What is the situation now?

* No principles in legislation for those working in social care.

* No definition of what community care is in law.

What’s the change?

Introduce basic principles of how those in social care should behave.

* Assume that service user is the best judge of their own well-being.

* Follow the individual’s views, wishes and feelings wherever practical.

* Make decisions based upon the circumstances of the person and not unjustified assumptions based on appearances.

* Give individuals the opportunity to be involved in assessments, planning, developing and reviewing their care and support.

* Achieve a balance with the well-being of others.

* Safeguard adults from abuse and neglect.

* Use the least restrictive solution when it is necessary to interfere with the individual’s rights and freedom of action.

How will this affect me?

Many of these principles already underpin social work and social care practice.

The General Social Care Council code of practice says social workers must protect people from harm, promote individuals' choice and independence and ensure the rights and freedoms of other people.

However, putting these principles on a legal footing will provide stronger ground for professionals to challenge management decisions where these are felt to compromise frontline workers’ ability to adhere to statutory principles.

There may also be stronger grounds for service users to challenge social workers’ actions through judicial review.


Will it have cost implications?

Possibly. Statutory principles provide a firmer footing for initiating a judicial review case, which could see a rise in cases, which would cost councils more.

However, having a shorter and leaner list of principles may also make it easier to settle complaints before they reach court.


Will it get government backing?

“It’s what we should have been doing for a long time,” said Ray Jones, professor of social work at Kingston University. He said such changes had been talked about for a long time and he expected to see them implemented.

What is the situation now?

Councils have a duty under the NHS and Community Care Act 1990 to assess people if they appear to be in need of community care services.

The Chronically Sick and Disabled Persons Act 1970 and Disabled Persons (services, consultation and representation) Act 1986 also place duties on councils to consider if they can provide services.

Local authorities can delegate parts of assessments carried out under these acts and have a responsibility to involve other agencies where appropriate.

Clients can only be assessed as adults at 18.

What’s the change?

* Single duty to assess all those who appearto have community care needs.

* Service users can refuse an assessment if they wish.

* Councils have greater ability to delegate community care assessments to allied professions or bodies, but councils must retain the final decision-making power on providing services.

* Teenagers can be assessed as adults from 16 and 17.

How will this affect me?

Some in social care are concerned that the ability to contract out assessments may endanger the role of the local authority social worker.

“I have experienced times when health and social care colleagues have differed in opinion about a way forward and fear that managers and decision makers (even those from social care) lend more weight to health words than social care words,” says Ruth Cartwright, manager for England at the British Association of Social Workers.

However, Caroline Bernard, deputy chief executive at Counsel and Care, says: “I think this will enhance the role of local authorities rather than erode it.” She says she feels this will encourage greater joined-up working between health and social care because expertise will be shared.

But Cartwright says a cultural shift to greater mutual understanding and respect will need to be fostered to ensure this proposal works smoothly in practice.

Delivering assessments to younger adults could initially increase social worker workloads, but should also make the transition to adult services less stressful for both teenagers and social workers.

Will it have cost implications?

Possibly. Some experts are concerned that independent social work practices could seek to charge councils for carrying out assessments.

Will it get government backing?

It’s likely as this reflects the current direction of multi-agency assessments.

What is the situation now?

* An eligibility framework is laid down in statutory guidance but this varies depending on which act is invoked.

* Councils have the discretion to choose which level of needs they meet based on resources.

* Service users moving from one area to another must obtain a new assessment of their eligibility for services.

What’s changing?

* A single duty to meet eligible needs applying to all client groups.

* Scope within the law for the English and Welsh governments to introduce national eligibility criteria.

* Impose an enhanced duty on councils to co-operate when a service user moves areas.

How will this affect me?

It should make the process of assessment simpler as an assessment of eligibility will follow an assessment of need in all cases.

The Law Commission considers a decision on national eligibility criteria a policy decision to be made by government. But campaign groups will use the Commission’s tacit approval for national criteria to pressure the government to introduce these in England, as Wales has already proposed to do.

The duty to continue providing the current level of service for new residents to an area may see clients get reassessed quicker.

Will it have cost implications?

Unlikely in the short term. National eligibility criteria could provide some authorities with financial issues, but this is a long way from implementation.

Will it get government backing?

As this is largely a codification of current law it is very likely to be implemented. The fate of national eligibility criteria is less certain.

What is the situation now?

What constitutes community care services is defined in narrow terms across multiple statutes.

What’s the change?

A wide-ranging but short list of community care services, explicitly including social work service, is set out by the Law Commission.

In addition, a list of elements of well-being that services are designed to meet would be laid down in law. The Law Commission proposes these should be:

* Health and emotional well-being

* Protection from harm

* Education, training and recreation

* The contribution made to society

* Securing rights and entitlements

Social workers would be required, by law, to produce a care plan, the constituent parts of which would be set down in regulation.

How will this affect me?

Naming social work as a community care service may return the profession to its roots in support, says Ruth Cartwright, manager of England for the British Association of Social Workers. “The concept of providing social work support to individuals as a thing in itself is in danger of disappearing in some areas. Social workers have told me in all seriousness that the main role of the social worker is to assess need, not to have any input after that.”

The duty to produce a written care plan and make it available to service users on request will make social workers more accountable, says David Congdon, head of policy at Mencap. “At the moment they give themselves plenty of scope for fudging it [if a service user complains],” he says.

Will it have cost implications?

Unlikely. Social workers already produce care plans but if it proves to provide stronger grounds for appeal there may be an increase in resources being used to support successful appellants.

Will it get government backing?

“It’s good practice being put on a statutory footing,” says Ray Jones, professor of social work at Kingston University, who thinks the recommendations will gain government support.

What is the situation now?

* Social workers must inform a carer of their rights to assessment and they must also take account of the carer’s needs when assessing a cared-for person.

* Carers only get assessed for community care services themselves if they request it.

* A carer must be providing “substantial and regular care” to qualify for an assessment.

What’s the change?

* Carers would no longer have to request an assessment to get one.

* They would be assessed against single eligibility criteria drawn up by the secretary of state health or equivalent Welsh minister.

* Carers would just need to appear to have needs that could be met by services for them or the person they care for to warrant assessment.

How will this affect me?

Social workers may find they are carrying out more carers’ assessments as a result. The Welsh government has expressed concern to the commission that the number of people receiving assessments could rise as a result of introducing a duty to assess.

However, in its final report the Commission argues: “The cohortof carers that would be eligible for an assessment under our proposal would be very similar to those who are entitled to an assessment under the current framework.” The commission points out that carers will still have to present themselves to the council in some form, which acts as self-selection.

Social workers will also no longer have to make a judgement about whether a carer is providing “substantial and regular care”. Dropping this tricky and inaccurate distinction should make social workers’ decision to assess carers simpler.

But as Emily Holzhausen, director of policy at Carers UK, points out, the Commission recommends assessments are “proportionate to need”. She says: “That’s the right way to proceed. Each local authority will need to draw up criteria on the way that they conduct different levels of assessments proportionate to need.”

Will it have cost implications?

Possibly. The Welsh government was one of a handful or organisations worried about pressures on staff time and resources.

Will it get government backing?

Possibly – but governments are always worried about a lack of resources.

What is the situation now?

* Unlike child protection, adult safeguarding procedures have no statutory basis but are only laid down in regulation.

* Safeguarding practice focuses on protecting “vulnerable adults”.

* Social workers can remove people from their homes under section 47 of the National Assistance Act 1948.

What’s the change?

* Councils have a legal duty to investigate suspected instances of adult abuse when an adult is at “risk of harm”.

* Councils take lead role in multi-agency safeguarding procedures.

* Abolition of section 47 of National Assistance Act 1948.

* NHS trusts and police will be required to appoint representatives to adult safeguarding boards.

How will this affect me?

Councils will have greater impetus to investigate instances of adult abuse. However, they will not be given any additional powers (such as powers of entry to homes where abuse is suspected) to do so.

Previously, commentators have expressed concern these powers could blur the lines between social workers as enablers and protectors of individuals. Gary FitzGerald, chief executive of Action on Elder Abuse, says this is a crucial debate which now needs to be had.

Although section 47 of National Assistance Act 1948 would be abolished, its use is patchy and clashes with the European Convention on Human Rights.

Some safeguarding boards find it difficult to get regular attendees from statutory organisations. The duty on other organisations to appoint representatives to safeguarding boards, combined with a general duty to co-operate (see health tab) may engender greater levels of co-operation between agencies.

Will it have cost implications?

Yes, in all likelihood. Areas that have not allocated many resources to adult safeguarding could find themselves facing sizable additional costs from this proposal, argues FitzGerald.

Will it get government backing?

“I think the [UK] government will probably run with it but their lack of public clarity on their position on adult safeguarding concerns me,” says FitzGerald. Action on Elder Abuse and Solicitors for the Elderly have called on the government to make a public statement on its position on adult safeguarding, which it has not done yet.

What is the situation now?

Direct payments cannot be used to pay for residential care.

What’s the change?

Direct payments could be used to pay for residential care.

How will this affect me?

There could potentially be greater pressure on council budgets if direct payments are used for residential care as it is the most expensive form of care. However, industry experts are concerned that direct payments may not be big enough to pay for residential care, leaving people with unmet needs. This, in turn, could put pressure on social workers charged with balancing these two competing pressures.

Will it have cost implications?

Yes, this is likely. Self-funders in residential care routinely pay more than those funded by councils. Unless councils are able to continue to demand the lowest price the cost to councils from those using personal budgets to pay for residential care could increase.

 
Will it get government backing?

As a principle it stands a good chance of being backed, says Ray Jones professor of social work at Kingston University. He argues any practical issues are more the concern of local authorities and individuals than government. The Welsh government has previously voiced opposition.

What is the situation now?

What constitutes continuing healthcare needs is interpreted locally.

What’s the change?

Eligibility for NHS continuing health care would be defined by the secretary of state for health or the Welsh health minister.

How will this affect me?

A clearer universal definition of who is eligible for continuing healthcare funding will make it easier for social workers to direct clients to the correct part of the system. It could also save time where social workers are involved in battling with PCTs over a client’s eligibility for this care.

Will it have cost implications?

Yes, this is likely. Some respondents to the Commission’s consultation said a whole indus try had developed to establish the dividing line between health and social care, which was costly to administer and police. This could shrink or cease to be necessary.

Will it get government backing?

“If there’s no primary care trusts or strategic health authorities someone has to creat a definition of continuing care,” says Ray Jones, professor of social work at Kingston University. “If you remove the intermediate layers then there’s only one place that it can be defined – government level.”