Local Authority
implementation of the
Care Act 2014
Hazel Summers
Head of Strategy Commissioning
Overview of this presentation
• To provide a picture of community care legislation
to provide the backdrop to adult social care
• To set out social care is provided is Manchester
• To provide an overview of the new governance
model
• To highlight the anticipated financial implications
• To set out the challenges for Manchester
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Slide 2
A brief history of care and support
Social care law and policy has evolved over more than 65 years, incorporating
around 30 Acts of Parliament, but reform has usually been piecemeal.
National
Assistance Act
1948: established
the welfare state
and abolished the
Poor Laws
1948
NHS and Community Care
Act 1990: first major set
of reforms, including first
right to assessments and
start of commissioner/
provider split.
1960…
1970…
Chronically Sick and
Disabled Persons Act
1970: reforms to key
entitlements to
community services
The Care and Support Reform Programme
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…
Carers and Disabled
Children Act 2000:
extending direct
payments to carers
2010…
The reform timeline
The Care Act is the latest step in the timeline for reform, and builds the
Government’s Vision for Adult Social Care document and White Paper.
Engagement and
pre-legislative
scrutiny on draft Bill
________________
Jul 2012 – Jan 2013
Law
Commission
Report
__________
May 2011
Caring for our
future
engagement
_____________
Sept - Dec 2011
Vision for
Adult Social
Care
___________
Nov 2010
Dilnot
Commission
Report
__________
July 2011
The Care and Support Reform Programme
• Caring for our
Future White
Paper
• Draft Care and
Support Bill
• Progress report
on funding
______________
July 2012
Care Act in
Parliament
__________
May 2013 –
May 2014
Announcement
on funding
reform
______________
Feb 2013
Implementation
_____________
April 2015 –
April 2016
Consultation on
draft regulations
and guidance
______________
Jun - Aug 2014
Caring for our Future
The care and support White Paper was
published in July 2012 and set out the
Government’s vision for the future system.
If adult care and support in England is going to
respond to challenges it must help people to
stay well and independent:
• Promote people’s wellbeing
• Enable people to prevent and postpone
the need for care and support
• Put people in control of their lives so
they can pursue opportunities to realise
their potential
The Care Act 2014 implements this
vision.
The Care Act: reforming care and support
What do we do now in terms of adult
social care provision?
• Contact Centre – gateway to service or signposting
• Fair Access to Care Services Screening
• Eligible customers progress onto community care
assessment
• Duty to meet identified needs
• Personalisation: Choice and Control
• Support Planning – Cash/Virtual or Mixed Individual
Budgets
• Follow up review after 6 weeks and annually
thereafter
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A picture of the process
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Current eligibility through FACS
Individual Budget to bands 1 & 2 at present
Critical
Statutory
under Fair Access to Care Services
1 duty
Critical – care needed NOW
Substantial
needed in next 6 weeks
2 – Care
Substantial
We meet Low and Moderate needs via early intervention and
prevention work e.g. social care equipment and community alarm
3
Moderate
4
Low
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Living Longer Living Better:
What are we aiming to achieve across the health and social care
economy?
Health and Wellbeing
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Slide 9
New Directions via the Care Act
2014
“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”
Norman Lamb, Minister for Care and Support
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New opportunities
• To meet the statutory requirements of the
Care Act 2014
• To revisit some areas that may need some
further transformation
• To welcome the new opportunities to codesign with Public Health e.g. wellbeing
• To work beyond the city at a regional level
through new approaches e.g. Prison Care
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Challenges for Manchester (1)
Financial
implications
LA Significant
Cash
Reductions in
Funding
Support per
Head Across
England
Challenges for Manchester:
•
New focus on self funders
•
•
Wellbeing – we already do that but no definition provided?
Market shaping and commissioning –Increased commissioning duties
around management of provider failure
•
New duties to assess both people who use care and their carers; we
are awaiting the regulations on the national eligibility threshold
Already started the work on improving advocacy & financial advocacy
for self funders
•
Other challenges (2)
•
•
•
•
Implications of charging for care and support, deferred
payment agreements and Care Accounts
Safeguarding – definitions of abuse and neglect welcomed,
role of the Safeguarding Board etc but set against new
demands around DoLS and Cheshire West ruling
Transition to adulthood – how does this complement work
already underway around SEN’D reforms and introduction
of Education, Health and Care Plans
Prisons – 1/3 of LAs have a prison within their authority –
how will we meet those needs?
Summary
• LAs are working at a regional level to prepare for
the Care Act implementation and the regulations
issued on 3rd week of October
• We welcome the strengthened duties towards
carers, as well as focus on early intervention and
prevention
• The work with self funders provides us with a new
opportunity to gain market intelligence and, in turn,
use that for market shaping
• Overall the Care Act provides a solid platform to
meet the needs of a wider group of older, disabled
and vulnerable people….we just need to resource
it….but all LAs are generally starting from the same
point
Our ‘ask’ of the VCS
• Continue to work with us to shape the
policy and commissioning landscape for
the city
• Feedback on the changing care
landscape; what’s working well/not so
well
• Support the implementation work through
a robust communications campaign
• Thank you for listening today