The Department of Health had been intending to introduce the policy in 2016 under the Care Act 2014, following a pilot in 17 local authorities. But it has now decided to delay this for four years, meaning that in most authorities, direct payments will only be available for community-based care and short stays in care homes of no more than four consecutive weeks.
The Department of Health has said that anyone currently receiving a direct payment for their long-term residential care will be able to continue doing so. Also, the 17 trailblazer sites will have the opportunity to continue offering direct payments to service users in long-term residential care, though they may instead cease doing so until 2020.
The DH has written to the 17 sites asking them to decide whether or not to continue offering the payments and, on the basis of their answers, will amend Care Act regulations providing for them to offer them. Also, the Social Care Institute for Excellence will work with the trailblazer sites to capture learning from them. An evaluation of the pilot, by the Policy and Research Unit, will be published in autumn 2016.
The news was confirmed in an update on the Care Act provided by the Care and Support Reform programme team, made up of staff from the DH, Local Government Association and Association of Directors of Adult Social Services.
No appeals system until 2020
The government has also confirmed that the appeals system due to be introduced under the Care Act will be delayed until 2020, said the programme team. The proposed system would allow individuals to challenge decisions made by local authorities by having them independently reviewed, though the authority would not be bound to accept the reviewer’s judgement.
It had been due to come into force in April 2016 but the DH announced last summer that it would be deferred, along with the cap on individuals’ care costs and a more generous means-testing system for care home residents. The DH has now confirmed that the appeals system, like the funding reforms, will now come into force in 2020.
The other element of the Care Act reforms whose implementation has been delayed until 2020 is the provision to allow self-funders to have local authorities arrange their care in a care home.
Under section 18(3) of the act, people with eligible needs but financial resources above the means-testing threshold may ask the local authority arrange their community-based care or support, but not services in a care home.
Interest rate cap for deferred payment loans
The reform programme also said that the government had confirmed the maximum interest rate that local authorities will be able to charge for deferred payment loans made under the Care Act, from 1 January to 30 June 2016. Councils will be able to charge interest of up to 2.15% on loans made to people to fund the costs of their residential care where they have signed a deferred payment agreement.
The Care Act statutory guidance specifies that councils must charge the same rate for any such loans, though they may charge a rate less than the maximum. A revised version of the statutory guidance is due to be published shortly.
Warning over Care Act progress
The programme team said it would publish shortly its latest “stocktake” of progress on the Care Act, the fifth in total. In an introduction to to the team’s latest bulletin, Adass president Ray James said: “Early findings from stocktake 5 show us that overall confidence remains high, however concerns around workforce and budgets are growing.
“There is a significant fall in confidence that councils will have sufficient money in the budget to implement the Act through [2016-17] and beyond, and growing numbers report the impact of emergency admissions and delayed discharges on the local provider market, and concerns around the impact of the [national] living wage.”