The Care Act
Consultation on guidance and regulations:
Personalisation and care planning
Personalisation: the journey so far
The Health and Social
Care Act: update to the
legislation and new
regulations to expand
direct payments
1996
2001
The Community Care
(Direct Payments) Act:
the first legislation for
allow for direct
payments to people
from the local authority
2
A Vision for Adult Social
Care: embedding
personalisation firmly in
Government policy
2007
2010
Putting People First:
the concordat which
enshrined the
personalisation agenda
and started the focus
on personal budgets
DH – Leading the nation’s health and care
The Care Act:
mainstreaming
personalisation into
adult social care
2012
Caring for our Future:
the White Paper
announcing plans to
legislate to provide
personal budgets to all,
supported by a draft Bill
The future
Personalisation & the Care Act – Overview
A new legislative focus on personalisation, increasing opportunities for
greater choice and control:
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•
Placing personal budgets into law for the first time, ensuring they will be provided to
everyone as part of the care and support plan (also mandatory).
•
Duties to review care and support plans generally, and a new right for people to request
a review of a care and support plan.
•
Clarifying the right to request a direct payment, with clear conditions to meet in primary
legislation.
•
Improving the range of services on offer for people with a direct payment or personal
budget by focusing on the local authority market shaping role.
•
Creating better information, advice and support for users of adult social care to inform
their choices, including rights to independent advocacy.
DH – Leading the nation’s health and care
Personalisation & the Care Act – Guidance
Aim: to aid interpretation of the Act and to set out the
general policy intentions
4
•
People should be encouraged to self-plan, and supported to do so.
•
There should be no limitations (within reason) about how people choose to
meet needs – flexibility and innovation should be encouraged.
•
People (and anyone else) should be involved throughout the planning processes.
•
The personal budget process should reflect the principles of: transparency,
sufficiency and timeliness
•
Direct payments must be provided where requested, providing the conditions in
the Act have been met, and Regulations do not state otherwise.
DH – Leading the nation’s health and care
Personalisation & the Care Act – Regulations
1) Exclusions of costs from the personal budget
[Care and Support (Personal Budget Exclusion of Costs) Regulations 2014]
•
Where intermediate care/reablement is being provided to meet eligible needs (ie not
being provided as a free universal service) the costs of this must be excluded from
the personal budget.
•
The definition of intermediate care/reablement is defined in the regulations as:
“intermediate care (including reablement support) services” means care and support
provided to an adult by a local authority under section 18 or 19(1) or (2) or 20(1) or
20(6) of the Act which—
– consists of a programme of care and support;
– is for a specified period of time;
– has as its purpose the provision of assistance to an adult to enable the adult to
maintain or regain the skills needed to live independently in their own home.”
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DH – Leading the nation’s health and care
Personalisation & the Care Act – Regulations
2) Direct Payments
[Care and Support (Direct Payments) Regulations 2014]
•
Mainly carry on the legislative framework under existing regulations (2009)
•
Changes include:
– Relaxing the ban on family members in the same household from receiving
DPs, to allow LAs discretion to allow DPs to these groups for admin &
management of the DP (but not care);
– new rules that prevent the DP holder being forced to use the DP with one
particular provider, and prevent the LA monitoring the DP excessively.
– Bringing forward the first review of making the DP from 12 months to 6
months
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DH – Leading the nation’s health and care
Consultation questions
Care planning
• Does the guidance on personalisation fully support and promote a care and support system
that has personalisation at its heart?
• Does the guidance on personalisation support integration of health and care (and any other
state support)?
• Does the guidance support care and support workers to do their job effectively?
Personal budgets
• Is this definition clear and does it conform to your understanding of intermediate care and
reablement? Is there any way it can be improved?
• Does excluding the cost of reablement/intermediate care from the personal budget as
defined above:
• Create inconsistencies with the way that reablement/intermediate care is provided in
NHS personal health budgets?
• Affect the provision of reablement/intermediate care for people with mental health
problems?
• Are the ways in which different personal budgets can be combined sufficiently clear?
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DH – Leading the nation’s health and care
Consultation questions
Direct Payments
• Will the easing of the restriction to pay family members living in the same household for
administration/management of the direct payment increase uptake of direct payments?
Will this create implementation issues for local authorities?
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•
The draft direct payment regulations decreases the time period to conduct a review of the
direct payment from 12 months to 6 months – is this workable?
•
The draft regulations seek to ensure choice is not stifled and the direct payment is not
monitored excessively – is it strong enough to encourage greater direct payment use, but
workable for local authorities to show effective use of public monies?
DH – Leading the nation’s health and care