RELEVANT INFORMATION
1. Introduction
The Care Act 2014 came into force on 1st April 2015. The Care and Support Statutory Guidance (Department of Health and Social Care) is the accompanying statutory guidance for local authorities and partner agencies.
The Care Act sets out how care and support should be provided to adults and carers, and how it will be paid for. It supports the personalisation of care services, putting adults and carers at the centre of the care and support process, and aims to make it easier for those who need to access care and support to understand why things happen in a certain way.
It also introduced duties and requirements of local authorities in a number of areas, including safeguarding adults. It provides, for the first time, a legislative framework for those working in adult safeguarding. Each local authority must:
- make enquiries, or ensure others do so, if it believes an adult is experiencing or at risk of abuse or neglect;
- set up a Safeguarding Adults Board (SAB);
- arrange, where appropriate, for an independent advocate to represent and support an adult who is the subject of a safeguarding enquiry or safeguarding adults review (SAR) where the adult has ‘substantial difficulty’ in being involved in the process and where there is no other appropriate adult to help them (see Independent Advocacy and Safeguarding Adults Reviews);
- cooperate with each of its relevant partners in order to protect adults experiencing or at risk of abuse or neglect (see also Integration, Cooperation and Partnerships).
2. Care Act and Safeguarding Practice
The Care Act introduced a major shift in safeguarding practice with a move away from a response which was process-led, to a person-centred approach which keeps the adult at the centre and seeks to achieve the outcomes they want.
Adults have different histories, circumstances, priorities and lifestyles, meaning it is not helpful to prescribe a single process that must be followed in all circumstances whenever a safeguarding adults concern is raised.
3. Care Act Duties and Rights
3.1 General responsibilities and universal services
Promoting wellbeing:
This principle applies to all functions under Part 1 of the Act (including care and support and safeguarding). Whenever a local authority makes a decision about an adult, it must promote the adult’s wellbeing.
Preventing, reducing or delaying needs:
Local authorities are required to ensure provision of preventative services which help prevent and / or delay development of care and support needs, or reduce such needs (including carer support needs).
Information and advice:
An information and advice service should be available to all people in the local authority area regardless of eligible care needs.
Market shaping and commissioning of adult care and support:
The Act gives local authorities a general duty to promote choice and quality in the market of local care and support providers. The local authority must ensure a range of care providers is available; shaped by demands of adults, families and carers, and that services are of high quality and meet needs and preferences of local people.
Managing provider failure:
If a provider fails, local authorities are required to temporarily meet an adult’s needs for care and support. This applies regardless of whether there is a contract in place between the provider and the local authority, if the adults affected pay for their own care, or if other local authorities had made the arrangements to provide services.
Market oversight:
The Care Quality Commission (CQC) has a duty to assess the financial sustainability of the most difficult to replace provider, and support the local authority to ensure continuity of care if providers fail.
3.2 First contact and identifying needs
Assessment:
The local authority must carry out an assessment, referred to as ‘needs assessment,’ whenever it appears an adult may have care and support needs. The Act also sets out what should happen where adult or a carer refuses to have a needs or carer’s assessment. All assessments must be proportionate to the level of need and consider the whole family. Self-assessments must also be offered.
Carer’s assessment:
Local authorities are required to carry out an assessment (‘carer’s assessment’) where it appears a carer may have needs for support either now or in future.
Eligibility:
Following a needs assessment or carer’s assessment, the local authority will determine if a person has eligible needs. National eligibility criteria are contained in regulations, which set the minimum level of eligibility at which the local authority must meet care and support needs.
Advocacy:
The Act specifies when the local authority must arrange an independent advocate to facilitate the involvement of an adult or carer in their assessment and care and support planning or review processes.
3.3 Charging and financial assessment
Charging:
The Act gives local authorities a general power to charge for certain types of care and support, if it chooses to do so.
Financial assessment:
The local authority is required to undertake a financial assessment if it chooses to charge for particular services.
Deferred payments:
Deferred payments allow adults to enter into an agreement to delay or defer paying for the care and support services they receive. This helps avoid the need to sell property or possessions.
Recovery of charges, transfer of assets:
This allows the local authority to recover as debt any sums owed, such as unpaid charges and interest.
3.4 Care and support planning
How to meet needs:
To reflect the aims of the Care Act, local authorities should take a flexible approach to meeting people’s needs.
Duty to meet needs:
The Act describes when the local authority will have a duty to meet an adult’s eligible needs for care and support.
Power to meet needs:
This provides broad power for the local authority to meet care and support needs in circumstances where a duty to meet needs (as above) does not arise. It also enables the local authority to temporarily provide care and support without first carrying out a needs assessment, where it is needed urgently.
Duty to meet carers’ needs:
There is a legal obligation for local authorities to meet carer’s needs for support.
Care and support / support plan:
The Act describes what must be included in a care and support plans (assessed adult) / support plan (carer).
Review of care and support / support plan:
This requires the local authority to keep plans under review generally, and to carry out re-assessment / review if the adult or carer’s circumstances have changed. The adult can also request a review of their plan.
Personal budget:
Under the Care Act, local authorities should provide a written personal budget to all adults (including carers) who are assessed as eligible for care and support. The amount of the personal budget should reflect the money that is needed to cover the cost of the adult’s care and support.
Direct payments:
Adults with mental capacity can request a direct payment and, where they meet the conditions set out, the local authority must provide direct payments to meet their assessed eligible needs.
3.5 Safeguarding
Adult safeguarding:
The Act sets out the local authority’s responsibility for adult safeguarding; including the responsibility to ensure enquiries into cases of abuse and neglect and establishing a Safeguarding Adults Board.
3.6 Integration and partnership working
Integration:
Under the Act, there is a duty on the local authority to carry out its care and support functions with the aim of integrating services with those provided by NHS or other health-related services.
Duty to cooperate:
The Act places a general duty on local authorities and other relevant authorities to cooperate in relation to functions relevant to care and support. There is also specific duty to cooperate where this is needed for an adult with care and support needs.
Delegation:
This provides a power for the local authority to authorise a third party to carry out certain care and support functions.
Transition from childhood:
This places a duty on the local authority to assess a child, young carer or child’s carer before their 18th birthday if they are likely to have needs once they (or the child they care for) turn 18 in order to help them plan and the assessment will be of ‘significant benefit’.
Prisoners:
The Act clarifies responsibilities for the provision of care and support for adult prisoners and people living in approved premises (including bail accommodation).
Continuity of Care:
The Act clarifies roles and responsibilities when an adult, and potentially their carer, notifies a local authority that they intend to move to another local authority area.
Ordinary residence:
Ordinary residence is used to decide if a local authority is responsible for providing care and support. The Act provides a mechanism for the local authority to reclaim money spent providing care and support to an adult for whom it was not in fact responsible.
Cross border placements:
This makes provision for a person with care and support needs who is ordinarily resident in England and requires residential accommodation, to be provided with accommodation in another part of the UK. It also allows for such placements in England for people ordinarily resident in Wales, or whose care and support is provided under relevant Scottish or Northern Irish legislation. Also there are similar arrangements for cross border placements not involving England that is, Wales / Scotland, Scotland / Northern Ireland and Northern Ireland / Wales.
Mental health aftercare:
The Act clarifies aftercare services provided under section 117 of the Mental Health Act 1983 to meet need arising from / related to mental disorder of person concerned.
