Final Care Act guidance published - Livability's view

Last week the Department for Health published the final regulations and guidance for the Care Act, following a public consultation earlier this year.

The final guidance and regulations will come into effect April 2015. The Care Act represents the biggest changes to the social care system in the past 60 years. You can read more about about Livability’s reaction.

What does Livability think generally about the Act?
Livability supports the act’s aspirations which aim to put the individual and their carers at the heart of the care system. We also welcome the timing of the act as the changing demographics of the UK population, particularly the increasing elderly population and the increased life chances of those living with long term health conditions, mean there is even greater demand for health and social care support. The act, which represents the most significant change to social care legislation in the past 60 years, is also positive in that it brings together all existing social care legislation into one clear law which will make it easier for those navigating the system. However we are concerned this cannot be fully realised without adequate funding.

Are there any welcome changes?
There are a number of changes we welcome. This includes:

  • The principle behind the National Eligibility threshold- which aims to standardise the way and time period within which local authorities assess and provide support for those individuals who qualify for it. This is good news as it means everyone will be treated fairly irrespective of geographical location.
  • The introduction of personal budgets – thereby giving people the power to spend money on tailored care that suits their individual needs as part of their support plan.
  • Greater support for carers- carers will now be entitled to an assessment of their needs and the right to get support if they meet the eligibility criteria.
  • New Health and social care ratings system – The Care Quality Commission (CQC) will introduce a new universal, independent system of performance ratings which will see all services rated by March 2016. This should make the process of looking for a quality care home for a loved one much easier.
  •  Cap on social care costs – This should, in theory, help to ease some of the financial pressures on families who may have previously struggled with the cost of care.
  • Tighter regulations on social care providers- this includes clamping down on the s19 loophole which will prevent registered care providers from deregistering from the CQC after the beginning of enforcement proceedings. This should allow CQC to take effective action against providers when the quality of their care is called into question. This is good news in terms of strengthening the sector and ensuring that its overall reputation and the excellent work of most of the organisations involved will not be tarnished because of the actions of a few.

Are there any areas that you think are a cause for concern?
The cap on social care fees; This cap relates to eligible needs only – so individuals would still be required to pay for any additional services they may want or need. Similarly living costs are not included in the cap. Specifically many local authorities are starting to raise concerns about the unknown number of older people that are currently self- funding and who may now come forward for an assessment under the act. There is a cost to this – even in the assessment process and this will have an impact – at a time when budgets are already stretched. Livability is concerned as it could impact on the amount of funding available for disabled and vulnerable people.

Do you think that the appropriate funding is available to fully and correctly implement the changes made in the legislation?
Livability still remains concerned that not all of the legislative changes can be fully implemented due to a lack of funding.

What do you think of the introduction of a national minimum threshold for receiving care and support? Will this end the postcode lottery of the current system? Some critics have said that the national threshold is welcome but that it has been set too high, excluding many people who need the help. Do you agree?
Livability welcomes the principle behind the national minimum eligibility criteria because it will standardise the time in which local councils are obliged to provide care. However we are concerned that the higher threshold, alongside the general lack of funding, could mean those with low levels needs are not well provided for and prevention services not prioritised in favour of those with more severe needs. This will impact on the quality of life of many disabled people potentially making them more vulnerable and isolated. It also makes it more likely that they will present at a time of crisis and at this stage will require high levels of support.

What will be the biggest changes to the lives of the people that Livability represents, as a result of the Act? What will be the effect of these changes?
The act has the potential to make a significant positive impact on the lives of disabled and vulnerable people. However we are concerned this will not be fully realised due to the lack of funding. Similarly, with the higher eligibility threshold being introduced we are concerned at the number of disabled and vulnerable people who will no longer qualify for formal support. This will have a detrimental impact on their daily living.