2014 is the year when the biggest change to adult social care law since the 1948 National Assistance Act passes on to the statute books. While implementation of the Care Act 2014 – as the Care Bill will become by April – will not take place until April 2015 and April 2016, the scale of the change is so significant that councils in England will need to be preparing from now.
In what they say is an unprecedented act of central-local government partnership, a joint programme management office has been set up to help councils prepare for implementation by the Department of Health (DH), Local Government Association (LGA) and the Association of Directors of Adult Social Services (Adass).
Just before Christmas the office issued some initial resources to guide directors and other senior adults’ services managers on their way.
For councils still in the starting blocks
For those councils who “have not yet started in earnest their preparation for implementation”, there is a guide to what the legislation will change and achieve, and some initial pointers on how councils should be preparing for implementation. This is broken into several sections: funding reform (covering the introduction of a cap on individuals’ liability for care costs from 2016); the introduction of a universal deferred payments scheme; the additional assessments that will be required under the Act and how eligibility arrangements will change; advice and information changes, and commissioning reforms.
The funding reforms appear to be councils’ biggest implementation headache. Not only do they face an influx of self-funding care users who will have to approach their council to take advantage of the cap on costs, but all these people must be assessed and those with eligible needs given a “care account” to track their progress to the cap. The programme office suggests that councils at the start of the implementation journey should:
- Identify local self-funders and estimate the time needed to assess their needs;
- Identify the additional capacity that will be required within the workforce to handle the big upturn in assessments;
- Examine how this challenge can be managed through increased use of self-assessment and outsourcing of assessments to the third sector;
- Calculate the costs of implementation, excluding the costs of the cap, which will be funded by government;
- Start discussions with providers over the impact of the reforms on them (which will be significant as this post shows);
- Assess the impact on IT systems (also significant, see this one) and on financial processes and information and advice systems;
What will change, what will not
This is supplemented by a helpful-looking analysis of the most relevant clauses of the bill, identifying provisions that simply modernise or consolidate the existing law (for example, clause 8 on how the needs of people with eligible needs can be met); those that creates new duties for councils, but in areas where they should be acting already under good practice or policy (for example, the duty to provide preventive services in clause 2); and those where new policy is being enshrined in law (for example, clause 10, which lowers the threshold for a carer’s assessment).
These definitions of what constitutes a modernisation of the law, a change in law that reflects policy, and new policy enshrined in law will have been agreed by the DH, Adass and the LGA, so reflect the views of local government leaders. But I would be interested in knowing if anyone thinks that they underestimate the scale of the changes that local authorities will have to deliver under the bill.
Questions councils must answer
The programme office has also published a list of key questions councils must ask of themselves in preparing for implementation, including whether they know the timescales for reform, have a change programme with appropriate leadership in place, are prioritising their resources or engaging service users, carers and partner agencies. There are also a series of expectations that the programme has included of how councils should be proceeding. Here are a few of these:
- Identify a lead officer with responsibility for Care Act implementation and consider whether a dedicated team should be put in place to deliver the changes;
- Share your implementation plans and be transparent with the local community, service users and carers;
- Establish as early as possible where the commissioning, design or level of provision of a service is likely to change and whether engagement or consultation with those with care and support needs, their carers or the wider community may be necessary;
- Consider how changes in response to the Act will require your local adult social care workforce (both council staff and those of providers) to be retrained and/or reconfigured.
Support is on hand
The programme office has also published information on how it intends to support councils meet implementation challenges. This will be based on the existing regional sector-led improvement structures, notably the nine Adass regional networks. Each region will be expected to set up “regional delivery partnership arrangements” for implementing the Care Act, based around the Adass regional network.
It is envisaged that these partnerships will identify both barriers to implementation and good practice examples to share with the national programme office. It is also expected that each region will have a named contact responsible for disseminating information from the national office to councils in the region.
There’s a lot more detail than this in the documents that have been published so do have a look, and email the programme office
Care Bill returns to Parliament
From next Thursday, a committee of MPs will start scrutinising the Care Bill in detail; amendments will be proposed and debated and the bill could conceivably change. The committee includes representatives from the government (care and support minister Norman Lamb and health minister Dan Poulter) and opposition (shadow care minister Liz Kendall), former care minister Paul Burstow (Lib Dem), and ex-social workers Meg Munn and Emma Lewell-Buck (both Labour).
We will be covering the committee stage as it progresses so keep your eyes peeled.