The Care Act 2014 constitutes the most significant reform of adult social care since the start of the welfare state, but not everything in it is new. It does a mix of creating new duties, putting into law things that local authorities have been doing in practice for several years, and consolidating or modernising existing law.
Part 1 of the Care Act 2014:
- ensures that people's wellbeing, and the outcomes which matter to them, will be at the heart of every decision that is made
- provides for a single national minimum threshold for eligibility for care and support
- puts carers on the same footing as those they care for, with a national eligibility threshold and rights to services
- creates legal duties to prevent and delay needs for care and support and to provide information, advice and advocacy
- puts Adult Safeguarding Boards on a statutory footing and makes the NHS and police statutory partners
- creates legal duties to co-operate and integrate between the NHS and adult social care
- embeds rights to choice, personalised care plans and personal budgets and requirements for councils to ensure a range of high quality services are available locally
- extends financial support through increased means test thresholds and a cap on the costs of care that people will have to fund themselves
- ensures that people do not have to sell their homes in their lifetime to pay for residential care, by providing for a new universal deferred payments scheme
- gives new guarantees to ensure continuity of care when people move between areas, to remove the fear that people will be left without the care they need
- includes new protections to ensure that no one goes without care if their provider fails, regardless of who pays for their care
- creates a new duty to provide social care to people in prisons (this does not include safeguarding which is the responsibility of the prison service).
Part 2 of the Act underpins the Care Quality Commission's new inspection regimes for hospitals and care homes, Part 3 relates to Health Education England and the Health Research Authority, and Part 4 creates the statutory underpinnings for the Better Care Fund.
London Councils supports the principles behind the Care Act and has been actively lobbying government throughout the passage of the Care Act through parliament (see drop-down section below). We have also been lobbying for London boroughs on the finalisation of policy details and guidance (see our statement ahead of our response and our March 2015 response to the consultation on implementing the new paying for care regime, as well as our response to the government consultation on implementation of the 2015 measures from August 2014 ).
As we begin to move into the implementation phase, it is important that the Act's goals are not undermined by factors such as:
- inadequate funding: We estimate that the total costs of implementing the Care Act in London, together with demographic pressures and inflation, could add £1.14 billion of pressures to adult social care in the capital by 2019/20. Local authorities must be fully funded for the new burdens, or the new requirements will only add to the increasingly unviable financial position of boroughs and their social care services on which some of the most vulnerable people in our communities depend - and which have a knock-on implication for other public services like the NHS.
- lack of public understanding of their entitlements: The details of the new paying for care regime are complex and many will find that behind the headlines - like a cap on the costs of care of £72,000 - lie nuances that mean they will still incur costs that they may not have expected. See our guide to the cap on the costs of care for over 65s, which shows how complicated this will all be. Unless the government is clear about how their policies will work in practice, local authorities will face a risk of increased challenge from people as they struggle to understand their entitlements.
- short timescales: There is concern about the time local authorities will have to develop and test systems adequately in preparation for 1 April 2016, particularly as key policy decisions have still to be clarified.
London Councils' lobbying during the Care Bill's passage through Parliament
London Councils was active in lobbying for the interests of London boroughs during the development of the Care Bill and its passage through Parliament in 2013/14.
Key submissions made London Councils can be found below.
- London Councils Care Bill Commons Report stage brief, March 2014 (PDF, 39Kb)
National Care Act Implementation Support Programme
The Local Government Association (LGA), Association of Directors of Adult Social Services (ADASS) and Department of Health have created a joint programme to support implementation of the Care Act.
Information about implementation and this programme can be found here.
London Care Act Implementation Support Programme
The Directors of Adult Social Services from boroughs, through their London ADASS network and supported by funding from the Department of Health, are working together to support implementation of the Care Act.