Care Act 2014

1. Care Act 2014 Briefing event 27 June 2014

2. House Keeping We don’t expect a fire alarm test today – if alarm sounds exit through front doors if safe to do so and assemble in the Sunken Gardens Toilets – into the corridor, turn right and toilets are on the right Time for questions has been built into the agenda

3. Care Act 2014 Welcome and Introduction Councillor Peter Connor Councillor Margaret Morris

4. Introduction The Act has been promoted by the Government as: ‘the most significant reform of care and support in more than 60 years’. We believe we are well placed to implement the requirements but still face significant challenges. We want to ensure staff throughout the council and our Partners across Salford are aware of the implications. Today’s event is the start of that process.

5. Care Act 2014 Overview of the Care Act Sue Lightup

6. Introduction The Act has been promoted by the Government as: ‘the most significant reform of care and support in more than 60 years’. It is in part a response to the Dilnot Commission on the Funding of Care and Support, some of whose recommendations have been implemented in full in the Act, others of which have implemented in part and others of which have not been implemented. It also responds to a report following a three-year review by the Law Commission of adult social care law, published in May 2011. Part of the Act is also intended to address some of the issues arising from failures at Mid-Staffordshire Hospital. The Care Bill received Royal Assent on 14 May and has now been passed into law as the Care Act 2014 (the Act).

7. Summary The Act introduces major reforms to the: • legal framework for adult social care, • funding system, and • duties of local authorities and rights of those in need of social care. The potential impact on local authorities’ finances and on their working practices is enormous. The main provisions of the Act: the Act is divided into four parts. • Part 1 reforms the adult social care system. • Part 2 relates to care standards, providing the Government’s legislative response to the Francis Inquiry into the failings at Mid-Staffordshire hospital. • Part 3 establishes new non-departmental bodies. • Part 4 contains technical matters.

8. Timing of implementation • The provisions of the Act as they relate to the legal framework for adult social care will come into force in April 2015. The funding provisions will come into force in April 2016. • consultation on draft regulations and guidance (for April 2015 elements) 6 June 2014, with a 10 week consultation period; • formal publication of regulations and guidance (for April 2015) October 2014; • Care Act provisions in force from April 2015 (excluding funding reform); • All Care Act provisions in force from April 2016 (including funding reform).

9. Summary of main provisions Part 1 reforms the adult social care system: • Sets out the general responsibilities of local authorities, describing their broader care and support role towards the local community, emphasising a preventive approach and giving them duties to consider physical, mental and emotional wellbeing and to provide information to those needing care; Well-being is a principal underpinning the entire framework - it isa broad concept, and it is described as relating to the following areas in particular: - personal dignity (including treatment - participation in work, education, of the individual with respect); training or recreation; - protection from abuse and neglect; - social and economic wellbeing; control by the individual over - domestic, family and personal ; day-to-day life (including over care relationships; and support provided and the way - suitability of living accommodation; it is provided); - the individual’s contribution to - physical and mental health and society. emotional wellbeing;

10. Summary of main provisions (continued) • Maps out the process of assessments, charging, establishing entitlements, care planning and the provision of care and support; • Makes provision for national eligibility criteria against which all local authorities will be required to assess individuals’ entitlements to care; • Enshrines the right of carers to receive support from their local council and introduces a duty to meet carers’ eligible needs for support;

11. Summary of main provisions (continued) • Introduces a cap on care costs which anyone over state pension age will be liable to pay. The Dilnot Commission’s original suggestion was for a cap of £25,000 to £50,000 in 2010-11 prices. The Government intends to set the cap at £72,000 in 2016/17 prices (equivalent to £60,000 in 2010/11 prices) – the maximum amount that any individual would have to pay for their care costs. Young people who already have care needs when they turn 18 will now receive free adult care and support when they reach that age; • Makes provision for local authorities to enter into ‘deferred payment agreements’ intended to enable people to meet their care costs without having to sell their homes during their lifetime; • Provides a new legal entitlement to a personal care budget for eligible individuals; • Outlines the responsibilities of local authorities and other partners in relation to safeguarding adults, including a new requirement to establish Safeguarding Adults Boards in every area;

12. Summary of main provisions (continued) • Provides for those in need of care to be able to move between local authorities without interruption to their care (this is known as ‘portability’ of care) and clarifies how, if a care provider goes out of business, individuals will be protected; • supports the transition for young people between children’s and adult care by giving local authorities powers to assess the needs and entitlements of children, young carers and parent carers.

13. Our Customer Journey A broad council-based approach with partners participation:

14. Partners participation in: • Wellbeing Well-being principal underpins the entire framework with well-being expanded to include dignity/accommodation. Requirement for collaboration, cooperation and integration with other public authorities and the NHS, including Housing) with list of relevant partners extended to cover registered housing providers and registered social landlords. • Prevention Sets out the general responsibilities of local authorities, describing their broader care and support role towards the local community, emphasising a preventive approach and giving them duties to consider physical, mental and emotional wellbeing and to provide information to those needing care • Information and advice Universal obligations for all people; prevention, information service, sign posting, quality and choice. Information should be available to enable people to make an informed decision re: identified needs and to enable better self support when relevant

15. Partners participation in: • Market Shaping and Commissioning New duty for LA to facilitate a vibrant. diverse and sustainable market for high quality care and support for the benefit of the whole local population • Safeguarding New duty for LA to carry out enquiries (or cause others to) where it suspects an adult is at risk of abuse or neglect. New ability for Safeguarding Adults Board ‘s to require information sharing from other partners. • Transition for children/young people Supports the transition for young people between children’s and adult care by giving local authorities powers to assess the needs and entitlements of children, young carers and parent carers. • Housing DoH intend to issue fresh guidance to include emphasis on importance of adequacy of housing provision being a vital component of safe and timely hospital discharge.

16. Consultation on Care Act guidance What are the draft regulations and guidance? • The Care Act contains the core legal duties and powers relating to adult social care. And it also contains regulation making powers - allowing Government to make secondary legislation (regulations) that provide more detail. • Statutory guidance is intended to provide local authorities (LA’s) with the information they need about how they should meet the legal obligations placed on them by the Act and the regulations. • LA’s are required to act under the guidance, which means that they must follow it, unless they can demonstrate legally sound reasons for not doing so. • The guidance will be used by LA’s to plan care and support at a local authority level, as well as by practitioners themselves. It will also be used by people using care and support, their families, the voluntary sector and providers of care and support to help them understand the new system, and by courts in deciding whether a local authority has acted within the law.

17. Consultation on Care Act guidance (continued) • The draft regulations and guidance published (on 6 June 2014) relate to the care and support reforms and provisions in the Act which will come into effect in April 2015. • The guidance describes how the care and support system should operate in 2015/16. And LA’s and other stakeholders have until the 15 August 2014 to comment on the guidance. • The final guidance is scheduled to be published in October 2014. • Regulations and updated guidance to support implementation of the additional reforms which come into effect in April 2016 (e.g. the cap on care costs), will be subject to a separate consultation, to be published later this year. • You can play your part – each workstream sponsor will be coordinating responses in their area, provide them with the name of someone to contact or feed back to them your views

18. Project structure • We have established a Project Steering Group with 6 work streams

19. Questions?

20. Care Act 2014 Advice and Information David Herne david.herne@salford.gov.uk

21. Requirements from the Act • A new duty to: Establish and maintain a service for providing …information and advice relating to care and support for adults and carers • Goes beyond basic care and support services to broader holistic view • Is a place leading role – i.e. lead the system • Focus on individualised information • Steer people towards relevant financial support/advice • Requirement for independent advocacy

22. Requirements from the Act • Emphasis on a “service” for providing the information • A broad audience, in care, seeking care, planning for care etc etc • Accessibility – eg Manner of provision, additional requirements, independent advocacy • Targeted to people at key “trigger” points on the pathway • Proportionate - type, extent and timing relevant to individual needs • Finances – understanding charging, ways to pay, money mgt, Independent financial advice

23. Gap analysis • Starting point is promising • Lots of aspects of the requirement in place but…. • Fragmented and couldn’t be described as a coherent service…… yet • Need a clear offer for access to IFA • Better information on independent advocacy • Some parts of the offer in development eg W2W portal and MECC • Need to assess whether all formats and languages currently covered

24. Partner considerations • Local Authorities must • co-operate with each of relevant partners • Promote integration between care and support provision • This can include integration of information and advice • Strategic planning must start with JSNA /JHWS • JHWS planning should include emphasis on alignment and integration of services

25. You can help with • Support for working up the Independent Financial Advisor offer • Information on independent advocacy • Care and support package through Way2Wellbeing portal • Re-launch of Making Every Contact Count – do the right thing • Identification of languages in common use • Anything else you can suggest!!!

26. Care Act 2014 Market Shaping and Commissioning Jennifer McGovern jennifer.mcgovern@salford.gov.uk

27. Market Shaping and Commissioning • The Act introduces new duties on local authorities to facilitate a vibrant, diverse and sustainable market for high quality care and support in their area, for the benefit of their whole local population (regardless of how the services are funded). • The local authority’s own commissioning and procurement practices should take account of these wider ‘market shaping’ duties.

28. Principles of Market Shaping and Commissioning • A focus on outcomes and wellbeing; • Promoting quality services, including through workforce development and remuneration and ensuring appropriately resourced care and support • Supporting sustainability, and ensuring choice; • Designing strategies that meet local needs; • Engaging with providers and local communities; • Understanding and facilitating the development of the market; and, • Securing supply in the market and assuring its quality through contracting.

29. Salford’s Starting Position Further ‘Act’ Requirements • Commissioning Strategies - Effective engagement with the providers • Market Position Statement - Refresh Market Position Statement • Engagement - Workforce Strategy • Personalisation Framework - Annual assessment ‘Self funders’ • Developing Quality Assurance - Housing Related Support Framework Commissioning Plan

30. Partner considerations • Local Authorities must • co-operate with each of relevant partners • Promote integration between care and support provision • This can include integration of commissioning and workforce planning • Strategic planning must start with JSNA /JHWS • JHWS planning should include emphasis on alignment and integration of services

31. You can help with • Partners to work collaboratively with provider engagement • Partners to work collaboratively with public engagement • Joined up workforce strategy • Partners supporting the care pathway from acute settings to ordinary living (including housing solutions)

32. Care Act 2014 Operational Practice Dave Clemmett dave.clemmett@salford.gov.uk

33. Care Bill Requirements..What Stays the Same and What Changes • Preventing Needs for Care and Support • Eligibility Framework in Law • New Approach to asset Based proportionate Assessments • Carers ...extra responsibilities • Self Funders...extra responsibilities • Transition from Childhood and tie in with Children and Families Act.

34. Who pays for care • How is this paid for by people? - What services are paid for - Will need to keep Care Accounts for people and what they have spent - Offer deferred payments

36. Pathway to Independence Home Life Support Community Life Money Promoting Health & Wellbeing Personal Safety & Responsibility

37. Other areas of increased responsibilities • Continuing Healthcare • Prison Population • Hospital Discharge • Terminal Illness • Review of Care/Support Plans • Duty to Cooperate • Promotion Integration • Complaints... robust challenge to City Council Decisions

38. Current Advocacy Services in Salford • Age UK • Dementia Support Service • CAB • Carers Centre • Healthwatch – Voice of People • Salford Disability Forum • Salford Being Heard • Mental Health CAB

39. Analysis of Impact to date • Capacity Planning 15% increase activity. • Carers • Self Funders • Job roles/skill mix • Capacity to Manage Change and keep show on the road • Same time as Integrating with Health

40. Care Act 2014 Safeguarding Keith Darragh keith.darragh@salford.gov.uk

41. Safeguarding Safeguarding is everybody’s business • Care Act requirements • New duty for LA to carry out enquiries (or cause others to) where it suspects an adult is at risk of abuse or neglect • New emphasis on making safeguarding personal – range of options besides safeguarding • Continuing theme regarding appropriate advocacy • Statutory Status for Adult Safeguarding Board (Health, Police, Local Authority) • Promotion of multi agency awareness, understanding and training • Specific training for elected members / Healthwatch

42. Partnership working – key points • Co-operation with investigation of suspected abuse • Sharing of resources to make safeguarding outcomes personal – joint workforce strategies • Continued support to the Multi Agency Safeguarding Board • Contribution to the development of relevant and inspiring training • Preparation work to be undertaken by the Safeguarding Board

43. Care Act 2014 Deferred Payment Scheme Keith Darragh keith.darragh@salford.gov.uk

44. Paying For Care – Care Act Principles • Currently • People pay for care through a means tested system • There are different rules for the amount a person pays depending on whether they are supported to live in their own homes or residential care • Care Act 2014 - Principles • Local Authorities can choose to charge (with certain exceptions) • People should only pay what they can afford (means test) • Charges should be clear and transparent • Apply charging rules equally to those with similiar needs

45. Care Act Requirements • Local Authorities must undertake a financial assessment of what a person can afford to pay • Different rules still apply - depending on whether a person is supported to live in their own homes or residential care • Main difference is for residential care, Local Authorities required to offer deferred payment agreements to people who meet criteria for the scheme

46. Deferred Payment Agreements - people not having to sell their home in their lifetime • The Act establishes a universal deferred payment scheme • Applies – When somebody’s needs are such that they need to live in a care home to meet their needs and allows people to defer / delay having to pay the costs of their care and support until a later date – Payment “deferred” not “written off” • Eligibility – Local Authorities must offer deferred agreements to • People who have local authority arranged care • People who arrange and pay for their own care (self funders) • Impact for the council – making large loans to individuals over long periods of time

47. Partnership working – key points • Charging is still a key part of the Adult Social Care system • Local Authority financial administration will increase • Deferred Payments cost will be carried by Local Authorities – interest charges will apply to the debt • Can we collaborate to do this?

48. Care Act 2014 Care Accounts Keith Darragh keith.darragh@salford.gov.uk

49. Care Act – Who Pays for Care The Care Act introduces • A financial “lifetime cap” on each individual’s contribution to eligible care needs - £72,000, whether that care is arranged by the Council or is paid for privately (self funders) – from April 2016 • Requirement for Adult Social Care to undertake assessments for self funders to determine • Are their care needs eligible for funding by the state ? • The cost of care paid for by the individual – as would be paid if the Council arranged for the care • Local Authority to set up “care accounts” to track what people pay to see when they reach the care cap of £72,000

50. Care Act – Implications • More assessment capacity required to assess self funders • Increase in financial administration resources • Development of systems to track care costs – over multiple years and potentially with varying care costs eligible as needs rise • And… • The full costs have not yet been determined nationally • The implementation date is after the General Election