Care Act 2014

1. Care Act 2014

2. Presented by Simon Cheverst of RadcliffesLeBrasseur November 2014

3. Background • Legislative development • Reflective of the changing philosophy • Complete review and overhaul required

4. Community care legislation at present • National Assistance Act 1948 • Health Services and Public Health Act 1968 • Chronically Sick and Disabled Persons Act 1970 • Section 117 of the Mental Health Act 1983 • Disabled Persons (Consultation, Recognition and Services) Act 1986 • NHS and Community Care Act 1990 • Carers (Recognition and Services) Act 1995 • Health and Social Care Act 2001 • Section 254 and Schedule 20 of the NHS Act 2006 • Not to mention the Guidance….

5. Review and Response • Reviews are undertaken by the Dilnot Commission and the Law Commission followed up by consultation, White Papers, debate and draft bills • Former legislation repealed and replaced with Care Act 2014. • Staggered implementation: • General community care provisions come into effect on 1 April 2015. • Funding aspects of reform to come into effect 1 April 2016.

6. Arrangement of the Care Act 2014 • General Responsibilities (s 1 – 7) • Examples of how to meet need (s 8) • Assessment of needs and eligibility (s 9 - 13) • Duties and powers to provide for needs (s 18 - 23) • Direct and deferred payments (s 31 – 36) • Continuity of care and ordinary residence (s 37 – 41) • Safeguarding (s 42 – 47) • Market Shaping and transitions for young people (s 53 – 66) • Advocacy (s 67 – 68) • Duty of Candour (Part 2) • Underpinned by statutory regulations and guidance.

7. General responsibilities of Local Authorities • Section 1 – Promoting individual wellbeing. • Outcome focused and underpinned by principles of wellbeing

8. Section 1 outcomes • Personal dignity • Physical and mental health, and emotional wellbeing • Protection from abuse and neglect • Control over day to day life • Participation in work, education, training or recreation • Social and economic wellbeing • Domestic, family and personal relationships • Suitability of living accommodation • Individuals contribution to society

9. Wellbeing checklist • Assumption that the person is the best judge of their wellbeing • Persons views, wishes and feelings • Importance of preventing or delaying needs • All the persons circumstances • Full participation in decision making • Balance with wellbeing of carers • Protection from abuse and neglect • Minimum restrictions

10. General duties • Preventing needs for care and support (s.2) • Promote integration of health and social care (s.3) • Information and advice (s.4) • Promote diversity and equality in services (s.5)

11. Duty to cooperate • General duty to cooperate with relevant partners (s.6) • Specific duty to request cooperation with relevant partners (s.7)

12. Assessment Sections 9 to 12 provide that: • The Local Authority are under a duty to assess where an adult appears to need care and support. • That adult has a right to refuse an assessment, save where he or she lacks capacity and the assessment is in their best interest, or where there are safeguarding concerns. • There is a duty to consult the adult, any carers and any other person named by the adult. • Regulations provide the right to a supported self assessment and a specialist assessment. • The assessment should be proportionate to the presenting issues.

13. Eligibility criteria Section 13 provides : • A national eligibility framework. • The governmental duty to set eligibility criteria in regulations. • New national minimum thresholds set at substantial. • In order to qualify the person must have 1) an impairment or illness; 2) be unable to achieve 2 of the listed outcomes which 3) has a significant impact on wellbeing.

14. Listed outcomes • Nutritional needs • Hygiene needs • Toiletry needs • Clothing needs • Safety at home • Maintain a habitable home environment • Develop or maintain relationships • Engage in work training, education or volunteering • Accessing and making use of community services • Looking after a child

15. Carers rights Sections 10 to 13 provide: • A duty to assess any carer who appears to have need for support. • Removal of the requirement that the support be provided on a regular/substantial basis. • Removal of the requirement for the carer to request an assessment. • A duty to provide a service if the need arises from 1) the caring activity, 2) a (one) listed circumstance applies and 3) this has a significant impact upon wellbeing.

16. Carers outcomes • Care for a child • Provide care to those other than the adult • Maintain a habitable home • Nutrition • Maintain personal relationships • Access the community • Engage in recreational activity

17. Following assessment • Sections 25 and 26 provide the right to a care and support plan, and also place a duty on the Local Authority to provide a personal budget. • Section 29 places a duty upon the Local Authority to provide a care account. • Section 30 places a duty upon the Local Authority to provide or arrange preferred accommodation. • Sections 31 to 33 provide a right to direct payment.

18. Financial assessments and charging At present and until April 2016: • Financial upper threshold of £23,250 (capital) and lower threshold of £14,250. • Minimum income for non-residential care linked to income support regulations (ISR) + 25% + disability related expenses. LA’s have some discretion. • Certain income and capital sums must be disregarded (personal injury payments, etc). • Those above the threshold can ask the LA to arrange though an administration charge may be levied.

19. The Reforms April 2016 Cap on care costs: • £72,000 for older people. • Lower for people of a working age (figure to be determined though estimated at somewhere in the region of £40,000) • Zero pounds for those 18 or younger at the point the need arose. Financial assessment for residential services (UL remains at the 23k level for non-residential services) • £118,000 upper limit • £17,000 lower limit Mandatory deferred payment scheme in operation.

20. Adult safeguarding • Puts for the first time adult safeguarding on a statutory footing. • Section 42 provides that the Local Authority must make enquiries it considers necessary (or cause enquiries to be made where it suspects: • An individual has care and support needs. • An individual may be subject to abuse or neglect. • Is unable to safeguard themselves.

21. Safeguarding Adult Boards (SAB) Section 43 and schedule 2 provides: • A duty on the Local Authority to establish a SAB • With primary objective to help and protect adults at risk of abuse or neglect. • NHS and Police must nominate members with required skills and experience. • Section provides statutory duty to provide information to an SAB. • Statutory safeguarding adults reviews (section 44). • SAB may do anything necessary or desirable in achieving the primary objective.

22. Additional reforms • Extension of the Human Rights Act to services procured by the Local Authority. • Right to portable assessments. • Changes to Section 117 of the Mental Health Act. • New appeals process. • Rights to advocacy. • Transitional assessments for young people. • Care and support in prison. • Duties in the case of business failure.

23. DISCUSSION…