The Care Act:
Reforming Care & Support
Staff Conference
10 November 2014
Cathy Kerr, Director, Adult and Community Services
WHAT I WILL TALK ABOUT:
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Care and support context
What the Care Act is
The timescales
Key points at national level
Challenges for the Council
Thames agreement and the Care Act
Local vision
CARE AND SUPPORT: DEMANDS ON THE SYSTEM
Three-quarters of people aged 65 will need care and support in their later years
19 per cent of men and 34
per cent of women will
need residential care
48 per cent of men and 51
per cent of women will
need domiciliary care only
33 per cent of men and 15
per cent of women will
never need formal care
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.
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NATIONAL CONTEXT – DEMANDS ON THE SYSTEM
Care and support affects a large number of people
In England there are…
Supported
Supported
…around
400,000 people
in residential
care, 56% of
whom are statesupported
…around 1.1
million people
receiving care at
home, 80% of
whom are statesupported
…1.5 million
people
employed in
the care and
support
workforce
…and around 6
million people
caring for a friend
or family member.
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WHAT IS THE CARE ACT? (1)
“Reforms mark a generational shift in our system
of care, a shift from a system that is essentially
paternalistic, reactive and prescribed to one that
is preventative, personalised and proactive in
its care approach.
A system that focuses on people's strengths,
that seeks to secure personal wellbeing
replacing one that focuses on deficits and
meeting need.”
Jon Rouse Director General for Social Care, Dept. of
Health, May 2014
WHAT IS THE CARE ACT (2)?
 Biggest change in Adult Social Care legislation for 60
years
 Reforms the law and funding regime relating to care
and support for adults and carers
 New legal framework - brings legislation together into
one modern law
 Encompasses the whole population not just those with
eligible social care needs
 Integration with health runs throughout the Act
 Some duties are not new and we have already
progressed these (Personal budgets, Direct Payments)
THE CARE ACT REPLACES MANY
PREVIOUS LAWS
National
Assistance Act
1948
1948
1960…
NHS and
Community
Care Act 1990
1970…
Chronically Sick
and Disabled
Person Act 1970
1980...
Community Care
(Direct
Payments) Act
1996
1990…
2000…
2010…
Carers
(Recognition and
Services) Act
1995
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AN INTEGRATED ACT
 Different sections of the Act
are designed to work together
 Local authority wide
 Overlap with Children and
Families, including transitions
 Partnerships and integration
 Leadership
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SUMMARY OF THE CARE ACT DUTIES
Key requirements
Timing
Duties on prevention and wellbeing
From April
2015
Duties on information & advice (inc paying for care)
Duty on market shaping
Assessments (including carers’ assessments)
National minimum threshold for eligibility
Personal budgets and care and support plans
Safeguarding
Universal deferred payment agreements
Extended means test
Care accounts
Capped charging system
From April
2016
NATIONAL PICTURE
 97% of Councils say that they are very or fairly
confident that they will be able to deliver the
Care Act Reforms from April 2015
 Potential support needs particularly around
costs, IT, workforce, information and advice,
carers and market shaping
 Other pressures on councils (e.g. funding
shortfalls, Better Care Fund) compounded with
uncertainty on key guidance and information
has delayed or otherwise impacted upon
preparations in a number of areas
CHALLENGES FOR THE COUNCIL
Area
Risks
Self funders Many self funders within the borough. With “Care Cap”
more self funders will become responsibility of Council.
Eligibility
New framework may mean more residents eligible for
services bringing more people into the care system.
Finance &
Resources
Increased demand for services but cannot accurately
predict additional demand or resultant financial impact
Workforce
Workforce already under pressure with problems recruiting
social workers and paid carers.
Financial
New ‘means test’; more residents eligible for Council
assessment funding
Carers
Over 15,000 carers in the borough, currently only a small
proportion with Council services.
THAMES AGREEMENT & CARE ACT
 Monthly meeting between Programme
Managers (Richmond and Kingston)
 Joint events to share knowledge
 Areas of joint interest :
 Commissioning new services (e.g. advocacy)
 Information and advice
 Common resource directory
OUR CARE ACT VISION
Consistent with our local plans and strategies
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Empowered people and strong communities work together to maintain
independence and wellbeing
Individuals not institutions take control of their care.
Information about care and support, including financial information, is available for
all local people, regardless of whether or not they fund their own care or whether
they are receiving health or social care.
Care and support is delivered in partnership between the NHS and social care
with wider support from voluntary and private sectors and housing.
The variety of people’s needs is matched by diverse service provision, with a
broad market of high quality service providers.
We can draw on a workforce across health and social care who can provide care
and support with skill, compassion and innovation, and who are given the freedom
and support to do so.
Carers are valued and supported and are given the same respect as those they
support.
FINALLY….
 This is new, significant and unknown; we are
establishing our understanding
 It is resource intensive – people and money
 The Council will have to make decisions on new
issues – we will at some point stop doing some
things we do and start doing new things
 Requires significant culture change
 Health services are an integral part of this
 Lots of challenges – but all consistent with our
agreed ‘direction of travel’
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Care Act - Reforming Care and Support