KICA conference 11 th February 2015 Hugh Constant S CIECareAct What well cover Overview of the Care Act 2014 What it means for local authorities What it means for providers Care Act 2014 ID: 793634
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Slide1
The Care Act 2014 – implications for providers
KICA conference – 11
th
February 2015
Hugh Constant
#
S
CIECareAct
Slide2What we’ll cover
Overview of the Care Act
2014What it means for local authoritiesWhat it means for providers
Slide3Care Act 2014
The
most significant piece of social care legislation since the establishment of the welfare stateBuilds on recent reviews and reforms
Consolidates good practice Replaces numerous previous laws to provide a coherent approach to adult social care in England
Slide4When is
it happening
?
Care
Act
care and support reform provisions
1 April
2015
Royal Assent
14 May 2014
Care Account and Care Cap
1 April
2016
Slide5What it seeks to achieve
The Care Act aims to ensure that the care and support system:
is clearer and fairer– more consistent and transparent
promotes individual’s wellbeing – physical, mental and emotional for all individualsenables people to
prevent, reduce or delay needs for care and supportputs individuals in control of their lives so they can pursue opportunities and realise their potential
Slide6Who is affected by the changes?
Slide7Where can the changes be found?
7
Different sections of the Act are designed to work together
Overlap
with children and families, including transitions
Slide8What is happening?
I
ncreased focus on individual wellbeing and prevention
Wider focus on the whole populationBetter access to information and advice
and assessments for allEmbed and extend personalisation
New model of paying for care - care account, care cap, PB and DPNew national eligibility thresholdDuty to
integrate
, cooperate and work in partnership between partners and local authorities
N
ew
safeguarding adults
duties
Slide9Wellbeing
Slide10Wellbeing
Individual contribution to society
Social and economic wellbeing
Work, education, training
& recreation
Personal dignity
Personal
control
Domestic, family
& personal
relationships
Protection from abuse & neglect
Suitability
of living
arrangements
Physical, mental & emotional health
Wellbeing
principle
Slide11Key points
Slide12General duties to all residents
Slide13General duties to residents with certain needs
Slide14Duties to individuals who meet certain criteria
Slide15General duties to people receiving care and support
Slide16General duties to people receiving care and support
Slide17What might this mean for local authorities?
New duties and
responsibilitiesChanges to local systems and processes
More assessments and support plansResponsibilities towards all local people
Training and development of the workforce Costs of reforms
Preparation for reforms needed
Slide18What might this mean for local authorities?
Slide19What does this mean for care organisations?
Offering services with regard to
the wellbeing principleGreater local authority focus on promoting diversity and quality in the market and market intelligence about self-funders needed
Greater local authority involvement in services focused on prevention and delayMarket oversight and provider failure arrangements
Charging changesOrdinary residence changesStatutory safeguarding arrangements
Slide20Market shaping Principles which should underpin market shaping and commissioning
Focus on outcomes and wellbeingPromoting
quality, including workforce development and remuneration, and appropriately resourced care and supportSupporting sustainabilityEnsuring choiceCo-production with
partnersA duty on local authorities to facilitate diverse, sustainable, high quality services in their area to provide people with meaningful choice regardless of who pays for care – it covers the whole market
Slide21Market position statement
Suggested, not mandatoryIt, market shaping, and the JSNA should involve consulting with:
people needing care and support, and representative organisationsindividuals and groups who are less frequently heardcarers and representative organisationshealth professionals, social
care managers and social workersindependent advocatessupport organisations that help people consider care choices (including financial options)
provider organisations (including housing providers and registered social landlords)wider citizens and communities
Slide22All in this together?
Slide23Market OversightApril 2015:
the financial health of the most difficult to
replace care and support providers will become subject to monitoring by CQCThese providers have a duty to provide information to CQCCQC have a duty to assess sustainability and inform local authorities when they consider a provider is likely to be unable to
continueAn early warning of likely failure so a local authority can prepare to step in if needed
Slide24Domiciliary CareApplies to only the largest and difficult to replace providers – i.e.
Domiciliary providers who deliver:30,000 hours or more care in a week,
or care to 2,000 or more people in a week, or care to 800 or more people in a week and they each receive more than 30 hours in that week
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Slide25Residential CareResidential care providers with:
bed capacity of 2,000 beds or more, or
bed capacity of between 1,000 and 2,000 beds and either they have beds in more than 16
LAsor the capacity in each of three or more LAs exceeds 10% of the bed capacity of those
LAs
Slide26Financial sustainability of other providers
The
vast majority of small and medium providers
LAs must ensure continuity of care in respect of business failure of all providers
Need to have contingency
plans an understanding of current trading conditionsa sense of the sustainability
of their pool of
providers
Strengthens
the need for contingency planning on all
parties
Slide27Managing provider failure and service interruptions
Triggered whenever there is business failure leading to a service
interruptionHowever this is only triggered “when the service can no longer be provided” What matters: whether the needs of the people affected appear to be
urgentThe duty on a local authority to ensure needs are met is not specific:providing information on alternative providers arranging
care and support
Slide28Charging and financial assessment – Care Act principles
Affordable Comprehensive
Clear and transparentPromote wellbeing, social inclusion, and personalisationIndependence, choice and control
Be person-focusedConsistent Encourage employment, education or training Help people plan for the future costs of meeting their needs Be sustainable for local authorities in the long-term
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Slide29Charging and Financial assessmentThis section replaces the Charging for Residential Accommodation Guidance(CRAG) and Fairer Charging
GuidanceIn 2015/16 sees little change from existing
practiceThe following do not change (save for annual uprating):DWP Benefits,Funded Nursing CareNHS Continuing CareUpper capital limit remains at £23,250 for 2015/16
Rules on the use of ‘top-up fees’ are re-enforced to make clear that all arrangements must be through the local authority. This means a provider must not seek a ‘top-up fee’ directly with the person receiving local authority funded care.
Slide30Charging changes for 2015/16
What does change from April 2015:
Deferred payments: People do not have to sell their homes in their lifetime to pay for residential careMust be offered by all local authoritiesCannot charge a carer for services provided to the person they care for, even if this is to meet the carer’s needs for
support
Slide31Deferred paymentsAll local authorities must offer deferred payment agreements when:
A) The person’s eligible needs are to be met by residential care,
B) The person has less than £23,250 in assets excluding the value of their home, andC) The home is owned outright and is not occupied by a spouse or dependent relativeLocal authorities may refuse a deferred payment if,They are unable to secure a charge on the property, orThe property is
uninsurableFirst party top ups are allowed within deferred payments
Slide32Charging changes: 2016
What changes from 2016:
Introduction of the cap on care costsRegulations now out for consultations£72,000 care costsNot included: up to £230 accommodation costs
Extension to the point at which means tested support becomes available. New limits will be:Upper capital limit of £118,000 in a care home, unless a property disregard applies Upper capital limit of £27,000 in all other settings or if a property disregard appliesLower capital limit of £17,000 in all settings
Slide33LA-arranged care for self-funders
For care in a care home:
“Self-funders” may ask their local authority to meet their needsThis may be by achieved by a range of activity, for example through signposting or
brokerageCan be chargedThe person cannot be charged more than the cost the local authority is able to secure, plus an administration charge
33
Slide34Ordinary residenceRegulations set out three types of accommodation:
Care home/nursingSupported living/extra
care housingShared lives schemes, where the principle of deeming appliesFor all of them, the relevant LA will be the placing LA, not the host LA, if the LA has arranged the careDetermining ordinary residence involves factors such as time, intention and continuity, and involves questions of both fact and
degreeThe “deeming provision”: the adult is treated as remaining ordinarily resident in the place the person has voluntarily adopted for settled purposes, whether for a short or long durationImplications, therefore, where the person lacks mental capacity
Slide35Safeguarding – LAs must:
Slide36Safeguarding – LAs must have regard to:
Slide37Safeguarding for providers
Poor care – a matter of practice and regulation, not
safeguardingDuty to share information
Slide38Summary – New Opportunities
Services aimed at prevention
different forms of intermediate carecommunity engagementinformation and adviceIndependent advocacy
Personal budgets and direct paymentsNew services as a result of integrationMore demand for carer support
Slide39More from SCIE
SCIE learning events
Safeguarding
Assessment and eligibilityCommissioningIn-house training and consultancy
SCIE resources www.scie.org.uk/care-act-2014
Register for SCIE e-bulletin at www.scie.org.uk Email CareAct@scie.org.ukPrevention Library http://
www.scie.org.uk/prevention-library
Social Care
Online
http://www.scie-socialcareonline.org.uk
/
Slide40National implementation support
Resources developed by SCIE, Skills for Care, Care Providers Alliance, The College of Social Work, etc.
www.local.gov.uk/care-support-reformRegister for care and support reform e-bulletin
CareBillReform@local.gov.ukPublic awareness campaign: Care and Support and You www.gov.uk/careandsupport
Care and support reform implementation
Slide41careact@scie.org.uk
hugh.constant@scie.org.ukwww.scie.org.uk