1 Care Act: What does it mean? Tara Chattaway

2 Care Act: overview Comes into force on 1st April 2015 Government is consulting on funding for care Funding will implemented on 1st April Dilnot Care Act - Well being, preventing needs There are 23 sets of guidance and 20 sets of regulations.

Preventing, reducing or delaying needs Local authorities must provide minor aids and adaptations up to the value of £1,000 free of charge, for the purpose of assisting with nursing at home or aiding daily living. Rehabilitation for blind and partially sighted people should not be limited to 6 weeks and should be provided irrespective of a person’s eligible needs when designing services, councils need to develop a local approach and understand and plan for local needs 3

Charging It is recommended that rehabilitation is not charged for beyond six weeks due to the clear benefits it has on preventing care needs and delaying hospital admissions Assessment and eligibility Any self assessment will have to be provided in an accessible format Assessments must be carried out by a person who has the necessary skill, knowledge and competency 4

Registers local authorities must maintain registers for blind and partially sighted people local authorities should make contact with an individual within two weeks of the CVI (Certificate of Visual Impairment) being issued 5

Preventing reducing and delaying needs Prevention is defined as Primary prevention/promoting wellbeing; Secondary prevention/early intervention; Tertiary prevention/intermediate care and reablement; 6

7 Preventing, reducing or delaying needs Local authorities should consider the potential impact and consequences of ending the provision of preventative services. Poorly considered exit strategies can negate the positive outcomes of preventative services, facilities or resources, and ongoing low-level care and support can have significant impact on preventing, reducing and delaying need. Where local authorities provide intermediate care or reablement to those who require it, this must be provided free of charge for a period of up to six weeks. This is for all adults, irrespective of whether they have eligible needs for ongoing care and support.

Charging Whilst they time-limited interventions, neither should have a strict time limit, the period of time for which the support is provided should depend on the needs and outcomes of the individual. In some cases, i.e. a period of rehab for a visually impaired person (a specific form of reablement) may be expected to last longer than six weeks. Whilst the local authority does have the power to charge for this where it is provided beyond six weeks, they should consider continuing to provide it free of n view of the clear preventative benefits to the individual and, in many cases, the reduced risk of hospital admissions. 8

Assessment and eligibilty The regulations are set to be equivalent to substantial care needs under FACs. The Government have therefore set a minimum eligibility criteria at significant. Local authorities can provide support for people with lower care needs, if they choose, but they can not provide support for people with only critical care needs. 9

Assessment and eligibility There is a three tier test (1) An adult’s needs meet the eligibility criteria if— (a) the adult’s needs arise from or are related to a physical or mental impairment or illness; (b) as a result of the adult’s needs the adult is unable to achieve two or more of the outcomes specified in paragraph (2); and (c) as a consequence there is, or is likely to be, a significant impact on the adult’s well-being. 10

(a) managing and maintaining nutrition; (b) maintaining personal hygiene; (c) managing toilet needs; (d) being appropriately clothed; (e) being able to make use of the adult’s home safely; (f) maintaining a habitable home environment; (g) developing and maintaining family or other personal relationships; (h) accessing and engaging in work, training, education or volunteering; 11

Assessment and eligibility The term “significant” is not defined by the regulations, and must therefore be understood to have its everyday meaning. LA will have to consider whether the adult’s needs and their consequent inability to achieve the relevant outcomes will have an important, consequential effect on their daily lives, their independence and their wellbeing. local authorities should look to understand the adult’s needs in the context of what is important to him or her. Needs may affect different people differently, what is important to one person may not be for others. 12

Eligibility and assessment (i) making use of necessary facilities or services in the local community including public transport, and recreational facilities or services; and (j) carrying out any caring responsibilities the adult has for a child. 13

Assessment and Eligibility cumulative impact – i.e. if a person meets 2 or more, it is not that these all must have a significant impact on wellbeing – but that the impact that they have combined. 14

Assessments There is a clear expectation that the assessment process should start from when the local authority begins to collect that information about that person (6.2). Assessments ‘must follow the core statutory obligations’ but the process can be flexible. (6.4) The assessment aim is to identify needs and outcomes to help people improve their wellbeing (6.5). Outlined below 6.12, sets out that eligibility can only be made on the basis of an assessment. Therefore a decision cannot be made as to whether someone is not eligible for care based upon their condition. An assessment must be carried out. 15

Challenges Local authorities are having to make tough choices based on resources There is not enough funding in social care 16

What are RNIB doing? Freedom of Information Request Raising the profile of care support for blind and partially sighted people with local authorities Identifying areas of bad practice and areas where rehabilitation needs to be addressed Reactive work Producing materials and resources Working with the sector Information leaflets for blind and partially sighted people 17

Role of the sector Local societies to promote their services within local authorities - particularly given that local authorities need to provide information and advice Ask questions around rehabilitation support Ensure that blind and partially sighted have the information they need so that they advocate their own needs 18

19 Contact details Tara Chattaway Or Campaigns Hotline RNIB registered charity nos (England and Wales), SC (Scotland) and 1109 (Isle of Man)