The Care Act and
Social Care Markets
June 2014
1
Summary of regulations and guidance
• Act introduces number of reforms concerned with adult social care markets
Market shaping
Market oversight & provider failure
Section 5
Sections 48 - 56
Guidance
Regulations
The Care Act
• Consulting on three draft packages of regulations and two packages of statutory
guidance in particular.
2
Definitions of
business
failure
Market shaping and
commissioning
The Care Act: adult social care markets
LA action on
provider
failure
Entry
criteria
Group
companies
Market shaping and commissioning
Market
intervention
Vibrant
Diverse
Sustainable
ALL LOCAL PEOPLE
i t y S e r v i c e s
The Care Act: market shaping
Market
Market Position
Statements
H i g h Q u a l
3
Strategic commissioning
i t y S e r v i c e s
– Focusing on outcomes and promoting
wellbeing
– Promoting choice to drive quality
– Supporting sustainability
– Working with partners and people
who use care/carers
– Approaches to market intelligence
and facilitation
– Importance of workforce
development and pay
– Securing quality and outcomes
through contracting
Local authority
H i g h Q u a l
Duty on local authorities to promote a
sustainable, diverse and vibrant market
for care and support that delivers high
quality services for all local people.
Continuity of care when a provider fails
Local authorities manage small
scale provider failure effectively,
and that most exits from the
market are handled responsibly by
providers.
Duty to step in to ensure that no
vulnerable person is left without
the care they need if their service
closes because of business failure.
•
•
•
4
Emphasis on contingency
planning.
Relationship with new CQC
regime for certain providers.
Determining the most
appropriate support for the
person.
The Care Act: provider failure
Business
failure
Service
closes
• Registered provider enters administration,
receivership, liquidation etc.
• The provider can no longer carry on providing
services.
• Local authority informed and steps in to meet
care and support needs for ‘as long as it
deems necessary’.
Local authority • Flexibility to determine how needs are met.
duty triggered • Duty applies in respect of all local people.
CQC oversight of ‘ difficult to replace’ providers
Southern Cross demonstrated potential
effect of a large provider failing financially.
CQC to begin monitoring the financial
sustainability of those 50-60 providers local
authorities would find difficult to replace
were they to fail from April 2015.
Aim is ensuring continuity of care and early
warning, not propping up failing providers.
CQC will engage with stakeholders to develop its operating procedures for the new
regime. Consultation on CQC’s proposed approach in autumn 2014.
– Regulations specify which “difficult to replace” providers are included – the entry criteria
– Requirement for CQC to assess financial sustainability – regulations allow CQC to look at
finances of organisations in providers group to assess sustainability
– Powers for CQC to require contingency plans, or an independent business review
– Requirement to inform local authorities when failure is imminent for a provider in CQC regime,
and to support local planning.
5
The Care Act: Market Oversight
Consultation Questions
We invite views on the entry criteria to the market oversight regime ,and whether and
how it should be made simpler for residential and non-residential care providers
We invite views on the approach to defining business failure by reference to insolvency
situations
We invite views on the insolvency situations listed e.g. are they appropriate and clear?
Should other situations be covered?
Are they appropriate and relevant to the various legal forms registered providers can
take?
Does the statutory guidance provide a framework to support local authorities and their
partners to take new approaches to commissioning and shaping their local market?
Are there any further suggestions of case studies or tools that can assist local
authorities in carrying out their market shaping and commissioning activities.
6
The Care Act: Market Oversight
Developing Care Markets for Quality and Choice
DH has funded the Developing Care
Markets for Quality and Choice
(DCMQC) programme, delivered
through the Institute for Public Care.
More information available at:
http://ipc.brookes.ac.uk/dcmqc.html
Support available to local authorities to
develop capacity to shape local markets
through:
Market intelligence
Market structuring
Market interventions
7
The Care Act: reforming care and support
Developing Care Markets for Quality and
Choice – outcomes…
• 126 local authorities have either published or are about to
publish a Market Position Statement (MPS)
• Facilitated provider engagement events
• A better understanding of self-funder market through
development of a toolkit for estimating self-funder use of
home care services
• Identification of potential future implementation support
programmes
8
The Care Act: reforming care and support
Commissioning Standards
• DH funded; ADASS/LGA led through Think Local Act Personal
group
• Delivery by Birmingham University Health Services
Management Centre
• Co-production with local government & sector
• Set of standards to be used as part of sector-led improvement
process led by LGA
• Aim of understanding and spreading best practice for local
government commissioning of social care
• Standards will be tested with local authorities later in the
year; final delivery by end of 2014.
9
The Care Act: reforming care and support
Further work on implementation
• Beyond Developing Care Markets for Quality & Choice and
Commissioning for better outcomes project… what support
would be helpful?
10
The Care Act: reforming care and support
The Care Act and
Social Care Markets
Dean.Morgan@DH.GSI.GOV.UK
Stephen.Airey@DH.GSI.GOV.UK
June 2014
11