The Care Act
Reforming care and support
4 June 2014
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Implementing the reforms
Primary legislation – the Care Act 2014
The legal duties and powers
Secondary legislation – the regulations
More detail on critical requirements, often related
to processes. The scope of regulations will depend
on the powers specified in the Bill.
Statutory guidance
Guidance on how to meet legal obligations in the Bill.
Will set out at a high-level the expectations of local
authorities when exercising their functions. These are
not mandated requirements, but the LA must have
“cogent” reasons that it can legally justify if it wants to
take another course.
Practice guidance/implementation support
Best practice guidance, toolkits and other products
which help support implementation. These do not
have any legal status, so may be used by LAs, or not.
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The Care Bill: reforming care and support
Regulations and guidance
• Draft regulations and guidance for
2015/16 published shortly for public
consultation.
• Final regulations and guidance will be
published in October 2014 – six
months before law comes into force.
• Wide-ranging engagement with local
government and other key
stakeholders in the care and support
sector to shape and guide reforms –
including developing the draft
guidance.
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The Care Bill: reforming care and support
There will be around 20 sets
of regulations, including:
Assessment
National eligibility criteria
Charging
Financial assessment
Care planning
Direct payments
Continuity of care
Ordinary residence
Choice of accommodation
Deferred payments
Market oversight
Consultation
• Covers guidance and regulations for elements of care
and support reform that take effect in April 2015
• During the consultation we want to hear what you think
about the draft guidance and regulations
– We welcome views on anything included (or omitted) from the
draft guidance
– Do you have examples of best practice to help support
delivery?
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The Care Bill: reforming care and support
General duties
Duty to Promote wellbeing
• The well-being principle underpins the entire legal framework.
• It sets a defining purpose for care and support, and influences the
way all functions are carried out in relation to individuals.
• Shift from duty to provide particular services to a duty ( and
power) to meet needs (sections 18-20 of the Act)
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The Care Bill: reforming care and support
General duties (continued)
• Duty to provide information and advice
– Also a universal duty, but tailored information and advice for
specific groups will be vital
– Financial information and advice
• Duty to shape local market
– Commissioning focussed on outcomes and promoting
wellbeing
– Promoting choice to drive quality
– Importance of workforce
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The Care Bill: reforming care and support
General duties (continued)
• Managing provider failure
– CQC oversight of financial health of providers most difficult to
replace (due to size or specialisation)
– Local authorities have temporary duty to meet needs in cases
of provider failure
– Emphasis on contingency planning and advance warning
– Regulations set out:
– Definition of “business failure” that triggers duty
– CQC power to request financial information
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The Care Bill: reforming care and support
First contact and identifying needs
• Assessments and carer’s assessments
• Eligibility
• 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, plan, review)
and safeguarding enquiries and reviews
– Regulations define “substantial difficulty” in involvement,
requirements for an advocate, and what their role looks like
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The Care Bill: reforming care and support
Charging and financial assessment
• Charging for care and support
– Charging framework clarified for 2015/16
– Regulations set out process of financial assessment (including
monies to be disregarded) and limitations on power to charge
Deferred Payment Agreements
– Powers to require local authorities to offer a deferred payment
agreement to people with particular needs, or in particular
circumstances.
– These powers will be used to implement a universal deferred
payments scheme, so that people do not have to sell their
homes in their lifetime to pay for residential care.
– Regulations set out the criteria around both the duty and the
power to offer DPAs, and other conditions around DPAs
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The Care Act: reforming care and support
Care and support planning
• Care and support plans
– Duty to prepare a care and support plan for all those whose
needs are being met, including carers
– Duty to involve people in the planning process
– Legal framework for combining or integrating plans for
different people where appropriate
• Personal budgets
– Right to a personal budget as part of the care and support
plan.
– Can be combined with other personal budgets, e.g. health
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The Care Act: reforming care and support
Care and support planning (continued)
• Direct payments
– Right to a direct payment to meet some or all of needs in the
care and support plan.
– Direct payments must have proper oversight and be reviewed
regularly without being too burdensome
– Regulations set out situations where a local authority must not,
or may not, offer a direct payment; and other conditions
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The Care Act: reforming care and support
Integration and partnership working
• Duty to promote integration and duty to cooperate
– Duty to promote integration with NHS and other services
(including housing)
– Requirement to work collaboratively and cooperate with other
public authorities, both generally and in specific cases
• Boundary with the NHS
– Maintains the current legal boundary between NHS and local
authority responsibilities
– Regulations set out details of the boundary and the process for
dispute resolution
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The Care Act: reforming care and support
Integration and partnership working (continued)
• Delayed transfers of care
• Employment and welfare services
• Transition to adult care and support
– Duty to assess young people and carers in advance of transition
from children’s to adult services, where likely need as an adult
and when of “significant benefit”
– Regulations set out conditions for providing services to child’s
carers in advance of child turning 18 where appropriate
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The Care Act: reforming care and support
Integration and partnership working (continued)
• Prisons
– Each local authority responsible for prisoners in custodial
settings in its area
• Delegation of local authority functions
– New power to local authorities to delegate certain of their
functions under the Act to an external organisation
– Local authorities retain ultimate responsibility for how
functions are carried out, so people always have redress
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The Care Act: reforming care and support
Safeguarding
– New duty for local authority to carry out enquiries (or cause
others to) where it suspects an adult is at risk of abuse or
neglect.
– Requirement for all areas to establish a Safeguarding Adults
Board to bring together LA, NHS and police to coordinate
activity to protect adults from abuse and neglect.
– SABs to carry out safeguarding adults 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.
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The Care Act: reforming care and support
Moving between areas
• Continuity of care
• Ordinary residence
– Clarifying the deeming rules for ordinary residence for people
placed in accommodation in another area, so that people
cannot be left between areas with responsibility uncertain.
– A Schedule with new powers for cross-border placements
between England, Wales, Scotland and Northern Ireland.
– Updating powers for the Secretary of State to resolve disputes
between local authorities, and to allow local authorities to
recoup costs from each other.
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The Care Act: reforming care and support
Other areas
• Registers
– Local authorities must keep a register of adults who are
severely sight impaired and sight impaired in their area.
– Local authorities may also maintain registers of other people
with disabilities.
– Regulations define who should be treated as sight-impaired or
severely sight-impaired
• Transition to new legal framework
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The Care Act: reforming care and support
What happens next?
• Public consultation on draft 2015/16 regulations and statutory
guidance
• Finalise 2015/16 regulations and guidance by October 2014.
• Ongoing work to develop practice guides, toolkits and
implementation support over 14/15.
• Separate consultation later this year on those elements of the Act
that come into force in April 2016
• New statute will come into force from April 2015. (Funding
reforms come into effect from April 2016).
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The Care Bill: reforming care and support legislation