The Care Act:
Assessment and eligibility
Paul Woods
Social Care Group
June 2014
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Assessment
• Assessment based on appearance
of care and support
• Assessment must:
– consider person’s needs & outcomes they
want to achieve;
– Consider if the person wants to carry out a
self-assessment
– Appropriate & proportionate;
– Whole family approach;
– Involve the person needing care, carer and
anyone else the person wants;
– consider if the person needs help to
participate in the assessment, advocacy?
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Assessment
• Assessment must also
consider:
– Prevention;
– Person’s own skills, wider support
network or community.
• Assessors must have
appropriate training and be
competent.
• Specialist training to carry out
assessment of people who are
deafblind.
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Eligibility
• National minimum eligibility threshold has been set through
the Spending Review for 2015/16.
• This will allow current practice continue in the vast majority
of local authorities.
• Eligibility threshold set in regulations. Engagement on first
version of the draft regulations started last June:
1.
2.
3.
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DH held engagement workshops;
– Eight workshops held: three in London, Birmingham, Taunton, Derby,
Preston, Gateshead. Around 250 people, representing over 100 local
authorities
The Care and Support Alliance engaged with people who use services and
their carer’s; and
–
Nearly 400 users of care services and carers took part in the survey.
Comments received through the eligibility mailbox
– 68 submissions from 63 respondents (34 third sector organisations, 24
local authorities, 5 individuals)
Key Messages on Eligibility for People with Care
and Support Needs
Workshops
(Local Authorities)
•Regulations are easier to
understand than FACS
•The draft regulations will increase
the number of people eligible for
local authority arranged services
•The language of the regulation
reflects the deficit model rather than
reflecting what the outcomes the
person wants to achieve.
•Request for definitions for certain
phrases (eg. significant) and
consistency in use of the language
•Groups that might not be covered
include no recourse to public funds
and substance misusers.
Survey
(Service Users &
Carers)
•Social care is vital to well-being –
explicit references to well-being in
the regulations are important.
•Definitions of basic personal care &
basic household activities on the
right track. Communication and
social interaction is missing and
should be specifically included.
•Mobility around the home is not
adequately reflected and should be
made clear.
•‘Fluctuating needs’ are common
and very important in the
regulations.
•High interpretation of ‘significant
risk’ broadly equivalent to critical
FACS.
•Language deficit based.
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Mailbox
•Voluntary Sector: Description of a
person’s ability to complete a task
should follow the PIP model.
• Prompting and supervision should
be part of definition of assistance.
•Level of threshold as currently
worded is too high to serve
prevention agenda.
•Emphasis on wellbeing is important
to progress social care, but worry
that ambiguous wording will not
lead to more people in need getting
the help they require.
•Local Authorities: Not equivalent to
description of substantial: ‘one or
more’ vs. majority of needs.
•Emphasis on wellbeing will raise
people’s expectation of eligibility for
funding. This could lead to legal
challenges, which will divert
resources from the right purpose.
•Costs of reforms are
underestimated.
Eligibility: Research
Estimated eligibility under FACS:
older people
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The Care Bill: reforming care and support legislation
Estimated eligibility under national
eligibility criteria: older people
Eligibility: How the draft regulations
have changed
• Making clear the tests to be considered: (1) care and support
needs (2) unable to carry out an activity (3) significant impact on
the person’s well-being.
• Requiring that an adult must require support to achieve some
“basic care activities”.
• The list of “basic care activities” includes “basic household
activities” and now includes the adult’s ability to getting up and
dressed and moving around their house.
• Clarified the wording of the carer’s eligibility criteria.
• Removed references to making carer’s eligible for support where
they do not want to carry out a caring role.
• Introduced a requirement to consider whether the carer or the
person they care for has fluctuating needs.
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The Care Bill: reforming care and support legislation
Continuity of Care
• New process to ensure that a person can move between
authorities without having their care interrupted.
• Guidance proposes that where possible and the person
agrees, equipment and adaptations will move with the
person.
• Is this the right approach?
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The Care Bill: reforming care and support legislation
Any Questions?
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