1 The Care Act and Social Care Markets June 2014

2 The Care Act: adult social care markets Market oversight & provider failure Sections Market shaping Section 5 Entry criteria Group companies Definitions of business failure LA action on provider failure Market shaping and commissioning Summary of regulations and guidance Act introduces number of reforms concerned with adult social care markets Consulting on three draft packages of regulations and two packages of statutory guidance in particular. The Care Act Regulations Guidance

3 The Care Act: market shaping Local authority Market ALL LOCAL PEOPLE Market shaping and commissioning Duty on local authorities to promote a sustainable, diverse and vibrant market for care and support that delivers high quality services for all local people. – Focusing on outcomes and promoting wellbeing – Promoting choice to drive quality – Supporting sustainability – Working with partners and people who use care/carers – Approaches to market intelligence and facilitation – Importance of workforce development and pay – Securing quality and outcomes through contracting

4 The Care Act: provider failure Continuity of care when a provider fails Local authorities manage small scale provider failure effectively, and that most exits from the market are handled responsibly by providers. Duty to step in to ensure that no vulnerable person is left without the care they need if their service closes because of business failure. Emphasis on contingency planning. Relationship with new CQC regime for certain providers. Determining the most appropriate support for the person. Business failure Registered provider enters administration, receivership, liquidation etc. Service closes The provider can no longer carry on providing services. Local authority duty triggered Local authority informed and steps in to meet care and support needs for ‘as long as it deems necessary’. Flexibility to determine how needs are met. Duty applies in respect of all local people.

5 The Care Act: Market Oversight CQC oversight of ‘ difficult to replace’ providers Southern Cross demonstrated potential effect of a large provider failing financially. CQC to begin monitoring the financial sustainability of those providers local authorities would find difficult to replace were they to fail from April Aim is ensuring continuity of care and early warning, not propping up failing providers. CQC will engage with stakeholders to develop its operating procedures for the new regime. Consultation on CQC’s proposed approach in autumn –Regulations specify which “difficult to replace” providers are included – the entry criteria –Requirement for CQC to assess financial sustainability – regulations allow CQC to look at finances of organisations in providers group to assess sustainability –Powers for CQC to require contingency plans, or an independent business review –Requirement to inform local authorities when failure is imminent for a provider in CQC regime, and to support local planning.

6 The Care Act: Market Oversight Consultation Questions We invite views on the entry criteria to the market oversight regime,and whether and how it should be made simpler for residential and non-residential care providers We invite views on the approach to defining business failure by reference to insolvency situations We invite views on the insolvency situations listed e.g. are they appropriate and clear? Should other situations be covered? Are they appropriate and relevant to the various legal forms registered providers can take? Does the statutory guidance provide a framework to support local authorities and their partners to take new approaches to commissioning and shaping their local market? Are there any further suggestions of case studies or tools that can assist local authorities in carrying out their market shaping and commissioning activities.

7 The Care Act: reforming care and support Developing Care Markets for Quality and Choice DH has funded the Developing Care Markets for Quality and Choice (DCMQC) programme, delivered through the Institute for Public Care. More information available at: Support available to local authorities to develop capacity to shape local markets through: Market intelligence Market structuring Market interventions

8 The Care Act: reforming care and support Developing Care Markets for Quality and Choice – outcomes… 126 local authorities have either published or are about to publish a Market Position Statement (MPS) Facilitated provider engagement events A better understanding of self-funder market through development of a toolkit for estimating self-funder use of home care services Identification of potential future implementation support programmes

9 The Care Act: reforming care and support Commissioning Standards DH funded; ADASS/LGA led through Think Local Act Personal group Delivery by Birmingham University Health Services Management Centre Co-production with local government & sector Set of standards to be used as part of sector-led improvement process led by LGA Aim of understanding and spreading best practice for local government commissioning of social care Standards will be tested with local authorities later in the year; final delivery by end of 2014.

10 The Care Act: reforming care and support Further work on implementation Beyond Developing Care Markets for Quality & Choice and Commissioning for better outcomes project… what support would be helpful?

11 The Care Act and Social Care Markets June 2014