislation - Care Act consolidates existing legislation into one single modern law.

•Driving up the quality of care following the Francis Inquiry.

•Take forward recommendations made by the Dilnot Commission.

•Delivers commitments made in the ‘Care for our future: reforming care and support ‘ White Paper.

•Strengthens rights for carers to access support and introduces a new safeguarding framework.

Produced by Law Commission

Overview

Key Requirements TimescaleDuties on prevention and wellbeing From April

2015Duties on information and advice (including advice on paying for care)Duty on market shapingNational minimum threshold for eligibilityAssessments (including carers assessments)Personal budgets and care and support plansNew charging frameworkSafeguardingUniversal deferred payment agreementsExtended means test From April

2016Capped charging systemCare Accounts

Key Requirements & TimescalesKey Principles

Produced by Law Commission

Strategic issues Key principles of the Care Act

The person knows best

Person’s views, wishes feelings and beliefs should always be considered

The focus should be on prevention or delaying the development of the need for care and support and reducing needs

Decisions should be made taking all circumstances into consideration

Decisions with the person’s participation

We need to balance the person’s wellbeing with that of family and friends involved with the person

We need to protect people from abuse and neglect

We need to minimum restriction of rights or freedom of action

A strength based approach is critical to assessment and promoting independence

Duty to Promote Wellbeing

Key Points•Local authorities must promote wellbeing when carrying out any of their care and support functions in respect of a person. This may sometimes be referred to as “the wellbeing principle” because it is a guiding principle that puts wellbeing at the heart of care and support.

•The core purpose of adult care and support is to help people to achieve the outcomes that matter to them in their life.

“Wellbeing” is a broad concept, and it is described as relating to the following areas in particular:

personal dignity (including treatment of the individual with respect)

physical and mental health and emotional wellbeing;

protection from abuse and neglect;

control by the individual over day-to-day life (including over care and support provided and the way it is provided);

participation in work, education, training or recreation;

social and economic wellbeing;

domestic, family and personal;

suitability of living accommodation;

the individual’s contribution to society.

What is Wellbeing?

Prevention• Critical to the vision in the Care Act that the care

and support system works actively to promote wellbeing and independence

₋ Primary prevention / promoting wellbeing

₋ Secondary prevention / early intervention

₋ Tertiary prevention / intermediate care and reablement• Consider local approaches and work with strategic

partners to focus on prevention.

Prevention

Key Points

•Provide or arrange for services, facilities or resources which would prevent, delay or reduce individuals’ needs for care and support, or the needs for support of carers

•Take steps to identify and understand both current and future demand for preventative support, and the supply in terms of services, facilities or other resources available.

•Consider how to identify ‘unmet need’ and share this with local partners to contribute to wider intelligence and strategies

Duty to Provide Information & AdviceKey Points

•Local authorities must: “establish and maintain a service for providing people in its area with information and advice relating to care and support for adults and support for carers”.

•The local authority must play an active and critical role in the provision of information and advice

•This duty to relates to the whole population of the local authority area, not just those with care and support needs or in some other way already known to the system.

Duty to Provide Information & AdviceKey Points

•In discharging this duty, local authorities must ensure that information and advice is provided on:

the care and support system locally

how to access the care and support available locally

the choice of types of care and support, and the choice of care providers available in the local authority’s area

how to access independent financial advice on matters relating to care and support

how to raise concerns about the safety or wellbeing of an adult with care and support needs (and also consider how to do the same for a carer with support needs)

Recap

Information from the national PMO http://www.local.gov.uk/care-support-reform

The Care Act represents the largest change in social care for sixty years – it will require significant resources to fully implement within challenging timescales.

Catering for the health and care needs of our growing and ageing population is a national priority. Reforming our care and support system is vital for us to be able to meet this challenge. The Care Act will provide a modern single law, putting people’s wellbeing at the heart of the care and support system and introducing legislation to provide protection and support to the people who need it most.

April 2016 Reforms

2050

Why is reform needed? • Care and support has never been free, but most people do not realise. • Current system is no longer fit for purpose:

– It is outdated in how we define rich and poor – It was created in 1948 when average life expectancy was 68 - it is now 80

and rising.

• Those unlucky enough to have high care needs for a long period risk losing nearly everything they have to meet that cost.

3 million

The aim is to protect people against catastrophic costs

• Current system can force people with average and lower wealth to spend >80% of their assets on care & support

• The cap provides protection from costs rising above £72,000 • But it is combining the cap with the extension to the means test

that delivers protection from significant asset depletion

100%

80%

60%

40%

20%

0%

Assets on going into care

Cap on care costs: How will it work?

• Everyone with eligible needs will be able to progress towards the cap. • The cap will be set at £72,000. • The rate at which they progress will be based on what the cost is, or

in the case of self-funders would be, to the local authority. • This cost will be set out in a personal budget or an independent

personal budget. • Progress towards the cap will be recorded in a care account. • The local authority will maintain the care account and provide people

with annual statements so they are informed of their progress.

Cap on care costs: How will it work?

• Everyone with eligible needs will be able to progress towards the cap. • The cap will be set at £72,000. • The rate at which they progress will be based on what the cost is, or

in the case of self-funders would be, to the local authority. • This cost will be set out in a personal budget or an independent

personal budget. • Progress towards the cap will be recorded in a care account. • The local authority will maintain the care account and provide people

with annual statements so they are informed of their progress. • Consulting on 3 different options for working age adults.

Cap on care costs: What happens when a person reaches the cap? • When a person reaches the cap the local authority will take

over paying for the care component of a person’s care package.

• The person will remain responsible for paying their daily living costs and any top-up they have chosen to pay.

Before reaching the cap self–funder contributes:

Coun s Doesn’t count

Care Costs

Daily living costs

“Top Up”

After reaching the cap :

LA contributes Person contributes

Care Costs

Daily living costs

“Top Up”

The Appeals Process • Means of redress – The Appeal system is a means to challenge council decisions

relating to care and support.

• Work with the existing complaints system – The intention is that the appeals system will only cover key care and support decisions. The complaints system will deal with all other areas.

• Independence – The Appeals system will introduce an independent review of the local authority’s decision.

• Openness and assurance – The Appeals system is intended to provide both the person and local authority with a clear line of sight on the rationale and recommendation of the Independent Reviewer (IR).

Adult Social Care & Carers Network

Carers and the Care Act 2015

Bernadette Jennings and Sarah MitchellSenior Commissioner for Carers

Chief Executive, Carers Network

Overview of the Care Act for carers?

New rights

•The Care Act increases the profile and rights of carers

•Advice/information must be offered to all carers

•There is increased focus on prevention and on carers’ wellbeing

•City of Westminster and Carers Network working closely to support carers

What does the Care Act mean for carers? Entitlement to an assessment of your own needs as a carer – even if the person you

care for does not want an assessment

Access to advice and basic support without an assessment.

A new assessment from and support plan for carers, based on supporting you to improve your wellbeing

Streamlined processes – now the council’s Adult Social Care team and Carers Network use the same single carers assessment form

The option of a supported self-assessment for carers who prefer this

The opportunity to apply for a Carers Personal Budget if you have had an assessment and caring has a significant impact on your wellbeing

How to get a carers assessmentNow you can have a carers

assessment with either Westminster City Council or carers Network as we all use the same system.

If the person you care for is already receiving a lot of support from Adult Social Care it may be better for you to be assessed by a care manager, otherwise Carers Network can do this.

Keeping informed about Care Act changes

Improved information for carers: •Every week there are carer activities listed on www.carers-network.co.uk

•Local carer information is on the People First website www.peoplefirstinfo.org.uk

Have your say on the Care Act changes:•People First consultation group - small group of carers to help review the PF information and find ways we might improve it. If you‘re interested in being part of this group, please contact peoplefirst@rbkc.gov.uk 

•Carers Action – a group of Westminster carers with a mission to make carer voices heard in locally. For information or to join contact Carers Network 020 8960 3033

•Contact Carers Network to feed back your views: info@carers-network.co.uk, 020 89603033

Focus on eligibility

Malcolm RoseService Manager, Older Persons and Physical Disabilities

National eligibility framework After completion of the assessment process, the local authority will

determine whether the individual has eligible needs

The Act introduces a national eligibility threshold:

whether the person has needs due to a physical or mental impairment or illness

whether those needs mean that they are unable to achieve two or more specified outcomes

as a consequence there is, or is likely to be, a significant impact on their wellbeing

Local authorities can also decide to meet needs that are not deemed to be eligible if they chose to do so – this is a power

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Interpreting the eligibility criteria

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An adult meets the eligibility criteria if:Their needs are caused by physical or mental impairment or illnessAs a result of the adult’s needs they are unable to achieve two or more specified outcomesAs a consequence there is or is likely to be a significant impact on the person’s well-being

The specified outcomes are: Managing and maintaining nutrition Maintaining personal hygiene Managing toilet needs Being appropriately clothed Being able to make use of the home safely Maintaining a habitable home environment Developing and maintaining family or other personal relationships Accessing and engaging in work, training, education or volunteering Making use of necessary facilities or services in the local community including public transport and recreational facilities or services Carrying out any caring responsibilities the adult has for a child

Interpreting the eligibility criteria

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An adult meets the eligibility criteria if:Their needs are caused by physical or mental impairment or illnessAs a result of the adults needs they are unable to achieve two or more specified outcomesAs a consequence there is or is likely to be a significant impact on the person’s well-being

An adult is to be regarded as being unable to achieve an outcomes if the adult:is unable to achieve it without assistance;is able to achieve it without assistance but:

doing so causes them significant pain, distress or anxiety; doing so endangers or is likely to endanger health or

safety; takes significantly longer than would normally be expected.

An adult meets the eligibility criteria:Their needs are caused by physical or mental impairment or illnessAs a result of the adults needs they are unable to achieve two or more specified outcomesAs a consequence there is or is likely to be a significant impact on the person’s well-being

An adult is to be regarded as being unable to achieve an outcome if the adult:is unable to achieve it without assistance;is able to achieve it without assistance but doing so causes the adult significant pain, distress or anxiety;is able to achieve it without assistance but doing so endangers or is likely to endanger the health or safety of the adult, or of others; or is able to achieve it without assistance but takes significantly longer than would normally be expected.

The specified outcomes are: Managing and maintaining nutrition Maintaining personal hygiene Managing toilet needs Being appropriately clothed Being able to make use of the home safely Maintaining a habitable home environment Developing and maintaining family or other personal relationships Accessing and engaging in work, training, education or volunteering Making use of necessary facilities or services in the local community including public transport and recreational facilities or services Carrying out any caring responsibilities the adult has for a child

Customer’s Eligibility threshold

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National carers eligibility framework After completion of the assessment process, the local authority will determine

whether the carer has eligible needs

Carers can be eligible for support in their own right

The Act introduces a national carers’ eligibility threshold:

whether the carer’s needs are due to providing necessary care for an adult

whether those needs puts the carer’s health at risk or means that they are unable to achieve specified outcomes; and

as a consequence there is, or is likely to be, a significant impact on their wellbeing Local authorities can also decide to meet carers’ needs that are not deemed to

be eligible if they chose to do so – this is a power

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Interpreting the carers’ eligibility criteria

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A carer meets the eligibility criteria if:Their needs are caused by providing necessary care for an adult. As a result:their health is at riskor they are unable to achieve specified outcomesAs a consequence there is or is likely to be a significant impact on the carer’s well-being

The specified outcomes are:Carrying out any caring responsibilities the carer has for a childProviding care to other persons for whom the carer provides careMaintaining a habitable home environmentManaging and maintaining nutritionDeveloping and maintaining family or other personal relationshipsEngaging in work, training, education or volunteeringMaking use of necessary facilities or services in the local community including recreational facilities or services Engaging in recreational activities

Interpreting the carers’ eligibility criteria

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A carer meets the eligibility criteria if:Their needs are caused by providing necessary care for an adult. As a result:their health is at riskor they are unable to achieve specified outcomesAs a consequence there is or is likely to be a significant impact on the carer’s well-being

A carer is to be regarded as being unable to achieve an outcome if the carer:is unable to achieve it without assistance;is able to achieve it without assistance but:

doing so causes them significant pain, distress or anxiety doing so endangers or is likely to endanger health or safety

A carer meets the eligibility criteria if:Their needs are caused by providing necessary care for an adult. As a result:their health is at riskor they are unable to achieve specified outcomesAs a consequence there is or is likely to be a significant impact on the carer’s well-being

A carer is to be regarded as being unable to achieve an outcome if the carer:is unable to achieve it without assistance;is able to achieve it without assistance but doing so causes significant pain, distress or anxiety, or is likely to endanger health or safety

The specified outcomes are:Carrying out any caring responsibilities the carer has for a childProviding care to other persons for whom the carer provides careMaintaining a habitable home environmentManaging and maintaining nutritionDeveloping and maintaining family or other personal relationshipsEngaging in work, training, education or volunteeringMaking use of necessary facilities or services in the local community including recreational facilities or services Engaging in recreational activities

Carers’ eligibility threshold

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Deferred Payments

Julian HallInterim Financial Assessments & Charging Manager

Universal Deferred Payment Scheme

As part of the new Care Act 2014, from April 2015 there is a mandatory universal Deferred Payment Scheme.

Tri-Borough

Deferred Payment Scheme

What will it mean?

The Deferred Payments scheme will affect people requiring residential care (i.e. care in a care home) where they also own their own property.

In the past some people were forced to sell their homes to pay for care.

The Deferred Payment scheme now means that people will not be forced to sell their home in their lifetime to pay for their care.

How do I check that I am eligible?

A person will be eligible if:

They have been assessed and have eligible needs that are agreed need to be met via a residential placement..

They have less than £23,250 in assets excluding the value of their home (i.e. in savings and other non-housing assets)..

Their home is not occupied by a spouse, or dependent relative

If they have property

Where a decision is made to charge, the council will support the person to identify options of how best to pay any charge..

This may include offering the person a deferred payment agreement..

All of their care related charges can be deferred..

How does it work?In simple terms, the cost of the care fees becomes a loan from the Council..

The loan is secured against equity in the property via a Deferred Payment Agreement (this has to be signed)..

The council will then place a legal charge against the property to secure the deferred care costs..

The full amount deferred will be recovered when the property is sold..

How much will it cost?

There are three basic costs:

A one time set up fee of £500.00

An annual fee of £100.00

Interest will be charged on the deferred amount (gilt rate + 0.15%)

Information & Advice

Westminster City Council

Income & Charging Team

Email: fincharge@westminster.gov.uk

Tel. 020 7641 8031

Question and Answer session

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