1. © Karen Ashton Public Law Solicitors June 2014 (C) Karen Ashton1

2. In much of the written and oral evidence we have received during the course of our inquiry we heard a consistent message about the inadequacy of funding for adult care and support. As a result care and support have increasingly been rationed and restricted to those with the highest levels of need. This is ultimately self-defeating—shunting costs and reinforcing the dominance of crisis and acute care over approaches that prevent and postpone the need for formal care and support 2(C) Karen Ashton

3. 3 Duty to:  assess on appearance of need  determine whether eligible needs  meet eligible needs But need for “care and support” - not need for community care services (C) Karen Ashton

4. 4 How to meet needs (1) The following are examples of what may be provided to meet needs (a) accommodation in a care home or in premises of some other type; (b) care and support at home or in the community; (c) counselling, advocacy and other types of social work; (d) goods and facilities; (e) information and advice. (C) Karen Ashton

5. 5 “Having an entitlement “to meet needs” rather than those in the past to provide a particular service (for example a care home) means that there is more flexibility to focus on ….. a package of care and support that suits them. It means that the person is not judged to need a service too soon before a proper care and support planning process has taken place” (Fact sheet) (Emphasis added ) BUT will this lead to more disputes about whether the support is adequate? (C) Karen Ashton

6.  Gov currently consulting  Much of detail will be here e.g. national eligibility criteria in regs  All old guidance will go – one new ‘suite ‘ of guidance (C) Karen Ashton6

7. 7  Overarching statutory principle  Supported self-assessment  National eligibility threshold  Personal budgets  Carers’ assessments and services  Human rights protection  Portability  Safeguarding  Advocacy  Self –funders  Delegation  Appeals (C) Karen Ashton

8. 8  General duty to promote individual's well- being  When exercising any function  Defines well-being  Failure to follow the principle challengeable by way of JR ‘Mere puff’ or something of substance? (C) Karen Ashton

9.  Personal dignity (including treatment of the individual with respect);  Physical and mental health and emotional well-being;  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 well-being;  Domestic, family and personal relationships;  Suitability of living accommodation;  The individual’s contribution to society (C) Karen Ashton9

10.  Draft regs “an assessment carried out jointly by the local authority and the individual.”  Guidance: Only if individual wants to use this process  Guidance: Must complete the same assessment paperwork as in ordinary assessment  LA must assure itself that complete and accurate  LS makes the eligibility decision. (C) Karen Ashton10

11. 11  Gov said would create something equivalent to current Substantial band  Draft regs (C) Karen Ashton

12.  Needs caused by physical or mental impairment or illness  Unable to achieve a specified outcome  Likely to be significant impact on adults well- being (C) Karen Ashton12

13. Specified outcomes:  Carrying out some or all basic activities  Maintaining family/ significant relationships  Engaging in work, training, education or volunteering  Accessing necessary facilities in community  Caring responsibilities for child. (C) Karen Ashton13

14.  Basic activities: means essential care tasks that a person carries out as part of normal daily life including –  Eating and drinking;  Maintaining personal hygiene;  Toileting;  Getting up and dressing;  Getting around one’s home;  Preparing meals; and  The cleaning and maintenance of one’s home.” (C) Karen Ashton14

15. NB not only inability to achieve an outcome BUT also Significant impact on well-being e.g. cleaning (C) Karen Ashton15

16. 16  Duty to provide a ‘care and support plan’ with PB  Personal budget - the cost to the local authority of meeting those of the adult’s needs  Draft guidance – must be enough to meet care and support needs  Is being able to point to a service which will provide it for that amount enough? (C) Karen Ashton

17. 17  No mention of RASs  No express right to choose how to spend only to be consulted  Impact of overarching principle? Well-being means well-being in relation to “control by the adult over day-to-day life (including over the care and support provided to the adult and the way it is provided)”. (C) Karen Ashton

18. 18  Equivalent rights to service users  No longer need to undertake substantial and regular care: “Carer” means an adult who provides or intends to provide care for another adult”  contracted carers or volunteers excluded unless LA decides otherwise) (C) Karen Ashton

19.  Draft regs - national minimum eligibility criteria:  eligible if, as a consequence, carer is unable to provide some of the necessary care or  Unable to undertake specified tasks such as household activities or health at risk. (C) Karen Ashton19

20.  Extended to apply to non-residential as well as residential care. (C) Karen Ashton20

21. 21  Sending authority notifies receiving authority  Receiving authority must assess  If not completed in time – receiving authority must meet the needs being met by sending authority  If receiving authority decides needs are different must give a written explanation  Does not apply where out of area res placement (C) Karen Ashton

22. 22  SABs to be on statutory footing  Coordinating and policy role and serious case reviews  But NB new duty to carry out enquiries in individual cases when LA reasonably suspects abuse (C) Karen Ashton

23.  Duty to arrange independent advocate  where individual would experience “substantial difficulty” participating in assessment, support planning, review.  Not if LA satisfied there is an approp person to represent and either adult consents or LA satisfied it’s in BI (C) Karen Ashton23

24. 24  Duty not only to assess but arrange services if requested to do so  Can charge a fee unless service user does not have sufficient mental capacity to make own arrangements and there is no one in a position to do so on their behalf (what happened to willing and able?) (C) Karen Ashton

25. 25  Broad power to delegate to any person (not just another statutory body)  Includes eligibility decisions  Exclusions include safeguarding, charging, making direct payments.  LA will retain legal responsibility - but transparency? (C) Karen Ashton

26.  S72 gives power to set up appeals system through regs  Nothing yet  Unclear what it might look like  Further consultation (C) Karen Ashton26

27.  £23m for introducing threshold similar to Substantial  £175m for carers’ services 27(C) Karen Ashton