Care plans should record unmet need and be focused on independent living, the British Association of Social Workers (BASW) has said in a paper designed to influence planned government reforms to adult social care.
The proposals, drawn up by a group of members and now open to wider consultation with social workers, would likely require amending Care Act 2014 provisions on wellbeing, assessment, eligibility and care and support planning.
But despite this week’s Queen’s Speech reiterating ministers’ commitment to reform adult care, including through legislation, it is not clear when or what proposals will be brought forward with a minority government in place and an election pending.
Independent living objective
A key plank of the BASW proposals is that the adult social care system should be focused on promoting independent living
The association said that the Care Act’s duty on councils to promote individuals’ wellbeing did not provide a sufficiently clear vision for what social care should achieve, which required a standard of wellbeing against which needs should be measured.
It said the objective should be the definition of independent living set out in the UN Convention on the Rights of Persons with Disabilities, which the UK has agreed to follow but has not been incorporated into UK law. The convention states that disabled people should have:
- the opportunity to live where and with whom they want, on an equal basis with others, without being obliged to live in a particular arrangement;
- access to a range of support services to promote inclusion and prevent isolation;
- general community services available on an equal basis to other people and in a way that is responsive to their needs.
Assessments would be structured to identify the care and support needed to achieve independent living, under BASW’s proposals, with a draft care and support plan setting out the most cost-effective way to do so. Any unresolved differences between the assessing practitioner and the service user should be set out transparently.
Recording unmet need
This would then be presented to a budget manager, who would decide how much of the plan could be afforded and whether there would be any delay in meeting some or all of the individual’s needs. Where there were unmet or undermet needs to achieve independent living that would not be funded, these should be set out in the plan, something which BASW said would make clear to central government how much additional resource was required to achieve independent living for all.
The ideas in the BASW paper draw on work previously done by social work consultant Colin Slasberg and academic Peter Beresford. The pair have penned pieces in a number of publications, including Community Care, over recent years, making the case for independent living being the objective of adult social care and unmet and undermet need being transparently measured, in order to influence central government funding.
During the passage of the Care Act, the government rejected making independent living a specific objective. The statutory guidance on the act says that the wellbeing principle “is intended to cover the key components of independent living”, as expressed in the UN disability convention, but that the language used in the act was clearer than what it called the “relatively abstract” concept of independent living.
On unmet need, BASW cited Age UK estimates that 1.4 million older people in England are not receiving adequate support to meet need.
Under the Care Act, councils have a power to meet non-eligible needs, and duties to record all needs identified by the assessment and provide written information and advice to individuals to assist them in preventing, reducing and delaying needs that have been determined as non-eligible. But there is no obligation to record or quantify unmet or undermet needs, as BASW proposes.
“It is alarming that local authorities do not record the numbers and needs of people they deem ineligible and the extent to which people are under-supported,” the BASW paper said.
“Therefore, there should be the proper recording of how need is translated into resource allocation so that we can establish the funding gap.”
BASW is now calling for social workers’ views on the proposals, which they can do by answering an online survey.
Green paper delays
The proposals come with the government’s promised green paper on reforming adult social care, which was originally due to be published in summer 2017, having been delayed multiply for over two years.
The Queen’s Speech said the government would “bring forward substantive proposals to fix the crisis in social care to give everyone the dignity and security they deserve”, including “setting out legislative requirements”.
However, with the government lacking a majority, the content and timing of any reforms will depend on the outcome of the next election, which is expected to be in the near future.