The Care Bill 2013

1. The Care Bill 2013 Caroline Baria Service Director, Joint Commissioning, Quality and Business Change

2. The underlying principles… Central to the Care Bill is: • Promoting people’s wellbeing • Helping to prevent and postpone the need for care and support • Putting people in control of their lives so they can pursue opportunities to realise their potential • People have greater certainty and peace of mind over the costs of meeting care and support needs

3. New and extended responsibilities… • people have a legal entitlement to a Personal Budget • carers have a legal entitlement to an assessment, and to information, advice and support • Transitions - legal entitlement to an assessment before young people turn 18 and ensuring there is continuity of provision of services that promote independence and reduce the need for long term care and support Presentation title

4. New responsibilitiescont… • access to comprehensive information and advice about services so that people can make informed decisions about their care and support, including independent financial advice • to arrange and make available services that prevent, delay or reduce the need for higher levels of care and support • identification of people in the local area who might have care and support needs that are not being met • supporting a market that delivers a wide range of high quality services so that people have choice

5. New responsibilities cont… • continuity of care and support for people who move geographical locations to different local authority areas • temporary duty to ensure continuity of service in the event of provider failure – this includes all people receiving care including self-funders • a legal framework for adult safeguarding, including establishing multi-agency Safeguarding Adults Boards and a requirement for an annual safeguarding plan

6. Changes to eligibility criteria • A new national eligibility framework - a single, consistent route to determining people’s entitlement to care and support • Based on principles of wellbeing • Assessments to be based on ‘strengths’ instead of deficits and to be asset based • Transportability of assessments • National consultation has been undertaken by Department of Health

7. What are the implications? • Increases the numbers of people that are potentially eligible for care and support services, including carers • Increase in assessments and support planning - for self funders • Workforce development and training • Transportability of assessment decisions • Transportability - IT and software changes and interfaces – national social care IT system? • Information governance

8. Funding Reforms and charging • Following Dilnot recommendations - Local authorities to assume financial responsibility for self funders - people who have eligible needs where they fund their own social care and support - once they reach a cap of £72,000 in April 2016, to be adjusted annually • People will still be required to pay ‘hotel costs’ of approx. £12 p.a • ‘Care accounts’ for self funders which track the costs accrued and their progress towards the cap • Deferred Payments Scheme • New charging regime - currently there are different systems for determining charges to service users, depending on the type of care that is being provided– to be replaced by a single universal system

9. What are the implications… • Identifying and communicating with people who are self funders • Comprehensive information and advice including signposting to independent financial advice • Financial impact– will sufficient funding be allocated • Resource and financial implications arising from significant increase in assessments and annual reviews • Risks of challenge on decisions by self funders?

10. Integration • local authorities and NHS organisations to integrate further in the commissioning and delivery of health and social care services – transformation of local health and social care arrangements to deliver increased community based care • Integration Transformation Fund (ITF) which will be allocated to local authorities to be administered through their Health and Wellbeing Boards • Allocation of £30m-£40m of funding in Nottinghamshire, - requires a coherent plan across health and social care services, in partnership with District/Borough Councils.

11. The role of partners • Engaging across the whole care and support sector including with service users and carers • Co-producing those elements that benefit all and recognising contribution of local providers and communities to enable meaningful choice • Establishing the national, regional and local partnerships with communities, voluntary sector, providers and others that will: • share good practice and approaches • support implementation • provide readiness assurance and confidence

12. Timeframes for implementation From April 2015: From April 2016: Duties on prevention and wellbeing Cap on care costs Duties on information and advice Care Accounts (including advice on paying for care) Duty on market shaping National minimum threshold for eligibility Assessments (including carers’ assessments) Personal budgets and care and support plans Safeguarding Universal deferred payment agreements Extended financial support

13. The position in Nottinghamshire • Programme Sponsor identified • Programme Manager being recruited • Dedicated Finance resource being recruited • Financial modelling commencing • Lots to do: - Programme plan to be scoped - Communications strategy to be developed