The legislative framework for adult social care in England has been described as out-dated by the Department of Health (DH) as it is focused on crisis intervention rather than prevention and early intervention, and on the provision of services, rather than enabling the system to be centred around the health and wellbeing of people and carers. The DH has therefore highlighted the need for government intervention to reform the legal framework so it better fits the purpose of modern care and support.
The government’s objectives for adult social care are to improve people’s quality of life, delay and reduce the need for care, ensure positive care experiences and safeguard adults from harm. The Care Act 2014 was passed into law on 14th May 2014 with the aim of transforming adult social care in England to meet these objectives. Although the Act is generally concerned with care and support matters in England, some provisions extend to the devolved nations. The main focus of the Act is on promoting individual wellbeing and preventing the need for care and support. In particular, it makes provision:
- to reform the law relating to care and support for adults and the law relating to support for carers;
- about safeguarding adults from abuse or neglect;
- about care standards;
- about Health Education England;
- about the Health Research Authority;
- about integrating care and support with health services; and
- for connected purposes.
According to Care and Support Minister, Norman Lamb: “the Care Act represents the most significant reform of care and support in more than 60 years, putting people and their carers in control of their care and support. For the first time, the Act will put a limit on the amount anyone will have to pay towards the costs of their care.”
Due to come into force in April 2015, with its provisions related to funding reform to be implemented a year later, the success, or otherwise, of the Care Act’s implementation is as yet unknown.
Nevertheless, there has been much discussion over the potential issues and challenges with regard to implementation. The College of Social Work (TCSW) argues that the implementation of the legislative reforms “will be challenging and demand significant cultural and attitudinal changes, both strategically and in professional practice”.
The Act presents significant changes for local authorities which will be challenging to implement in the proposed timescale. Concerns have been raised by both local authorities and charities over the funding of the Act’s provisions and the sustainability of adult social care services. A recent article published in Community Care highlights such concerns among councils, noting that nine out of 10 councils believe key parts of the Act will be jeopardised if the government fails to provide local authorities with adequate funding for implementing the reforms.
According to London Councils, London is facing double the shortfall in funding to prepare for the Care Act than previously thought with proposed new funding arrangements unveiled by the government to leave the capital with a £36 million gap.
Moreover, a subsequent article in Community Care suggests that local authorities need to consider the training challenge now in order to negotiate the issues raised by the new funding reforms.
The main costs of the Act relate to improved legal rights for carers (rising to £175 million per annum). However, there may be additional costs, for example where local authorities face increased demand for services due to improved information. Greater clarification on the support available to carers could potentially increase the workload for social care professionals as the number of carers’ assessments could also increase.
The additional requirements of providing support to self-funders as well as carers could also take its toll on councils. Caroline May, business partner in finance at Havering LBC noted at a recent roundtable that:
“There are a lot of unknowns out there that will present us with financial challenges. I think culture shift is going to be huge across the board.”
The Association of Directors of Adult Social Care (ADASS), which represents local authorities, is unconvinced that local authorities can implement the changes required in the proposed timescale. In a joint report with the Local Government Association, they highlight the financial challenges local authorities face, particularly at a time of budget cuts and increasing demand for services. A recent inquiry into adult social care in England has highlighted that there was an 8% real terms cut in spending between 2010/11 and 2012/13; and demand for care provided by adults is projected to rise by over 50% between 2007 and 2032, while the supply of this care is projected to rise by only 20%, according to Carers UK.
Despite these funding issues, however, cost savings have also been identified in relation to public expenditure savings of improved support for carers, according to the DH’s recent impact assessment, which also states that these cost savings outweigh other new costs overall. The potential benefits of the Act for people with care and support needs which could also lead to savings were identified as: “improved wellbeing, better prevention of care and support need, greater clarity, consistency and equality of access to care and support and reduction of unmet need.”
It will undoubtedly be challenging to implement the provisions of the Care Act and it remains to be seen whether the funding provided will be adequate.
Only time will tell whether the proposed reforms will truly transform the currently outdated adult social care system.
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