Transcript THE CARE ACT What’s in it for social workers

THE CARE ACT
What’s in it for social workers
Joe Godden
[email protected]
With Thanks to Peter Feldon, BASW member
BASW want to know what your views
and experiences are re the Act
• Will be discussion in a few minutes
• going to do a bit of an overview of the
Act and identify key things identified for
social workers
Background to the Care Act
•
•
•
•
•
Consolidation
Philosophy
Funding – Dilnot etc.
Integration agenda
Filling some gaps e.g. Carers and Advocates
What are the most important changes?
•
•
•
•
Asset based approach / personalisation
Independent advocates
National eligibility criteria
Statutory requirement for prevention
and advice
• Cap on care costs
• Carers rights
• Consolidation in one place
Care & Support Statutory Guidance
• Published in late October 2014
• Over 200,000 words
• Overview from SCIE
What the Guidance says about the role of social
workers
• providing advice to other staff
• debt recovery
• managing complexity
• safeguarding
Providing Social Work Advice
• Information and advice – staff undertaking this
role should have “access to the support of
registered social work advice”
• Person-centredness – “In ensuring that the (care
and support planning) process is person-centred,
the local authority should ensure that ..there is
sufficient local availability of …access to social
work advice.”
Debt Recovery
• Positive resolution through use of social work
skills
• Mediation
• Debt indicative of a wish to leave a care home
or depression, mental ill-health or dementia
Managing Complexity
•
•
•
•
Eligibility
Prevention
Safeguarding
‘Substantial difficulty’
in involvement
• ‘Sufficiency’ of the
personal budget
Your views
• Q1 Do you support the principles of the Act?
• Talk to person on either side of you and discuss:
– Something you are positive about, including positive examples of potential
benefits of the Act
– Something you are worried about re the implementation
– Other issues you want to raise:
• Do you feel that you have adequate training?
• https://www.facebook.com/BASW.UK May 6th
Survey 176
How do you think implementation of the Act is
going?
Cause of problems
Any problems in implementation
Comments ctd
• “Understanding that this is a fundamental change to the way social
work is practiced to support a strengths based model of support,
means reclaiming the heart of social work”.
• “None whatsoever. It has been a shambles. And I thought Council
couldn't stoop much lower”
• “Assessment forms introduced with the new Act have been easier to
use than expected and seem to focus well on client need”.
• “It has led to significant simplification of our processes and
forms/plans”.
Budget pressures
• The cash invested in Adult Social Care will reduce by a further 1.9%
in 2014 - 15 (equivalent to £266m). This is the third year of
continuing cash reductions and the fifth year of real terms
reductions in spending.
• Since 2010 spending on Social Care has fallen by 12% at a time
when the population of those looking for support has increased by
14% requiring savings of 26% to be made, totalling £3.53bn over
last 4 years. ADASS
• The LGA has long warned that the health and social care system is
chronically underfunded.
Additional funding
• £335 million for cost of implementation
• £135 under Better Care Fund (BCF)
• The Public Accounts Committee has criticised initial planning for
the £5.3bn better care fund as 'deeply flawed'.
• NHS spending “was judged a higher priority than supporting adult
care”. MPs say there are serious concerns with regard to the
protection of adult social care and that it appears likely the fund
will not support adult social services to the extent originally
anticipated LGC
• £4m for training
Post election
• British Association of Social Workers – Guy Shennan, chair:
“We want to see a return to a commitment to social justice.
Social workers have had to deal with the fallout of the austerity
agenda. It’s time for government to play fair and stop
punishing the poor for the economic failures of the rich”.
Guardian 8.5.15
Post election
• Association of Directors of Adult Social Services – Ray James,
president: “We urge the government to act to meet the
significant growth in the volume and complexity of needs faced
by generations that rightly expect to lead longer, more fulfilled
lives. We want to see a system that is protected through
adequate funding and a sustainable workforce
• Guardian 8.5.15
Conservative party manifesto
• “The manifesto is silent about the unprecedented challenges
facing social care”. Kings Fund
• according to the Institute for Fiscal Studies the Tories will also
need to find £30bn in real-terms cuts from ‘unprotected’
departments, including social care
• Labour manifesto made reference but no funding
So what do we do social workers do re the Care Act
• Stay positive about the principles
• Get to know the Act – it is a requirement of your HCPC
registration to be up to date re legislation – and it is your
responsibility
• Partnership with users and carers – lets learn together and if
necessary challenge together
• Think about outsourcing – debate is taking place
• Stronger together in BASW “The strong independent voice for
social work and social workers”
National eligibility framework
 After the assessment process, the LA will
determine whether the individual has
eligible needs
 National eligibility threshold:
- whether the person has needs due to a
physical or mental impairment or illness
- whether those needs mean that they are
unable to achieve two or more specified
outcomes
- as a consequence there
is, or is likely to be, a
22
Eligibility Framework
Interpreting the eligibility criteria
The specified outcomes are:
 Managing and maintaining nutrition
An adult meets the
eligibility criteria if:
 Their needs are caused
by physical or mental
impairment or illness
 As a result of the adult’s
needs they are unable to
achieve two or more
specified outcomes
 As a consequence there
is or is likely to be a
significant impact on the
person’s well-being
 Maintaining personal hygiene
 Managing toilet needs
 Being appropriately clothed
 Being able to make use of the home safely
 Maintaining a habitable home environment
 Developing and maintaining family or other
personal relationships
 Accessing and engaging in work, training,
education or volunteering
 Making use of necessary facilities or
services in the local community including
public transport and recreational facilities
or services
Carrying out any caring responsibilities the
adult has for a child
24
Interpreting the eligibility criteria
An adult meets the eligibility criteria if:
 Their needs are caused by physical
or mental impairment or illness
 As a result of the adults needs they
are unable to achieve two or more
specified outcomes
 As a consequence there is or is
likely to be a significant impact on
the person’s well-being
An adult is to be regarded as being unable to achieve an
outcomes if the adult:
 is unable to achieve it without assistance;
 is able to achieve it without assistance but:
 doing so causes them significant pain, distress or
anxiety;
 doing so endangers or is likely to endanger health
or safety;
 takes significantly longer than would normally be
expected.
25
Eligibility threshold
An adult meets the eligibility criteria:
 Their needs are caused by
physical or mental impairment or
illness
 As a result of the adults needs
they are unable to achieve two
or more specified outcomes
 As a consequence there
is or is likely to be a
significant impact on
the person’s well-being
An adult is to be regarded as being unable to achieve an
outcome if the adult:
 is unable to achieve it without assistance;
 is able to achieve it without assistance but doing so
causes the adult significant pain, distress or anxiety;
 is able to achieve it without assistance but doing so
endangers or is likely to endanger the health or safety
of the adult, or of others; or
 is able to achieve it without assistance but takes
significantly longer than would normally be expected.
The specified outcomes are:
 Managing and maintaining nutrition
 Maintaining personal hygiene
 Managing toilet needs
 Being appropriately clothed
 Being able to make use of the home
safely
 Maintaining a habitable home
environment
 Developing and maintaining family
or other personal relationships
 Accessing and engaging in work,
training, education or volunteering
 Making use of necessary facilities or
services in the local community
including public transport and
recreational facilities or services
 Carrying out any caring
responsibilities the adult has for a
child
26
Case studies
• Florence Brown is 75 years old and lives alone in a house that
she used to share with her husband (who died six months ago)
and her two daughters. She suffers from COPD, is frail and has
restricted mobility
• Adam is 47 years old and has a diagnosis of moderate/severe
learning disability
• Mishal is in her early 30’s and was diagnosed with multiple
sclerosis four years ago.

National carers eligibility
framework
After completion of the assessment process, the
local authority will determine whether the carer
has eligible needs
 Carers can be eligible for support in their own right
 The Act introduces a national carers’ eligibility
threshold:
- whether the carer’s needs are due to providing
necessary care for an adult
- whether those needs puts the carer’s health at risk or
means that they are unable to achieve specified
outcomes; and
- as a consequence there is, or is likely to be, a
28
significant impact on their
wellbeing
Prevention
• Preventing or delaying the development of needs
for care and support, and also reducing needs that
already exist – can help people maintain
independence for longer
• Information and advice to be given regardless of
eligibility
• Assessments to consider whether the person
“would benefit” from preventative and other
services
• Should be evidence-based?
• Preventive services could result in a person no
‘Substantial difficulty’ in involvement
• Consider if a person might have substantial
difficulty in being involved with the care and
support process or safeguarding
• Areas of difficulty:
– understanding the information provided
– retaining the information
– using or weighing up the information as part of
the process of being involved
– communicating the person’s views, wishes or
feelings.
• Areas of difficulty are the same as those listed
Supporting a person’s involvement
Might this
person have
difficulty in
being
involved?
Do they still
have
‘substantial
difficulty’ in
being
involved?
Yes
Can they be better
supported to
enable their
involvement?

Yes
Provide
support and
make
adjustments
Yes
Agree
‘appropriate
individual’
No
Duty to
arrange for
independent
advocate
[Reasonable
adjustments under the
Equality Act 2010]
Yes
Is there an
‘appropriate
individual’ – a
carer, friend or
relative – that can
facilitate their
involvement?


31
‘Sufficiency’ of the personal budget
 The personal budget must:
– always be sufficient
– reflect the cost to the local authority of meeting the person’s needs
 Direct payments are not intended to be less than is required to
purchase care and support on the local market