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.
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.”