1. Heather Begg Adult Social Care Redesign Team
The Care Act 2014 Overview
Heather Begg
Adult Social Care Redesign Team

2. Care Act 2014 Consolidates and Replaces:
National Assistance Act 1948
Chronically Sick and Disabled Persons Act 1970
NHS and Com Care Act 1990
Carers (Recognition and Services) Act 1995
Community Care (Direct Payments) Act 1996
Aims to:
Be Clearer and Fairer
Promote Wellbeing
Prevent/delay needs for support
Put people in control

3. Principle of Wellbeing Assessment, including Carers
National Eligibility Criteria
Care and Support Planning and Review
Deferred Payments
Funding Reforms
Principle of Wellbeing-Care Act recognises that new models of care and support are emerging which embrace innovation and flexibility, rather than previous legislation which focussed on traditional models of care. Providers need to understand the principle of wellbeing and consider if there are any additional services providers might wish to supply.
Funding Reforms: From April 2016 the cap will be set at £72,000. This means the maximum amount anyone will have to pay for care to meet their eligible care and support needs from April 2016 onwards will be £72,000. In many cases, particularly with the extension to the means test, people will pay less than this before they reach the cap. This is because those receiving help with their care costs from the local authority will not pay the full amount themselves, but the total cost of meeting their eligible needs will accrue towards the cap. We are proposing to set daily living costs at £230 per week. This is the amount that will not count towards the cap. When a person reaches the cap they will still be responsible for paying their daily living costs.
We are also consulting on a different approach for working age adults. Under our proposals from 1 April 2016 anyone who develops eligible needs before they turn 25 years of age will benefit from a ‘zero cap’ meaning that they will not have to pay the costs of care to meet their eligible care and support needs for life.

4. Nine Areas Of Wellbeing
Individual contribution to society
Social and economic wellbeing
Work, education, training and recreation
Personal dignity
Personal control
Domestic, family and personal relationships
Protection from abuse and neglect
Physical, mental and emotional health
Strengths-based approach:
The most robust sense of wellbeing is the one coming from within the individual;
The more fragile sense of wellbeing is that coming from outside the individual and from sources distant from the individual
Suitability
of living arrangements

5. Wellbeing Principle
All the different areas are related
Different times = different priorities
Different people have different priorities
Important to start with the assumption that the individual is best placed to judge their own wellbeing. Affects how care/support is expected to be delivered in a very positive way

6. New Areas most affecting providers:
Market Shaping
Managing Provider Failure and Service Interruptions
Market Oversight
Commissioning high quality, outcomes-based services that focus on wellbeing
Market Position Statement-encourage dialogue and understanding between private providers, third sector and voluntary and community based organisations
Market sustainability
LAs have a duty to ensure customers needs are met where any business has failed
Outcomes Based-Services: Moving more to an outcomes-based approach therefore means changing the way services are bought: from units of provision to meet a specified need (for example, hours of care provided) to what is required to ensure specified outcomes for people are met. The approach should emphasise prevention, enablement, ways of reducing social isolation and promotion of independence as ways of achieving and exceeding desired outcomes, as well as choice in how people’s needs are met. Outcomes should be used as a principal measure for quality assurance of services.
Tom Penney comments:
Market Shaping-’Open to active dialogue and strategic discussions about what role they can play in the Market.’
Market Position Statement- ‘Merton’s Market Position Statement will be available on the Website September this year’.
Market Oversight-’Commissioning have regular contact with all key providers to ensure their business is in good shape’.
CQC’s new function to oversee the financial sustainability of providers that would be difficult to replace were they to fail.

7. New Areas most affecting providers:
Statutory Safeguarding
Information, Advice and Guidance
New statutory framework for protecting adults from abuse and neglect
6 Key SG Principles: Empowerment, prevention, proportionality, protection, partnership and accountability
Providers to always report to borough as LA make decision on whether safeguarding or not(where person has care and support needs)
Multi-agency Safeguarding Adults Board
LA has a duty to provide information and advice to whole population and tailored to people following needs/carers assessment
Establish and maintain an information and advice service, in accessible ways and tailored to the needs of the individual/local people in Merton.
Providers to ensure LA has information about service, including costs

8. New Areas most affecting providers:
Duty of Candour:
Requires all health and social care providers registered with CQC to be open when things go wrong
Legal requirement requires providers to offer an apology and state what further action the provider intends to take
For further guidance:

9. New Areas most affecting providers:
Prevention
Independent Advocacy
Personal Budgets and Direct Payments
Smoothing transition
Integration, co-operation and partnerships
New Opportunities:
Prevention:
Prevent-promote wellbeing. Reduce, early intervention. Delay, rehabilitation, reablement. A preventative approach requires a broad range of interventions which LA may provide or in partnership with local providers
Primary Intervention- e.g. Universal services, info and advice, safer neighbourhoods, promotion healthy and active lifestyles, reducing isolation
Secondary Intervention- Reablement services, falls clinics, assistive technology, minor adaptations ... Providers customers may benefit from these.
Independent Advocacy:
If you as a provider conclude that a person you are working with has “Substantial” difficulty in being involved with these processes and that there is no appropriate individual to support and represent them for the purpose of facilitating their involvement you must arrange for an independent advocate to support and represent them.
Personal Budgets and Direct Payments:
All customers(and some Carers) who have a Care and Support plan will have a personal budget. Some people have their PB via a Direct Payment, others will appoint a provider to manage a customer’s PB via an ISF-this could be something Merton explores in the future.
Smoothing Transition:
Ensuring assessment is done at a point where it is of significant benefit to the young person, and ensure there is continuity of Care, so all agencies and providers work together to ensure that this happens.
Integration, co-operation and partnerships:
Duty for all organisations involved in someone's care and support to work together. New services are likely to emerge as a result of this.
Some ways on which Las will promote greater integration are Health and Wellbeing Boards, Joint Strategic Needs Assessments, joint health and Wellbeing and Commissioning strategies, local development plans.

10. Heather.Begg@merton.gov.uk 0208 545 4515
Any Questions ?