The Care Act is a new law about care and support for adults in England that will come into action from 1st April 2015. Currently there are many different laws regarding care and support which makes it difficult to know what help is available. The Care Act will bring them together in one new law.
Clear and simple rules and guidance accompany the Act which say:
- What people are able to get, and
- What councils have to do.
The main themes of the Care Act are around promoting:
- Independence and well-being: Having greater choice and control in what care and support you receive so that you can live your life the way you want to
- Prevention: Thinking about things that will help to stop problems before they start, or to stop them getting worse as early as possible
- Integration: Working with other organisations to provide the support that you need
- Choice and control: Your care and support plan will help you to do the things that are important to you
- Information and advice: Having good quality information to help you choose the right care and support for you
- Carers entitlements and rights: Carers will be entitled to their own assessments to see if they are eligible for support
- A national eligibility criteria and changes to assessment for care: The same rules about who can get care and support will apply all over the country
- Advocacy: If you find it very difficult to be involved at any stage of your assessment or care planning, and there is no-one else to speak for you, then the council must find you an independent advocate who will help you to say what you want to say and represent your best interests to get the services you need
- Keeping adults safe: This is the first time we have had a law telling councils what to do to help keep adults safe from abuse or neglect.
The most important part of the Care Act is called the wellbeing principle. This says that councils must promote the individual’s wellbeing in all decisions taken or activities performed in relation to them. Failure to promote individual wellbeing will be illegal.
This means ensuring that people have:
- Personal dignity (including treatment of the individual with respect)
- Physical and mental health and emotional wellbeing
- Protection from abuse and neglect
- Control over their day-to-day lives (including over care and support provided to the individual and the way in which it is provided)
- An opportunity to participate in work, education, training or recreation
- Social and economic wellbeing
- The ability to enjoy domestic, family and personal relationships
- Suitable living accommodation
- A chance to contribute to society.
A very critical report into the state of adult social care law, written by the Law Commission, concluded that:
- The care system often fails to live up to the expectations of the people who rely on it
- The care system is inflexible forcing people to accept what was on offer instead of shaping services around what is important to individuals, what they find acceptable and what they want to achieve
- The legal frame work underpinning adult social care is so confusing that many of the people who used care services did not understand what they were entitled to and councils were unclear about their responsibilities.
Concerns about the care system were heightened by the Mid Staffordshire NHS Hospital Trust scandal (which centred on a hospital which covered up its unusually high death rates and poor patient care), the Dilnot Report into the ‘unfair’ cost of care and the failure of Southern Cross Health Care, the biggest care home provider, threatening elderly patients with eviction from their care homes.
Against this background case and with increasing concern about the care systems ability to support a growing population of elderly people, the case for change is vital.
No. It is important to understand that while the Care Act is primarily concerned with adult social care it is not just about adult social care. It is relevant to organisations which commission (purchase) and provide health and adult social care services, to voluntary organisations, to housing providers, to children’s services and to those bodies responsible for inspecting services and making sure that they are safe to use. In fact it is hard to think of any aspect of welfare provision in Wigan and across England that the Care Act will not touch upon.
A needs assessment is how Wigan Council decides whether a person needs care and support to help them live their day-to-day life.
A carer’s assessment focuses on people who provide, or intend to provide, care for another adult, not as part of paid or voluntary work.
Where an individual provides or intends to provide care for another adult, councils must consider whether to carry out a carer’s assessment if it appears that the carer may have any level of need for support.
Wigan has a duty to carry out a needs assessment to determine whether an adult has a need for care and support. This means that the assessment:
- Must be provided to all people who appear to need care and support, regardless of their finances or whether the council thinks their needs will be eligible
- Must be of the adult’s needs and how they impact on their wellbeing, and the outcomes they want to achieve
- Must be carried out with involvement from the adult and, where appropriate, their carer or someone else they nominate, including an independent advocate provided by the council.
If you agree and are able to do so you may carry out a self-assessment. This allows you to take the lead in identifying your needs and outcomes. The council will still be involved to support your self-assessment and to ensure that you have identified all of your needs, but you will have more control.
You have the right to refuse an assessment and if, at a later date, you change your mind you can just request one. However, if we believe an individual lacks the mental capacity to refuse an assessment or is at risk of experiencing abuse or neglect we will carry out an assessment where this is in the person’s best interests.
Assessments must be carried out by trained assessors, for instance a social worker, and will consider a number of factors:
- Your needs and how they impact on your wellbeing – such as a need for help with getting dressed or support to get to work
- The outcomes that matter to you – such as whether you are lonely and want to make new friends
- Other circumstances – such as whether you live alone or someone supports you.
The aim of an assessment is to get a full picture of you and what needs and goals you may have.
After carrying out the assessment, a decision has to be taken about whether, or not, any of the needs identified in the course of the assessment process are eligible for help from the council.
At the moment, each council sets its own eligibility for care and support. This means that in some areas needs will be supported, but in others they won’t. To make things fairer the Care Act introduces, from 1st April 2015, a new national eligibility criteria, so all councils will have to meet the care and support of someone who has the minimum level of need. Councils may also meet needs that are not covered by the minimum, if they choose.
To meet the Care Act’s eligibility criteria a person’s needs must meet all of the following conditions:
- They have care and support needs as a result of a physical or mental condition
- Because of those needs, they cannot achieve two or more of the outcomes specified:
- 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.
- The person’s needs have a significant impact on their wellbeing.
You can see the government's national eligibility criteria in their care and support statutory guidance document (external link).
If you are currently receiving care and support and your needs meet the new eligibility criteria, you will continue to receive this support. If you do not meet the criteria you will be provided with the advice and information needed to find alternative provision. Wigan Council believes that it already meets the new national minimum criteria.
Care and support planning is about you working with an assessor to find out:
- What is important to you
- Things you can do to live well and stay well
- What care and support you might need from others
Care and support planning is for anyone who has health and care needs over time.
The council must prepare a support plan that sets out in detail how a person's needs will be met. The plan will detail the needs to be met and how they will be met, and link back to the outcomes that you want to achieve in your day-to-day life. It’s important that your care and support plan and your assessment reflect your wishes, needs and aspirations, and what matters most to you.
Good care and support planning is central to providing person-centred care and support that provides people with choice and control over how to meet their needs. We will take all steps to agree a care and support plan with you. We will involve you and anyone else you ask to be involved in the production of your plan.
The council also recognises that it has a legal responsibility to review care and support plans to make sure that your needs and outcomes continue to be met over time.
We recognise that some people will need assistance to make plans and decisions and to be involved in the planning process. Therefore we will always, with your permission, include your carer and any other person you want to be involved in planning your care and support.
Where there is no one who can represent your views we will make sure that you have an independent advocate to facilitate your involvement. Particularly where people experience substantial difficulty in understanding relevant information, or retaining that information, or using that information as part of the process of being involved, or communicating their views, wishes or feeling.
For the first time, carers will be recognised in the law in the same way as those they care for. This will affect how carers are assessed and their eligibility and will also affect how carers interact with councils as a result.
You can ask for a carers assessment whether or not the person you care for receives financial support from the council. The Care Act says that to be considered for an assessment you need to have support needs of your own and caring responsibilities now or in the future.
A carer’s assessment might lead to practical help, a break from caring responsibilities, or things that will help you or support your wellbeing (such as a laptop computer or a gym membership).
If carers needs meet the new national eligibility criteria they qualify for help from the council and we will offer to undertake a carer’s assessment.
If you live in a different area to the person you care for, it will be the local council for the person you care for that is responsible for assessing and supporting your needs.
A personal budget is the amount of money made available to meet an individual’s eligible needs and allows that person to take informed decisions about how their needs will be met.
The Government hopes that personal budgets will take the form of direct payments which allows the service user or carer to receive cash in lieu of services. Once made, these payments can be used by their recipients to arrange and pay for their own services.
No problem. We recognise that some people will not want to arrange their own services and others will struggle with this task. Therefore, while everyone must have a personal budget, we will manage it and your service arrangements for you, if that is what you want.
The Care Act introduces 'independent personal budgets'. These are entirely new and allow people (following assessment) with eligible needs that the council is not under a duty to meet (either because they do not qualify for financial assistance or do not want the council to meet their needs) to request an independent personal budget, setting out what the council would spend on meeting their eligible needs. This then enables them to qualify for state funding when their accrued costs reach the cap.
As with actual personal budgets, the council must keep independent personal budgets under review and reassess people on these budgets if they feel their circumstances have changed and revise them accordingly. Independent personal budgets are complemented by 'care accounts' (see below) which record or measure people’s progress towards the cap.
DPAs mean that if you move into a care home but do not want to sell your home in your lifetime, you are not forced to do so. Wigan Council will consider a deferred payment agreement if you have insufficient income to meet the full cost of your stay in care and your capital is under the current threshold of £23,250 (not including the value of your home). Under the Care Act this threshold will rise to £118,000 in 2016.
From April 2015 a national ‘universal deferred payments scheme’, will be introduced as part of the government’s reform of the way that care is paid for. The council will have discretion to consider a ‘deferred payment’ if you are someone that has other capital, excluding your home, that is reducing to near or below the threshold amount. A national interest rate will be set for councils to help cover the cost of lending for the duration of a stay in a care home.
No, councils have been offering DPAs for some time (since 2001), however what is new is the requirement to offer these to all individuals who meet the eligibility criteria. What this means is expanding and building on existing systems.
The Act also changes how DPAs will work, for example, councils will be able to charge interest on the fees deferred and pass on administration charges.
The government will set the maximum interest rate attached to DPAs. This is expected to be between 3.5% to 5% and is intended to cover the costs councils incur in providing the scheme.
We will pay for the fees in the meantime. You will have to pay them back when the house is sold or when the deferred payment arrangement ends. However, you will not have to pay back the money that Wigan Council paid for the first 12 weeks of your stay or the first 12 weeks that they take over the funding, if you were originally funding yourself.
If you give your capital away in order to reduce your contribution to the cost of the care home, we can treat you as still having the capital you gave away.
You should always seek specialist information and advice before entering into an agreement with us to ensure this is appropriate for your personal situation.
The money must be repaid by the earliest of these dates:
- When your property has been sold
- When you terminate the agreement
- Within 56 days of your death.
If the debt is not repaid by these dates, interest is charged at the County Court rate. We expect the debt to be repaid within 12 months of the end of the agreed period.
If you are planning to live in a residential home following a needs assessment and are thinking about deferred payments you should discuss it with your assessor. If you decide to go ahead, the assessor will notify the Council's Financial Assessment Team.
A contract letter and terms of the agreement will then be sent to you. This shows the assessed payments to be made under the scheme and the terms of the agreement.