Welcome Carers’ Hub Lambeth Carers’ Forum The Care Act th March 2015 West Norwood Health & Leisure Centre

The Care Act 2014

What is the Care Act about? Part One of the Care Act focuses on reforming adult social care (ASC). It aims to: create a legal framework that is clear and easy to navigate bring the law up to date to focus on outcomes that people want rather than their disabilities and put the individual in control of their life address areas of unfairness. It is an important piece of legislation because it: replaces current legislation under which Adult Social Care is provided places new duties on organisations with major impact on practice, including around safeguarding, eligibility, assessment, supporting carers, etc. changes and reforms the Adult Social Care funding system. Robert Hill

Implementation  Received Royal Assent May 2014 >> Statutory guidance – setting out expectations of local authorities and best practice guidance in delivering care and support. >> Secondary legislation – the regulations. Detailed information on scope and critical processes >> Primary legislation – the Care Act Legal duties and powers  Published in final form late autumn 2014 (although funding reform elements will be later)  The majority of Care Act reforms will be implemented from April  Funding reforms will be implemented from April Robert Hill

Main changes and new duties Wellbeing and prevention General duty to promote wellbeing underpinning all functions. Duty to prevent, reduce or delay needs for care and support, and requirements around information and advice, including access to independent financial advice. Assessment and eligibility National minimum eligibility criteria for local authority support. This is replacing Local Authorities previous eligibility which was based on Fair Access to Care (FACS) guidelines. Single duty to assess people who may need services with focus on outcomes as well as needs and the impact on wellbeing. Entitlement to support based on eligible needs, ordinary residence and outcome of financial assessment (where relevant). Robert Hill

Carers New rights for carers - the right to an assessment and to receive support provided for eligible needs. Safeguarding First statutory framework for safeguarding adults investigations. All areas must have a Safeguarding Adults Board involving Local Authority, NHS and police as minimum. New duty for Local Authority to carry out enquiries (or cause others to) where it is suspected that an adult is at risk of abuse or neglect. Integration Requirement to work collaboratively and cooperate with other public authorities, including duty to promote integration with NHS and other services (including housing, Dept.Work & Pensions, Jobcentre Plus). Main changes and new duties … continued Robert Hill

Transition to adult services Includes young people, young carers and carers of children. Assessment of need under adult statute pre-18 for good planning. Links with the Children and Families Act and Special Educational Needs and Disability reforms. Continuity of care and cross-border placements Ensuring people don’t miss out on services in care & support if they move between areas. There are duties on authorities to share information. Ability to arrange care home placements across the UK. Personalised care and support planning If a person or carer is assessed and has eligible needs they have right to a support plan. The support plan will include the cost of the care provided – this is called the personal budget. Local Authorities must inform the person of the needs that can be met with a direct payment. Main changes and new duties … continued Robert Hill

Provider failure New central regime overseen by the Care Quality Commission. Based on response to what happened to Southern Cross and a consultation – focused on ‘difficult to replace’ providers. Local Authorities remain responsible for managing impact of failure and ensuring continuity of care for people. Care standards/provider indicators The Act also allows for a new system of regulation for health and social care providers. This has been developed by the Care Quality Commission. Main changes and new duties … continued Robert Hill

Independent advocacy must be available where someone has substantial difficulty being involved in the process and there is no one available to act on their behalf. Provision to increase the freedom of the Care Quality Commission to take action where poor care is provided to people. Human Rights Act will be applied to providers of care and support where the local authority arranges or pays for care and support (directly or indirectly, in whole or in part). Local authority will be responsible for prisoners in custodial settings in its area (assessment and, if eligible, ensuring support is available). Other areas of importance..... Robert Hill

Cap on reasonable care costs People of state pensionable age will have a care funding cap of around £72,000. This means that once the amount that the Council and the person pays for eligible needs reaches £72,000; the Council will pay for on-going care to meet eligible needs. People of working age who have eligible care needs should benefit from a lower cap. (not yet determined) Young people who are assessed before they turn18 as having ongoing eligible care needs should have their cap set at £0. Extending financial protection for people in residential care with modest wealth At present, a person with assets, including their home, worth more than £23,250 is not eligible for help if they need residential care. This threshold will be raised to £118,000 (2016/17 prices) Most financial support will go to people with greatest care needs and the least in savings or home value. The poorest people will continue to have the majority of their costs paid. Summary of funding reforms (April 2016) Robert Hill

Contribution towards general living costs for people in residential care This is about people in residential care contributing the sorts of costs they would have to meet if they were living in their own home, for example food, energy bills, accommodation. The Government has suggested this will be set at around £12,000 per year from April This does not count towards the cap. Universal deferred payment scheme (from April 2015) In some cases, people can defer the payment of charges for residential care (possibly to avoid them having to sell their home immediately). Summary of funding reforms continued... Robert Hill

More on changes for carers.... What is a carer? A carer is someone who provides support to someone else in living their day-to-day life. A carer is unpaid, and is usually a relative or friend. This is not the same as someone who provides care professionally on behalf of a local authority care package or support provided through a voluntary organisation. The Care Act mostly relates to adult carers, that is people aged 18 and over who are caring for another adult. Young carers (under 18 years old) and adults who care for disabled children can be assessed and supported under children's law. Regulations under the Care Act however, allow the government to make some rules about looking at family circumstances when assessing an adult's need for care. This means for example ensuring that the position of a young carer within a family is not overlooked. The Care Act also has new rules about working with young carers or adult carers of disabled children to plan an ‘effective and timely’ move to adult care and support. This is normally known as Transition. Robert Hill

More on changes for carers … continued What difference does the new Care Act make? Currently, carers have no legal right to receive support. Local authorities can provide support at their discretion. This means that access and eligibility for assessment and the range of support available can vary considerably throughout the country. The existing law says the carer must be providing "a substantial amount of care on a regular basis" to qualify for an assessment. The Care Act now gives local authorities a responsibility to assess a carer's need for support. There will be a national eligibility criteria for carers. Local authorities must consider whether the carer’s need for support arises as a consequence of providing necessary care for an adult. Carers can have eligible needs even when the adult does not. This means that more carers should be able to have an assessment. The local authority will assess whether the carer has eligible needs. The assessment will also consider the impact of caring on the carer. It will also have to consider the things a carer wants to achieve in their own day-to- day life. It must also consider other key issues, such as whether the carer is able or willing to carry on caring, whether they work or want to work, and whether they want to study or take part in more social activities. If both the carer and the person that they care for agree, a combined assessment of both their needs can be undertaken. Robert Hill

More on changes for carers … continued Am I eligible for support as a carer? When the carer's assessment has been completed, the local authority must decide whether the carer's needs are eligible for support from the local authority. This approach is much the same as the process that is used for adults with care and support needs. In the case of carers, eligibility for support depends on the carer's situation. The carer will be entitled to support if: They are assessed as having needs that meet the eligibility criteria, the person they care for lives in the local authority area (which means their established home is in that local authority area) If there is a charge (as there sometimes may be, as explained below), it has to be accepted by the carer (or the adult being cared for, if it falls to them).

Robert Hill More on changes for carers … continued Carers and their Support Planning The carer and the local authority will agree a support plan, which will set out how the carer's needs will be met. This may include information and advice and support from organisations in the borough. It may also include a personal budget which could be taken as a direct payment. It may be that the best way to meet a carer's needs is by providing care and support directly to the person they care for – for example, by providing replacement care to allow the carer to take a break from caring. It's possible to do this as long as the person that is being cared for agrees.

Robert Hill More on changes for carers … continued Financial assessment for carers and charging In most cases, local authorities don't charge for providing support to carers, in recognition of the valuable contribution carers make to their local community. But this is something the local authority can decide. If the local authority does decide to charge a carer for providing them with support, it must carry out a financial assessment to decide whether the carer can afford to pay. If supporting a carer involves providing care to the person being cared for and the local authority chooses to charge for that type of care, the authority must carry out an assessment and financial assessment of the person who is being cared for, providing the person agrees to this. This is because the care would be provided directly to that adult, and not to the carer. The Act makes it clear that in such cases, the carer cannot be charged.

More on changes for carers … continued Carers and Carers’ Personal budgets Carers with eligible needs will receive a support plan which includes a personal budget, which is a statement showing the cost of meeting their needs. It will include the amount the carer will pay, if any, and the amount the local authority is going to pay. The local authority must identify eligible needs that can be met by a direct payments. Carers will then have the right to request a direct payment, which will give them control over how their support is provided. Robert Hill

More on changes for carers … continued Young carers and the Care Act The Care Act and The Children and Families Act both give young carers rights to assessment as other carers have. Regulations under the Care Act set out how assessments of adults must be carried out to ensure the needs of the whole family are considered. This could include assessing what an adult needs to enable them to fulfil their parental responsibilities towards their children, or to ensure that young people do not undertake inappropriate caring responsibilities. Young carers: transitioning to adult services The Act says adult social services need to be involved in planning the support a young carer may need once they reach 18. This also applies to adult carers of children where it appears likely that the adult carer will have needs for support after the child turns 18.

Robert Hill More on changes for carers … continued Adults caring for disabled children An adult caring for a disabled child can get support through children's services. This is usually the best way to meet their needs, so they are not covered by this Act. However, there is provision in the Act for an adult carer of a disabled child to ask for an assessment of their caring needs before the child reaches 18. When a local authority carries out such an assessment, it has the power to provide support to the carer, even though they are caring for a child, rather than an adult. This would, for example, enable a local authority to provide the support available through an adult carers' centre or an equivalent service

Further information and support..... For information on Care Act 2014: Care Act factsheets (Department of Health) Care Act regulations and guidance (Department of Health) The Care Act 2014 (Legislation UK website) For Information and support locally: Healthwatch Lambeth – Lambeth Mencap – Carers Hub – Lambeth Resolve – Every Pound Counts AgeUK Lambeth London Borough of Lambeth Robert Hill

Workshops Carer’s Assessments and eligibility Personal Budgets and what that means Keeping safe Information, advice and advocacy