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Care Act 2014 Overview
What is the Care Act? • The most significant reform of social care legislation in more than 60 years • A single modern law that makes it clear what kind of social care people should expect • Takes into account: • Dilnot Commission’s Report into the funding of care • Francis Inquiry into failings at the Mid Staffordshire NHS Foundation Trust
The Care Act replaces many previous laws National Assistance Act 1948: established the welfare state and abolished the Poor Laws 1948 1960… NHS and Community Care Act 1990: first major set of reforms, including first right to assessments and start of commissioner/ provider split. 1970… Chronically Sick and Disabled Persons Act 1970: reforms to key entitlements to community services 1980… Community Care (Direct Payments) Act 1996: new powers to make direct payments 1990… Carers (Recognition and Services) Act 1995: the first Act to recognise carers Health and Social Care Act 2001: updates on direct payments 2000… 2010… Carers and Disabled Children Act 2000: extending direct payments to carers
Why is the Care Act necessary? Demands on the system • Care and support affects large numbers of people • Three-quarters of people aged 65 will need care and support in their later years Financial pressures • Councils are facing significant and increasing demand • Nationally, adult social care spending has fallen by around 8. 5% from 2011/12 to end of 2013/14
What is the Care Act trying to achieve? • Make care and support clearer and fairer • Promote people’s wellbeing • Enable people to prevent and delay the need for care and support • Put people in control of their lives so they can realise their potential • Develop integration with health and other partners
General duties Duty to promote wellbeing • Concept of wellbeing central to the Care Act • Need to consider physical, mental and emotional well-being • Influences the way all functions are carried out in relation to individuals • Assumption that the individual is best placed to judge their own wellbeing • Importance of achieving a balance between individual’s wellbeing and that of any carer
General duties Duty to prevent, reduce, and delay needs • Applies equally to those not receiving services and their carers • Three general approaches aimed at: • individuals who have no current health or care and support needs • individuals who have an increased risk of developing needs • minimising the effect of disability or deterioration for people with complex care and support needs • Working with independent, community and voluntary services key to prevent people’s needs escalating
General duties Duty to provide information and advice • Local authorities will need to ensure that information is provided so that the public can: • know how the care and support system works • access services that help prevent care needs from becoming more serious • make informed choices about care and support • know how to access independent financial advice • raise concerns about the safety or wellbeing of an adult • Financial information and advice even more important given funding reform from 2016
General duties Duty to shape the local market • Local authorities required to promote diversity and quality of local services so there is a range of high quality providers for people to choose from • Commissioning focussed on outcomes and promoting wellbeing • Need to foster an effective care and support workforce • Pay at least the minimum wage
First contact and identifying needs Eligibility • New national minimum eligibility threshold ensures more consistency • Based on “significant impact on wellbeing” - considered equivalent to current ‘substantial needs’ criteria
Carers • New rights to support for Carers • Carers put on same footing as those they care for • Carers supported to maintain their caring role for longer
First contact and identifying needs Independent advocates • Duty to provide an independent advocate where someone has substantial difficulty being involved in the process and there is no one to act on their behalf • Applies to care planning process - assessment, planning, review - safeguarding enquiries and appeals
Integration and partnership working Duty to promote integration and duty to cooperate • Greater integration between Adult Social Care, Health and Housing to improve outcomes for people • Commitment to make joined-up health and care the norm by 2018
New relationships Self-funders • Local authorities will need to establish a closer relationship with people who self-fund their care as: • there is a legal obligation to promote the health and wellbeing of the entire population; • if self-funders are not well informed about preventative support services and care options this may result in the earlier loss of independence; • once the funding reforms are introduced, self-funders who are eligible for support will want to register their spend on care with their local authority to start their care account.
Funding Reform 2016/17 • Current system for paying is based on laws written over 65 years ago • Developed at a time when few people lived into their 70 s and fewer needed care and support • Life expectancy is now 80 and rising • People more likely to need more care and support and need it for longer
Funding Reform 2016/17 Cap on Care Costs • Limit on the costs of care for eligible care and support needs • Cost per week is the amount that it would cost the person’s local authority to meet their needs if they were eligible • Does not include the costs of daily living • Cap on care costs set at £ 72, 000
Funding Reform 2016/17 Cap on Care Costs • When a person reaches the cap the local authority will pay a contribution towards the person’s care fees to cover the cost of care • Person will have to pay only a set amount for their daily living costs - £ 230 per week
Funding Reform 2016/17 Means test • Current rules – if a person has less than £ 23, 250 in assets they will receive means-tested help. • New system – people in a care home with less than £ 118, 000 in assets will qualify for means tested help with their care costs
Funding Reform 2016/17 Working Age Adults • People who develop eligible care and support needs below the age of 25 will have a zero cap for life • Those who develop a care and support needs from the age of 25, the cap will be set at £ 72, 000
Funding Reform 2016/17 Appeals • New Appeals system • People able to more easily challenge decisions about their care • Sits alongside existing complaints system and option of going to the Local Government Ombudsman.
What does this mean for partners and care organisations? • Need to respond to the wellbeing principle • Greater local authority involvement with self-funders • Greater local authority involvement in services focused on prevention • Greater local authority focus on promoting diversity and quality in the market
What’s happening in Derby? • Because of all the work we have done to introduce self -directed support and personalisation, we already complied in many areas • Carried out self assessment - identified gaps and developed projects to meet the requirements of the act • Completed financial models to estimate the additional cost of implementing the Care Act in Derby
Timetable • April 2015 – Part 1 - Majority of Care Act came into force • Summer 2015 – Receive confirmation of direction of travel for Part 2 following election • October 2015 – Receive final guidance and regulations for Part 2 • April 2016 – Part 2 - Funding reforms come into effect
Adult Social Care Restructure Aims of restructure - implemented in April 2014 • Improve the availability of advice and information • Focus on community support and early intervention • Promote self directed support for people with eligible needs and their carers • Make financial savings
Adult Social Care Restructure Objectives • Reduce hand-offs • Develop Local Area Co-ordination • Improve efficiencies in the Enablement service • Reduce duplication through clearer locality links with community matrons • Improve outcomes in specialist mental health settings • Improve self directed support through more customers support planning for themselves • Review safeguarding
Review of Adult Social Care Restructure Have partnerships with other organisations improved? • Has locality working led to more joint working and a more integrated approach to the delivery of health and social care in communities? • Does the current structure support hospital discharge more effectively? • Have the specialist teams created any improvement in the integration of their services with other partners? • How can partners work more effectively together to prevent, reduce or delay social care needs?
Questions • What’s working well? • What needs to change? • What would work better?
Opportunities for Feedback Workshop • Friday 29 May • 10 am – 12. 30 pm • Derbyshire Healthcare Foundation Trust, St James House, St Mary’s Wharf, Mansfield Road, Derby DE 1 3 AD • email Jodie Smith if you would like to attend Email • Send your feedback on what is working/what is not working by 5 pm on Thursday 28 May to Jodie. [email protected] gov. uk
More information • Olwen Wilson, Programme Manager, Derby City Council • Email: olwen. [email protected] gov. uk • Telephone: 01332 642742 • www. derby. gov. uk/careact