The Care Act 2014

Briefly, what is the Act about?

Prevention

Assessment & Eligibility for support, how funded, and who pays

Needs (Not about services or packages of care)

Adults and Carers have control over their own care needs and the outcomes they desire

‘Wellbeing’

An Act in Two parts

Changes happening in April 2016:

A cap on costs people pay to meet their eligible needs; Creation of a care account giving people with eligible needs an annual

statement of their progress toward the cap; Extending financial support provided by the LA by raising the means test

threshold for those with eligible needs.

Changes impacting on Halton and happening in April 2015:

Duty to provide prevention, information and advice services; National minimum threshold for eligibility for service users and carers; Carers entitled to an assessment, support services and support planning; People who fund their own care have a right to receive advice and support

planning; A universal system for deferred payments for residential care

National Assistance Act 1948: established the welfare state and abolished the Poor Laws

NHS and Community Care Act 1990: first major Government reform, including right to assessments

Community Care (Direct Payments) Act 1996: new powers to make direct payments

Health and Social Care Act 2001: updates on direct payments

Chronically Sick and Disabled Persons Act 1970: major reforms, providing entitlement to community services

Carers (Recognition and Services) Act 1995: the first Act to recognise carers

Carers and Disabled Children Act 2000: extending direct payments to carers

A brief history of care and support law

Around 30 Acts of Parliament over more than 60 years:

1948 1960… 1970… 1980… 1990… 2000… 2010… 2014…

Care Act 2014

A Closer Look at Wellbeing

• Personal Dignity – treating the person with respect

• Physical and Mental Health and emotional wellbeing

• Protection from abuse and neglect - safeguarding

• Control by the person over their day-to-day life - including care & support provided and how it is provided

• Participation in work, education, training or recreation

• Social and economic wellbeing

• Domestic, family and personal relationships

• Suitability of living accommodation

• The person’s contribution to society

A Closer Look at Prevention

Day CareTelecare and Visbuzz pilotIntermediate CareRARSBridgewater Community Falls PreventionHalton’s Integrated Wellness ServiceLoneliness Strategy:• Community Bridge Builders• SureStart• Intergenerational activities• Health Improvement Team – groups for older people• Numerous Activities from: Age UK, Red Cross…etc

What does the Care Act 2014 do?

It delivers many of the commitments in the Caring for our future White Paper. It is built around people and: Ensures that people’s wellbeing and the outcomes

that matter to them are central to every decision that is made involving that person and their care

Puts carers on the same footing as those they care for giving them enforceable rights and an assessment

Focuses on preventing and delaying needs for care and support

Puts personal budgets on a legislative footing for the first time, which people can receive as direct payments if they wish

What else is does it do?The Act makes care and support clearer and fairer, it:

Provides a single national threshold for eligibility to care and support

Guarantees continuity of care when people move, so their care package moves with them

Ensures no one goes without care if their provider fails, regardless of who pays for their care

Ensures young adults are not without care and support during their transition to adult social care

Introduces a cap on care costs to limit on what people will pay in their lifetime £72,000

Ensures people do not have to sell their homes in their lifetime (to pay for residential care) by providing a deferred payments scheme

Eligibility Criteria - AdultsAdults must meet all three bullet points: 1. Needs result from physical/ mental disability or illness;2. Person cannot achieve at least 2 specified outcomes;3. Not meeting these outcomes will significantly affect the person’s wellbeing.

Specified outcomes are:• Carrying out some or all Basic Care Activities• Maintaining family or other significant personal relationships• Accessing or engaging in work, training or volunteering• Accessing local community services – transport, medical services…etc• Carrying out any responsibilities the adult has for a child

An adult is considered unable to achieve an outcome if: They cannot achieve it without assistance; They can do so without assistance, but the result is personal pain, stress or anxiety; They can achieve it without assistance, but are likely to endanger their health and the

safety of others; They can achieve it without assistance, but would take much longer than expected.

If a person’s needs fluctuate, the LA must take into account their circumstances over whatever period is deemed necessary to establish their level of need

Eligibility Criteria - Carers

Carers must meet all three bullet points: [1]. A Carer’s physical/ mental health is at risk of deteriorating

[2]. The Carer cannot achieve any of the following outcomes: - Carrying out any caring responsibilities for a child; - Providing care to other people for whom the carer provides care; - Maintaining a habitable home environment in the Carer’s home; - Managing and maintaining nutrition; - Developing and maintaining family or other personal relationships; - Engaging in work, training, education or volunteering; - Using necessary facilities or services in the local community; - Engaging in recreational activities.

A Carer is regarded as unable to achieve an outcome if: a) Cannot achieve it without assistance; b) Can achieve it without assistance, but causes pain and distress; c) Can achieve it without help, but endangers their/ others health & safety.

[3]. Failure to meet outcomes will significantly impact on the Carer’s wellbeing

Where Carer’s needs fluctuate LA takes into account circumstances over a period

Maintaining Skills and Knowledge

Assessments must be of the highest quality. This means that LAs must ensure their staff have the skills, knowledge and competence to undertake assessments and that this level of best practice is maintained through appropriate training. This means that assessors must:

Identify the person’s needs and outcomes

Identify how these impact on wellbeing

Consider the person’s strengths and capabilities

Consider universal services that may help to improve their wellbeing

Person-centred care and support planning

Individuals are entitled to a care and support plan (support plan for carers), including a personal budget

This CS Plan is negotiated with the person A legal responsibility to ensure the support plan meets the

individual’s needs and outcomes Includes principles for calculating a personal budget Strongly promotes direct payments – a right in law Councils with low numbers of direct payments may need

to expand capacity and back office functions Duty to provide information and advice on meeting and

preventing need to people who are not eligible for support

Wider role for Local Authorities

Requirement to arrange independent advocacy

LAs are required to work collaboratively and cooperate with other authorities including a duty to promote integration with NHS and other services.

Partnerships and dependencies

• Closer planning, collaboration and integration with health and housing. Councils will need to assess current practice, identify gaps, Public Health and Health Improvement messages would be part of the integrated approach

• Training in best practice / models for health and social care integration

Safeguarding

• New duty for LA to carry out enquiries (or cause others to) where it suspects an adult is at risk of abuse and neglect

• Requirement to establish a Safeguarding Adults Board (SAB) to bring together LA, NHS and police to coordinate activity to protect adults from abuse and neglect

• SABs to carry out reviews into cases where someone who is experiencing abuse or neglect dies or there is concern about how authorities acted, to ensure lessons are learned

• New ability for SABs to require information sharing from other partners to support reviews or other functions

• Councils will need to review current practice and ensure senior managers, external partners understand their legal responsibilities

First statutory framework to protect adults from abuse and neglect:

Questions ?