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The Big Debate - The Care Act 2014

Further to my blog The Big Debate – Transition between Children’s and Adult Services, informative presentations were given at this event by Neil Evans from Shropshire County Council and Neil Davies, Head of the Court of Protection team at Lanyon Bowdler.

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Neil Evans set out what the expectations should be of people under the Care Act from the point of view of the Council. He mentioned the availability of Shropshire Choices, which is an online information service. Shropshire Choices is a website pulling together information from Adult Social Care of Housing and Health, which assists with finding information, advice and support. It presents a variety of options which are available in the local community.

Neil Evans emphasised that carers are at the heart of the requirements under the new Act, and that some carers may be entitled to receive some of their support in the form of a personal budget. He discussed commissioning new offers for carers, the information and advice which was available, independent advocacy and the CAAN Consortium.

He also mentioned that the Department of Health had announced the implementation of the funding reforms, which were due to come into force in April 2016, would now be delayed until April 2020. The elements delayed include a cap on care costs which will limit the amount people would have to pay towards their eligible care needs at £72,000, and the extension of the means tested financial support which would increase the upper capital limit to £118,000 from the current £23,250.

Unified legislation

Lanyon Bowdler’s Neil Davies, who acts for many professional deputies, outlined how the Care Act 2014 replaced numerous different statutes and statutory instruments, and unified legislation. Neil’s presentation can be viewed here.

Neil talked about the duty to promote the individual’s wellbeing, which includes, for example, physical, mental, emotional, social and economic wellbeing and more control by the individual over the care provided to them. He then went on to discuss how when the Local Authority exercised that duty, there are various factors and assumptions about the individual which they must regard. These include the individual’s views, wishes, feelings and beliefs, and not making unjustified assumptions about the individual based on their age, appearance or other factors.

Written copy of the assessment

He took the delegates through the needs assessment for individuals and carers, and emphasised that a written copy of the assessment must be provided, plus he highlighted that the assessment must involve the individual and that there is a duty to assess the extent to which the provision of services could contribute to the achievement of outcomes. Neil then discussed national eligibility criteria, which must be applied by every Local Authority, and that the needs must arise from, or be related to, a physical or mental impairment or illness, and as a result of the needs the individual must be unable to achieve two or more outcomes.

Neil discussed the test for individuals being unable to achieve an outcome, and that the consequence of being unable to achieve the outcome is or is likely to have a significant impact on the individual’s wellbeing. Where the needs meet the criteria, the Local Authority must meet those needs. He then went on to discuss the outcomes which include, amongst other things, being able to make use of their home safely, developing and maintaining family or other personal relationships, as well as accessing and engaging in work, training, education and volunteering.

He concluded by discussing the unified approach to charging, and how the Local Authority treats capital and income when deciding whether someone has to pay and the sum which has to be paid. He discussed deferred payment arrangements but drew to our attention the 2.25% compound interest which is now included.

Change is scary

Our group was then asked to reflect on the presentations about the Care Act. Some of those who use services expressed concern that “change is scary”. There was much concern about subjective interpretation of the wording of the Care Act, in a manner which is least expensive to the Local Authority. The Care Act is intended to revolutionise care services and have a positive impact. Much concern, however, was expressed about the lack of resources to underpin the Care Act. This would include having sufficient employees with appropriate experience, as well as time to carry out the required initial assessment. Available resources would also be required for the implementation of the assessment. Finally, concern was expressed about the lack of redress if Local Authorities do not fulfil their obligations under the Care Act. There is a right of appeal and then a right to have decisions reviewed by the Local Government Ombudsman. As it is a matter of public law, there is also the right to go to court and seek a judicial review. However, concern was expressed about the eligibility for Legal Aid in this important area.

Worse now than 20 years ago

In the concluding remarks one speaker expressed concern that, as a society, things are worse now than they were 20 years ago. I have been able to see at first hand the benefits which can be made with respect to the provision of services for education, health and social care, when acting for clients who have sustained serious injuries and, in particular, brain injury when they have damages available to meet their needs. My concern is the gap, between what can be provided by the State and those who have the benefit of damages from a personal injury case, is widening. Surely we should be able to look after the most vulnerable people in our society now and going forward better than we did 20 years ago.

The aim of the Big Debate event was to help shape and inform future development of services. There is a lot of information that came out of the debate, some of which I have summarised above, and I hope the feedback is addressed and actioned by the relevant authorities, enabling everyone to move away from fire-fighting and constant battles for service users and carers.

Details of the other presentations from the event are covered within my blog entitled The Big Debate – Transition between children’s and adult services.