Catherine Stillman-Lowe offers an overview of new care legislation, and considers its potential impact on those affected by M.E.
From InterAction 89, spring 2015
The Care Act 2014 is the biggest change to adult social care for 60 years. From April 2015 local authorities will have new duties and responsibilities to make sure that people who live in their area are supported as well as possible to:
- receive services that prevent, reduce and delay their care needs from becoming more serious
- get the information, advice and guidance they need to make good decisions about care and support
- have a good range of care and support providers to choose from.
Previously, local authorities had been able to set their own criteria based on government guidelines to determine who qualifies for care and support services funded by the council.
The Care Act introduces a new national minimum eligibility criteria threshold which local authorities in England must comply with. The threshold is based on identifying how a person’s needs affect their ability to look after themselves and how this impacts on their well-being. A person will be eligible for support with their care needs if they are unable to carry out two or more key tasks (outcomes) in a list set out by the government. If the person’s needs do not meet the minimum criteria the local authority must still provide a written record of advice on what could be done to reduce, prevent and meet their needs.
Local authorities should consider each of the following outcomes:
- 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.
Local authorities must take account of the potential fluctuation of a person’s needs, so where the local authority is aware that an adult’s needs fluctuate over time, the assessment carried out at a particular moment may take into account the adult’s history to get a complete picture of the person’s needs. Carers also have new rights and are treated the same as the people they care for. Local authorities have a duty to provide an assessment of needs and provide support to carers.
Where a person meets the eligibility criteria for care and support, they are legally entitled to receive a personal budget, a statement showing the cost of meeting their needs. It includes the amount that the adult must pay towards that cost themselves (on the basis of their financial assessment), as well as any amount that the local authority must pay. The person will also have the right (as now) to ask for a direct payment to meet some of or all of their needs. A direct payment is where funding is given to the person, or to someone on their behalf, so they can purchase support to meet their needs.
While some types of care and support are provided free (for instance, information and advice), many types will be subject to a charge. Sometimes the person will pay the full cost and sometimes the cost will be shared between the person and their local authority. To decide what a person can afford to pay, a local authority will carry out a financial assessment.
The Care Act requires each local authority to provide a universal information and advice service, available to all people who request it and not just limited to those people with assessed care and support needs.
This service must include details of:
- how the local authority system operates
- the choice of types of care and support
- the choice of care providers in the local authority area
- how to access the care and support that is available
- how to access independent financial advice
- how to raise concerns about safety/well-being of an adult who has needs for care and support.
If a person needs help and support through the social care process, and in understanding their options and making a decision regarding their care and support, and there is no other appropriate individual to support and represent them, then the local authority must arrange for an independent advocacy service to carry out this role and to facilitate the involvement of the person. For the first time, there will also be a system by which people may appeal against a local authority’s decisions on eligibility and funding for care and support.
The Department of Health publishes detailed factsheets on the Care Act, and subsequent updates, which you may find useful.