Welsh Government unveils ‘can and can only’ eligibility test for social care

The new framework aims to reduce the number of people on care and support plans by improving access to preventative services.

Photo: National Assembly for Wales/ Flickr

The Welsh Government’s plans for a social care ‘eligibility test’ that applies to children, adults and carers have been laid before the National Assembly.

Under the new framework, people will become eligible for a care and support package if their needs ‘can and can only’ be met by social services intervention.

Local authorities will first have to determine whether a care and support package can meet the person’s ‘wellbeing outcomes’ or enhance resources that will help to achieve them.

The person should then be assessed to see if their needs can be ‘sufficiently met’ by support coordinated by themselves, their family or carer, or by community-based services. If this is not the case, they will be eligible for a care package managed by the council.

The regulations state that local authorities must also provide an automatic right to eligibility for children and adults experiencing, or at risk of, abuse and neglect.

Welsh ministers have said the framework will ensure people have greater control over the care and support they need. But legal experts are concerned that it could create new barriers to accessing personalised services.

‘Greater control’

The changes are being introduced as part of the Social Services and Wellbeing (Wales) Act 2014 and will replace the existing eligibility criteria, under which people only receive help when they cross thresholds of low, moderate and critical levels.

Mark Drakeford, minister for health and social services in Wales, said: “The proposed changes are crucial to enable current and future generations to live their lives as fully as possible, providing the correct level of support to promote their wellbeing and to help sustain them in their families, networks and communities.”

The aim of the national model is to reduce the number of people on care and support plans by creating more opportunities for accessing preventative services.

The Social Services and Wellbeing Act places a duty on councils to provide preventative services and promote social enterprises, co-operatives, and the voluntary sector, and the regulations on eligibility have been designed to encourage this.

Under sections 2.23 and 2.24, local authorities will be expected to provide information and advice on these services during the assessment process, but must also continue to do so even when a determination of eligibility has been made.

‘Culture change’

Sue Evans, president of the Association of Directors of Social Services in Wales (ADSS Cymru), welcomed the regulations.

“A single assessment process for everyone, children and adults, is a major shift, and one to be welcomed. The guidance gives a really clear message about the approach required from all professionals, identifying what matters to people,” she said.

“This Act is about changing a culture. A culture, which has often created dependency, pledged much and at times fallen short of promises. We have contributed to the development of this legislation and are committed to making it a success.”

But Luke Clements, professor of law at the Cardiff Law School, expressed concerns that the eligibility test could be a ‘profound step backwards’.

“It seems to me that this model is creating new barriers to accessing personalised services. People will have to show a generic service has been tried and does not work for them, before they can access personalised services,” he said.

“There’s a lot to be said for having a vibrant, mixed-economy of preventative services, but I personally don’t think that is going to happen in the next eight months.”

‘People model’

The eligibility test will be applicable to all people – children, adults and carers – and local authorities must ensure individuals are fully involved in the assessment process by communicating in a manner that is appropriate to age, disability and cultural needs.

Local authorities will not be expected to provide care and support to adults and children if they are satisfied that their needs are being (or will be) met by a carer. However, the regulations state that eligible needs must be identified during assessment to enable the council to respond quickly when a carer becomes unwilling or unable to meet them.

The final regulations will be published in November 2015 and the Social Services and Wellbeing (Wales) Act 2014 comes into force on 1 April 2016.

The wellbeing principle

A local authority must determine whether a care and support package, or support for a carer, will assist the person to meet their personal wellbeing outcomes. The definition of “wellbeing” is set out in Part 2 of the Social Services and Wellbeing Act (Wales) 2014:

“Wellbeing” means well-being in relation to any of the following:
(a) physical and mental health and emotional well-being;
(b) protection from abuse and neglect;
(c) education, training and recreation;
(d) domestic, family and personal relationships;
(e) contribution made to society;
(f) securing rights and entitlements;
(g) social and economic well-being;
(h) suitability of living accommodation.

In relation to a child, “well-being” also includes:
(a) physical, intellectual, emotional, social and behavioural development;
(b) “welfare” as that word is interpreted for the purposes of the Children Act 1989.

In relation to an adult, “well-being” also includes:
(a) control over day to day life;
(b) participation in work.

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