Chief social workers say suspension of Care Act duties should continue through winter

No councils currently using Care Act easements but government signals continuing them into 2021 to help authorities manage pressures

description_of_image_used_in_where_councils_are_going_wrong_in_their_implementation_of_the_care_act_image_of_care_act_book_front_page_Gary Brigden
Photo: Gary Brigden

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The chief social workers have advised ministers to keep legislation suspending certain Care Act 2014 duties in place through the winter to ensure local authorities are able to meet urgent and acute needs.

The advice from Fran Leddra and Mark Harvey – the joint interim chief social workers – was set out in the government’s adult social care winter plan, published last week. This indicates that the government will keep the so-called Care Act easements, legislated for under the Coronavirus Act 2020, in place until March next year, despite no councils currently making use of them.

The House of Commons will get a vote on whether or not to continue them when the act comes up for review next month, though there is little chance of the government being defeated given its 80-seat majority.

Suspended duties

The easements enable authorities to suspend Care Act duties to assess, develop and review care plans, carry out financial assessments and meet needs – subject to ensuring people’s human rights are not breached.

Statutory guidance under the Coronavirus Act  – which councils are required to have regard to – says councils “should only take a decision to begin exercising the Care Act easements when the workforce is significantly depleted, or demand on social care increased, to an extent that it is no longer reasonably practicable for it to comply with its Care Act duties”.

They should also notify the Department of Health and Social Care when they start or cease using them.

Eight councils made use of the easements between April and June, with only two making use of the most significant easement suspending the duty to meet need.

But while no authorities are using the easements, concerns have been raised that councils have taken other steps during the pandemic undermining their legal obligations, including through stopping services such as day centres and reducing care packages.

In its final report, also published last week, the government’s Social Care Sector Covid-19 Taskforce said “a number of organisations raised with us the concern that Care Act duties may be subject to prioritisation by local authorities”.

‘Worried about rights’

This point was made particularly strongly in a separate report by the taskforce’s advisory group on carers.

“Although the easements are not currently operating in any areas, the changes to assessments, very few face-to-face, services reductions because of social distancing etc. and community-based support not operating that were featured in people’s care plans, carers are worried about their rights in the future,” the report said. “We strongly recommend reassurances that services will be reinstated and to check that the delivery of assessments and care planning are done as close as possible to the Care Act 2014.”

Similar concerns were raised by the parliament’s joint committee on human rights in a report today on the government’s Covid-19 response.

The committee said it had “received evidence that local social care provision has significantly reduced, including in areas where the easement provisions have not been used”.

In its recommendations, it said the government “must justify its reasoning for the continuation of the powers to trigger easements to social care provision, and they must only continue if absolutely necessary and proportionate”. If the easements are to continue, it said the government must produce specific guidance about meeting human rights standards in discharging Care Act duties and carrying out human rights assessments.

Tackling ‘unique pressures’ on social care capacity

The winter plan is designed to help the sector manage the impact of Covid-19, as well as seasonal illlnesses, over the next six months, which the Department of Health and Social Care (DHSC) said would create “unique pressures”, including on sector capacity and the viability of providers.

Shaped by the recommendations of the taskforce, it is designed to balance providing good access to services with controlling Covid-19 infection and enabling people to stay connected to loved-ones. Key measures include:

  • The extension of the infection control fund, providing £546m, via councils, to enable care homes to pay staff normal wages while self-isolating and limit staff movement between homes, something which would be enforced by new regulations.
  • The provision of free personal protective equipment to care homes and home care providers, until March 2021, through the existing PPE portal, which is designed to help services meet the additional PPE demands arising from the pandemic. Free stock will also be provided to councils and local resilience forums – multi-agency partnerships designed to tackle emergencies – for those providers unable to use the portal.
  • As announced previously, the government has funded the NHS to provide six weeks’ care and support for those discharged from hospital with needs, and urgent support for those at risk of a hospital admission.
  • Developing a scheme in which the Care Quality Commission will designate care homes as safe to receive Covid-positive people from hospital, and requiring councils to provide alternative accommodation for people discharged whose care home cannot accommodate them.
  • Providing free flu vaccines to all social care staff in frontline roles, including personal assistants funded by direct payments, personal budgets or personal health budgets.

‘Pivotal role’ for social workers

The plan set out what it described was a “pivotal role” for social workers and other professionals in the planning and organisation of local services. One specific task highlighted by the plan for social workers was supporting care homes in risk-assessing visits to residents and advising on decision-making in relation to visits where a person lacks capacity to decide whether to receive a visitor.

The plan also said that directors of adult social services and principal social workers should ensure practitioners apply the law and strengths-based practice frameworks and are able to respond to inequality and deprivation and the impact this has on access to care services. It also said they should review quality assurance frameworks to ensure “winter and Covid-19 pressures do not reduce the ability to deliver high-quality social work practice”.

The plan also echoed concerns raised by charities and human rights groups about the inappropriate use of do not attempt cardiopulmonary resuscitation (DNACPR) orders in relation to disabled and older people.

It said: “Any advance care decision, including do not attempt cardiopulmonary resuscitation (DNACPR) decisions, should be fully discussed with the individual and their family, where possible and appropriate, and should be signed by the clinician responsible for their care. It is unacceptable for advance care plans, including DNACPR decisions, to be applied in a blanket fashion to any group of people.”

8 Responses to Chief social workers say suspension of Care Act duties should continue through winter

  1. Social Worker September 22, 2020 at 6:15 am #

    I think the CSWs make a strong case to keep the easements there if they are needed and to protect rights. They provide some checks and balance and should prevent LAs at service level making arbitrary decisions to substantially reduce statutory rights with no legal basis, which regrettably is not the wit of some LAs. That said, in all the 7/8 LAs that used the easements in the spring I have yet to see any evidence from any of them that their staff numbers were substantially depleted. The enacting of the easements in some LAs looked woolly and confused (Ie they didn’t really understand the criteria for change) and in others it looked to be downright opportunism.

    • Chris Lee September 30, 2020 at 1:18 pm #

      Reducing someone’s care needs is a discrace my 85 year old mother living at home alone had social shopping and cleaning time withdrawn for 16 weeks during lockdown no one could visit carers nor sw informed us she has dementia we ended up doing shopping online As a Sci wheelchair person myself reducing my care would be detrimental to my wellbeing

  2. Anonymous September 23, 2020 at 6:39 am #

    Easement as an option has to continue. However, it should be made mandatory that if a council wishes to use easement, all assessors are trained in human rights and how to practice within easement first.

    If Councils continue to flout the good will of informal carers, this will could have a catastrophic impact later down the line. It’s those informal carers that have given up having their eligible needs met that will get us through.

  3. Chris Sterry September 23, 2020 at 8:51 pm #

    Are easements good or bad, now that is the question and what is the real reason why some regulations of the Care Act 2014 regarding adults and similar areas for children were allowed to be temporarily suspended in the Coronavirus Act 2020 should Local Authorities (LAs) wish to do so.

    For a family carer the question for myself is do I trust the Government and even more so LAs, well the simple answer is I do not, especially the management, while I am more inclined to trust some Social Workers, if not all.

    To suspend some regulations, when it is more than likely than there will be more need required not less.

    We have gone through 10 years of austerity cuts from the Tory Governments and while many LAs did try to minimise the cuts on Social Care, eventually cuts had to occur, again when need was increasing.

    To be correct funding of Social Care has never been sufficient since it was brought into LAs in 1970 and even though it was better than the mishmash of what was supposed to be Social Care pre-1970, without the required sufficient funding it was always going to be on a road to not fully succeed.

    In many areas, if not all, Social Care is in a dire state and all areas of need should be accommodated, not only urgent and acute needs. For when do moderate needs come into the realm of urgent and acute and if moderate needs have already been refused, will the change to urgent and acute be noticed.

    It take much strength for a family to contact Social Services and after being refused, they may be very reluctant to contact again, as they will not wish to be refused again.

    This Government has thrown money around as if it is going out of fashion in many other areas, but there appears great reluctance to do so for Social Care. Yes, some money has been made available, but that is but a mire drop in the ocean for what is really required. Maybe as much as £12 billion, just to bring Social Care to 2020 levels, which were again very inadequate.

    If, major funding is not forthcoming very soon then Social Care could cease to exist in many areas.

    As well as major funding, should there not be a major reorganisation of Social Care with Health, for it is clear that LAs can not cope, especially with an insensitive and ignorant Government.

    Unfortunately Social Care does not receive a good press and until people need social care, many people have a down on social care and feel people using it should do more for themselves.

    I feel very strongly that social care needs all the help it can, but feel easements are not the answer.

    Social Care is in crisis and it needs to be solved, so I created the petition Solve the crisis in Social Care, https://you.38degrees.org.uk/petitions/solve-the-crisis-in-social-care .

    More information can be found at https://1drv.ms/w/s!Aq2MsYduiazgnyZzm4SoJrp3NW38?e=ONsEa9.

    While this is lengthy it is not exhaustive as there are many other areas in Social Care, which need to be solved.

    • Chris Lee September 30, 2020 at 1:22 pm #

      Become a person that needs care for a month then you might change your opinion we only get the minimum we are assesed for

    • Chris Lee September 30, 2020 at 1:29 pm #

      Perhaps we should also look at the way LA waste money on social care, adaptations ,having been involved for many years some of actions are reprehensible but no one in Authority is prepared to stick their head above the parapet

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