‘Councils need to get a better grip on Care Act duties to blind and partially sighted’

Research findings on eligibility raises important questions for how local authorities transition to the new Act

May 27, 2015 in Adults, Care Act 2014, Your Say

Photo: Gary Brigden

By Tara Chattaway, policy and campaigns officer, RNIB

One of the core pillars of the Care Act is ‘preventing, delaying and reducing’ a person’s care needs, based on the old adage that prevention is better (and more cost effective) than cure.

The Act dedicates a whole section of guidance on the importance of providing information, advice and advocacy. However, it also makes it very clear that preventative support for some people will take the form of a more structured intervention. It recognises that for blind and partially sighted people the importance of ‘rehabilitation’ support as a preventative measure.

An essential service

Rehabilitation is an essential service that provides training and support to people to help them adapt to their sight loss and learn new skills. The Care Act guidance clearly recognises rehabilitation for blind and partially sighted people as an important preventative service. It identifies the service as having ‘clear preventative benefits to the individual’ and, in many cases, the reducing ‘risk of hospital admissions.’

Because the guidance identifies this rehabilitation support as a form of reablement and a preventative service this means that a person should not have to demonstrate they have eligible needs to access it. After all this makes perfect sense, if a person requires support to prevent them from developing future care needs, then why should they wait until they develop those needs before receiving the preventative support?

The eligibility question

The problem is that there are signs that in the months before the Act’s introduction many authorities were applying strict eligibility criteria to rehabilitation support for blind and partially sighted people.

In January of this year the RNIB sent out a Freedom of Information request to local authorities. We wanted to know if they applied eligibility criteria to a person to enable them to access rehabilitation support. We received responses from 155 local authorities. Worryingly, around a third (32%) applied FACs criteria to accessing rehabilitation. We also found a large regional difference, a staggering 43% of local authorities in the South (London, Eastern, South East and South West) applied eligibility criteria, compared to only 18% of councils in the North (North West, North East, East Midlands, West Midlands and Yorkshire and Humber).

Lack of clarity

When we followed up with authorities to ask what system they would be putting place instead of FACs under the Care Act, there was a concerning lack of clarity from several councils.

A case could perhaps have made pre-Care Act for local authorities to apply FACs – that people with a moderate care need could be found eligible for rehabilitation support to prevent them from developing substantial care needs. But now that we have a national eligibility criteria, this line of thought does not ring true.

The Care Act regulations and guidance are clear. Blind and partially sighted people should not have to demonstrate eligible needs to access rehabilitation. Local authorities must ensure that people are assessed by their need, rather than their eligibility for long term care support.

What the Care Act guidance says

by Community Care

Paragraph 2.60 of the guidance says that reablement services – which would include rehabilitation for visually impaired people – will “usually be provided as a preventative service under section 2 of the act”.

This means access to the service is not dependent on eligibility, though the guidance adds that reablement can also be provided as part of a package of care and support to meet eligible needs. When carrying out an assessment local authorities must consider, under section 9(6), whether a person would benefit from a preventative service, such as rehabilitation.

Though this does not create an entitlement to preventative services for people would benefit from them, the guidance – which local authorities must follow unless they can demonstrate sound legal reasons for not doing so – says that councils “should take steps to support the person to access those services” (at paragraph 6.62).