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People Group The Care Act 2014 David Soley Service Manager Social Care and Support Warwickshire County Council davidsoley@warwickshire.gov.uk
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People Group Contents: A brief history of care & support Context for change Key provisions of the Care Act Implementation in Warwickshire Questions? 2
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People Group National Assistance Act 1948: established the welfare state and abolished the Poor Laws 19481960…1970… Chronically Sick and Disabled Persons Act 1970: reforms to key entitlements to community services A brief history of care and support NHS and Community Care Act 1990: first major set of reforms, including first right to assessments and start of commissioner/ provider split. 1980…1990…2000…2010… Carers (Recognition and Services) Act 1995: the first Act to recognise carers Community Care (Direct Payments) Act 1996: new powers to make direct payments Carers and Disabled Children Act 2000: extending direct payments to carers Health and Social Care Act 2001: updates on direct payments Social care law and policy has evolved over more than 65 years, incorporating around 30 Acts of Parliament, but reform has usually been piecemeal. The Care Act: reforming care and support
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4 Vision for Adult Social Care ___________ Nov 2010 Law Commission Report __________ May 2011 Dilnot Commission Report __________ July 2011 Caring for our future engagement _____________ Sept - Dec 2011 Caring for our Future White Paper Draft Care and Support Bill Progress report on funding ______________ July 2012 Engagement and pre-legislative scrutiny on draft Bill ________________ Jul 2012 – Jan 2013 Care Act in Parliament __________ May 2013 – May 2014 Announcement on funding reform ______________ Feb 2013 Implementation _____________ April 2015 – April 2016 The reform timeline The Care Act is the latest step the Government’s reform of Adult Social Care Consultation on draft regulations and guidance ______________ Jun - Aug 2014
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People Group Three-quarters of people aged 65 will need care and support in their later years Older people are the core user of acute hospital care - 60% of admissions, 65% of bed days and 70% of emergency readmissions. 72% of recipients of social care services are older people, accounting for 56% of expenditure on adult social care. Supported …and around 6 million people caring for a friend or family member. …around 400,000 people in residential care, 56% of whom are state-supported …around 1.1 million people receiving care at home, 80% of whom are state- supported …1.5 million people employed in the care and support workforce Care and support affects a large number of people In England there are… Context for change: demands on the system The Care Act: reforming care and support
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People Group Context for change factors affecting health & wellbeing 6
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People Group 7 Norman Lamb, Minister for Care and Support The principle of personalisation is at the core of these reforms. Rather than the state deciding what people need, people themselves will be able to shape their care and support around what they want, to achieve the outcomes that matter to them. To help them do this, the Act ensures that people will have clearer information and advice to help them navigate the system, and a more diverse, high quality range of support to choose from to meet their needs. The Act places more emphasis than ever before on prevention – shifting from a system which manages crises to one which focuses on people’s strengths and capabilities and supports them to live independently for as long as possible”
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People Group 8 The Care Act 2014: Relates primarily to adults in need of care and support, and their adult carers. Some provisions for the transition of children in need of care and support. Main provisions for Parent carers of children and young carers are in the Children and Families Act 2014 and are generally provided by Children's services
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People Group Underpinning Principles Wellbeing – Not Just about individual needs but “should also be considered by LA when it undertakes broader strategic functions e.g. planning” Prevention – Ranging from “to individual interventions to wide-scale whole population measures that promote health and well-being” 9
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People Group Cont.. Information and Advice – “Duty relates to the whole population and should address; care & support, prevention, wellbeing, finances, health, housing, employment, Adult Protection” Market Shaping – “Vibrant responsive market able to provide high quality personalised care regardless of who arranges or funds it” 10
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People Group The Care Bill: reforming care and support Built around people: New duty to promote well-being. New duty to prevent &/or delay the need for care & support. Assessments Emphasis on Outcomes (not deficits) Carers given the same status as the cared for (no longer required to provide ‘regular and substantial’ support). New duty to support Transition into Adult Services New duty to provide Information, Advice and Independent Advocacy (including financial advice)
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People Group Introduces funding reform: New legislative framework for Personal budgets & the right to receive Direct Payments. Cap on the care costs (£72,000). Universal deferred payments scheme prevents people having to sell their home in their lifetime to pay for residential care costs. Single national threshold for eligibility (new FACS) Increase Capital threshold (£23,250 - £118,000)
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People Group Greater protection: New legal framework for protecting vulnerable adults including Safeguarding Adults Boards. Ensures continuity of care when people move between Local Authority areas. New protections to ensure people don’t go without care if their provider fails regardless of who pays for their care. Ensures young adults receive appropriate care and support during their transition to adult services.
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People Group Key provisions of the Act Implementation April 2015: Wellbeing Prevention Safeguarding Vulnerable Adults Transitions to Adulthood Information & Advice (Including financial advice) Independent Advocacy (financial advice)
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People Group Implementation April 2015: Assessment (asset not deficits based) Carers Assessment (similar rights as ‘cared for’) Personal Budgets & Direct Payments Eligibility (Impairment, Outcomes, Wellbeing) Continuity of Care Cooperation with other statutory organisations Delegation of Local Authority Functions
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People Group Implementation April 2016 Cap on Care Costs Independent Personal Budget (eligible self funders) Care Accounts (for Self funders) Part 1 Appeals (against LA decisions)
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People Group Building on existing good practice Warwickshire County Council already provides: Personalised Adult Social Care services. Multi-Agency Adult Safeguarding arrangements Support for Carers. Deferred Payment scheme. Integrated Health and Social Care Services. Independent advocacy Engagement with the Third and voluntary sector in the commissioning cycle. WCC commission Community And Voluntary Action to support the Third and Voluntary Sector.
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People Group Person centred care and support planning People and their carers “must be actively involved and influential throughout the planning process”. Increases access to Advocacy including financial advice. Everyone should have a personal budget and the ability to meet needs by taking a direct payment must be clearly explained (DP’s are the preferred option). People should be free to choose innovative forms of care and support from a diverse range of sources including non-service options. 18
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People Group 19 Following a personalised assessment people are: Given a personal budget and asked the level of control they wish to take: o Direct Payment (preferred) o Managed budget o Combination of the two above o Independent Service Fund (ISF) People are supported to plan how they will use their personal budget; if they need help, then advocates, brokers or others can support them People can use their personal budget to achieve the outcomes that are important to them. Local authority continues to check people are okay and can change things if people are not achieving the outcomes they wish to achieve.
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People Group 20 Think Local Act Personal (Making it Real) Marks progress towards personalised, community based support Sets out what people who use services and carers expect to see and experience if services are truly personalised. 26 “ I " statements written by people who use services, carers and citizens describing what sort of support people want. Progress markers - written by real people and families to help organisations check progress towards personalised adult social care. Making it Real aims to give people more choice and control so they can live full and independent lives.
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People Group 21
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People Group 22 Health and Care Strategic Partner Programme Enables the Voluntary and Community Sector (VCS) organisations to work in equal partnership with the Department of Health, NHS England and Public Health England. Working at a national level. It allows each organisation to demonstrate leadership and innovation in the wider health and social care reform agenda. Programme developed from a partnership of 11 to 22 organisations establishing a robust model for working in partnership. It is estimated that through these Strategic Partners, over 300,000 organisations across the voluntary sector can be reached.
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People Group 23 Thank you Questions?
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