The Care Act:
Reforming Care & Support
Staff Conference
10 November 2014
Cathy Kerr, Director, Adult and Community Services

 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…
…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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“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

 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)

National
Assistance Act
1948
NHS and
Community
Care Act 1990
Community Care
(Direct
Payments) Act
1996
1948 1960… 1970… 1980... 1990… 2000… 2010…
Chronically Sick and Disabled
Person Act 1970
Carers
(Recognition and
Services) Act
1995
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 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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Key requirements
Duties on prevention and wellbeing
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
Timing
From April
2015
From April
2016

 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

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
Workforce Workforce already under pressure with problems recruiting social workers and paid carers.
Financial assessment
New ‘means test’; more residents eligible for Council funding
Carers
Increased demand for services but cannot accurately predict additional demand or resultant financial impact
Over 15,000 carers in the borough, currently only a small proportion with Council services.

 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
 Empowered people and strong communities work together to maintain independence and wellbeing
 I ndividuals 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.

 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’