People Group

The Care Act 2014

David Soley

Service Manager Social Care and Support

Warwickshire County Council

davidsoley@warwickshire.gov.uk

People Group

Contents:

• A brief history of care & support• Context for change• Key provisions of the Care Act• Implementation in Warwickshire• Questions?

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People Group

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

A brief history of care and support

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

Social care law and policy has evolved over more than 65 years, incorporating around 30 Acts of Parliament, but reform has usually been piecemeal.

The Care Act: reforming care and support

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Vision for Adult Social

Care___________

Nov 2010

Law Commission

Report__________

May 2011

Dilnot Commission

Report__________

July 2011

Caring for our future

engagement_____________Sept - Dec 2011

• Caring for our Future White Paper

• Draft Care and Support Bill

• Progress report on funding

______________July 2012

Engagement and pre-legislative

scrutiny on draft Bill________________Jul 2012 – Jan 2013

Care Act in Parliament

__________May 2013 – May 2014

Announcement on funding

reform______________

Feb 2013

Implementation_____________

April 2015 – April 2016

The reform timelineThe Care Act is the latest step the Government’s reform of Adult Social Care

Consultation on draft regulations

and guidance______________

Jun - Aug 2014

People Group

48 per cent of men and 51 per cent of women will need domiciliary

care only

33 per cent of men and 15 per cent of women will never need formal

care

19 per cent of men and 34 per cent of women will need residential

care

Three-quarters of people aged 65 will need care and support in their later years

Older people are the core user of acute hospital care - 60% of admissions, 65% of bed days and 70% of emergency readmissions. 72% of recipients of social care services are older people, accounting for 56% of expenditure on adult social care.

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…and around 6 million people caring for a friend or family member.

…around 400,000 people in residential care, 56% of whom are state-supported

…around 1.1 million people receiving care at home, 80% of whom are state-supported

…1.5 million people employed in the care and support workforce

Care and support affects a large number of peopleIn England there are…

Context for change: demands on the system

The Care Act: reforming care and support

People Group

Context for changefactors affecting health & wellbeing

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Norman Lamb, Minister for Care and Support

The principle of personalisation is at the core of these reforms. Rather than the state deciding what people need, people themselves will be able to shape their care and support around what they want, to achieve the outcomes that matter to them. To help them do this, the Act ensures that people will have clearer information and advice to help them navigate the system, and a more diverse, high quality range of support to choose from to meet their needs. The Act places more emphasis than ever before on prevention – shifting from a system which manages crises to one which focuses on people’s strengths and capabilities and supports them to live independently for as long as possible”

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The Care Act 2014:

• Relates primarily to adults in need of care and support, and their adult carers.

• Some provisions for the transition of children in need of care and support.

• Main provisions for Parent carers of children and young carers are in the Children and Families Act 2014 and are generally provided by Children's services

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Underpinning Principles

• Wellbeing – Not Just about individual needs but “should also be considered by LA when it undertakes broader strategic functions e.g. planning”

• Prevention – Ranging from “to individual interventions to wide-scale whole population measures that promote health and well-being”

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Cont..• Information and Advice – “Duty relates

to the whole population and should address; care & support, prevention, wellbeing, finances, health, housing, employment, Adult Protection”

• Market Shaping – “Vibrant responsive market able to provide high quality personalised care regardless of who arranges or funds it”

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The Care Bill: reforming care and support

Built around people:

• New duty to promote well-being.• New duty to prevent &/or delay the need for care &

support. • Assessments Emphasis on Outcomes (not deficits) • Carers given the same status as the cared for (no longer

required to provide ‘regular and substantial’ support).• New duty to support Transition into Adult Services • New duty to provide Information, Advice and

Independent Advocacy (including financial advice)

People Group

Introduces funding reform:

• New legislative framework for Personal budgets & the right to receive Direct Payments.

• Cap on the care costs (£72,000).• Universal deferred payments scheme prevents

people having to sell their home in their lifetime to pay for residential care costs.

• Single national threshold for eligibility (new FACS)• Increase Capital threshold (£23,250 - £118,000)

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Greater protection:

• New legal framework for protecting vulnerable adults including Safeguarding Adults Boards.

• Ensures continuity of care when people move between Local Authority areas.

• New protections to ensure people don’t go without care if their provider fails regardless of who pays for their care.

• Ensures young adults receive appropriate care and support during their transition to adult services.

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Key provisions of the ActImplementation April 2015:• Wellbeing • Prevention• Safeguarding Vulnerable Adults• Transitions to Adulthood• Information & Advice (Including financial advice)• Independent Advocacy (financial advice)

People Group

Implementation April 2015:

• Assessment (asset not deficits based)• Carers Assessment (similar rights as ‘cared for’)• Personal Budgets & Direct Payments• Eligibility (Impairment, Outcomes, Wellbeing)• Continuity of Care• Cooperation with other statutory organisations• Delegation of Local Authority Functions

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Implementation April 2016

• Cap on Care Costs• Independent Personal Budget (eligible self

funders)• Care Accounts (for Self funders)• Part 1 Appeals (against LA decisions)

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Building on existing good practice

Warwickshire County Council already provides:

• Personalised Adult Social Care services. • Multi-Agency Adult Safeguarding arrangements• Support for Carers. • Deferred Payment scheme.• Integrated Health and Social Care Services.• Independent advocacy• Engagement with the Third and voluntary sector in the

commissioning cycle.• WCC commission Community And Voluntary Action to

support the Third and Voluntary Sector.

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Person centred care and support planning

• People and their carers “must be actively involved and influential throughout the planning process”.

• Increases access to Advocacy including financial advice.• Everyone should have a personal budget and the ability

to meet needs by taking a direct payment must be clearly explained (DP’s are the preferred option).

• People should be free to choose innovative forms of care and support from a diverse range of sources including non-service options.

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Following a personalised assessment people are:

• Given a personal budget and asked the level of control they wish to take:

o Direct Payment (preferred)o Managed budgeto Combination of the two aboveo Independent Service Fund (ISF)

• People are supported to plan how they will use their personal budget; if they need help, then advocates, brokers or others can support them

• People can use their personal budget to achieve the outcomes that are

important to them.

• Local authority continues to check people are okay and can change things if people are not achieving the outcomes they wish to achieve.

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Think Local Act Personal (Making it Real)

• Marks progress towards personalised, community based support

• Sets out what people who use services and carers expect to see and experience if services are truly personalised.

• 26 “ I " statements written by people who use services, carers and citizens describing what sort of support people want.

• Progress markers - written by real people and families to help organisations check progress towards personalised adult social care.

• Making it Real aims to give people more choice and control so they can live full and independent lives.

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Health and Care Strategic Partner Programme

• Enables the Voluntary and Community Sector (VCS) organisations to work in equal partnership with the Department of Health, NHS England and Public Health England.

• Working at a national level.  It allows each organisation to demonstrate leadership and innovation in the wider health and social care reform agenda.

• Programme developed from a partnership of 11 to 22 organisations establishing a robust model for working in partnership.  It is estimated that through these Strategic Partners, over 300,000 organisations across the voluntary sector can be reached.

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Thank you

Questions?