The Care Act Reforming care and support

1 4 June 2014

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. 2 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and other key stakeholders in the care and support sector to shape and guide reforms – including developing the draft guidance.

3 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and support reform that take effect in April 2015 • During the consultation we want to hear what you think about the draft guidance and regulations – We welcome views on anything included (or omitted) from the draft guidance – Do you have examples of best practice to help support delivery? 4 The Care Bill: reforming care and support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) 5 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 6 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 7 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 8 The Care Bill: reforming care and support

Charging and financial assessment

• Charging for care and support – Charging framework clarified for 2015/16 –

Deferred Payment Agreements

– Powers to require local authorities to offer a deferred payment agreement to people with particular needs, or in particular circumstances.

– Regulations set out process of financial assessment (including monies to be disregarded) and limitations on power to charge 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 9 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 10 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 11 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 12 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 13 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 14 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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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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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 17 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 18 • New statute will come into force from April 2015. (Funding reforms come into effect from April 2016).

The Care Bill: reforming care and support legislation