Many of us may need care and support at some point in our lives and most people will be required to pay something towards the cost of this care. In order to give people who receive care and support, or people who look after someone as a carer, an opportunity to have a bigger say about what sort of care is best for them and their family, the Care Act 2014 was introduced.
The act places a series of duties and responsibilities on local authorities about care and support for adults. It also created a consistent route to establishing an entitlement to public care and support for all adults with needs for care and support. In addition, it produced the first ever entitlement to support for carers, on a similar basis.
The Care Act 2014 came into effect in 2015 and was the most significant reform of care and support for more than 60 years. It set out to put people and their carers in control of their care and support. The act changed many aspects of how support is arranged and aimed to give those in need of support greater control and influence about how that care is delivered.
The Care Act 2014 requires local authorities to ensure the provision or arrangement of services, facilities or resources to help prevent, delay or reduce the development of needs for care and support.
The Care Act 2014 combined various existing pieces of legislation which previously shaped how social care was arranged.
These included:
These laws were confusing and complex. They tended to focus on what service should be provided, rather than on what the person actually needs or wants. The Care Act 2014 was designed to be a simpler, modern law for 21st century care and support focussing on the individual needs of people.
The aim was to make the law fair and more consistent, removing certain anomalies that treated particular groups of people differently; the notion was to create a single route for determining entitlement, which works for all groups of people in all circumstances. The act was therefore intended to remove the chance of discrimination and unfair treatment taking place when assessing care needs and provision.
The act clearly states the steps that must be followed to work out this entitlement, to help people better understand the process. It follows the person’s “journey” in the care and support system.
The Care Act 2014 introduced:
There are six principles under the Care Act 2014, which are:
These six principles underpin the work of professionals and other staff who work with adults. They apply to all sectors and settings that work to care for and safeguard adults, including care and support services, further education colleges, commissioning, regulation and provision of health and care services, social work, healthcare, welfare benefits, housing, wider local authority functions and the criminal justice system.
The main principle of the Care Act 2014 is to help to improve people’s independence and wellbeing and for care providers and givers to promote a person-centred approach to the care and support they provide.
The core purpose of adult care and support is to help people to achieve the outcomes that matter to them in their life. The act requires local authorities to involve adults in their assessment, care and support planning and review. Considering the person’s views and wishes is critical to a person-centred system. Person-centred care and support planning mean that a person can receive part or all of their personal budget as a direct payment. Direct payments aim to enable a person to exercise the maximum possible choice over how they are supported, who they are supported by and where they are supported.
The Health Foundation has identified a framework that comprises four principles of person-centred care:
The Care Act 2014 holds the local authority responsible for ensuring that an individual receives the care and support they require and that their carers receive the support they require, as a result of an assessment of their individual needs.
The act highlights wellbeing as one of the key responsibilities for local authorities, with an inextricable link to the main principles, that is of prevention and protection.
The Statutory Guidance of the Care Act 2014 says at paragraph 1.21: “Promoting wellbeing does not mean simply looking at a need that corresponds to a particular service. At the heart of the reformed system will be an assessment and planning process that is a genuine conversation about people’s needs for care and support and how meeting these can help them achieve the outcomes most important to them.”
The Care Act 2014 places a duty on local authorities to promote an individual’s “wellbeing”. This means that they should always have a person’s wellbeing in mind when making decisions about them or planning services.
Wellbeing can relate to:
Wellbeing is a broad concept and there is no hierarchy in the areas of wellbeing listed above – all are equally important. There is also no single definition of wellbeing, as how this is interpreted will depend on the individual, their circumstances and their priorities. Wellbeing encompasses several areas of life. Therefore, using a holistic approach to ensure a clear understanding of the individual’s views is vital to identifying and defining wellbeing in each case.
The wellbeing principles are part of the Care Act 2014 eligibility criteria and as such local authorities also have to consider carers and the impact of their role on their wellbeing. Similarly, they have to consider the impact of a cared for person’s needs on their carer’s wellbeing. If the impact is significant then the eligibility criteria under the Care Act 2014 are likely to be met.
Before the Care Act 2014, the legal framework for adult protection was neither systematic nor coordinated, reflecting sporadic development of safeguarding policy over the last 25 years.
Sections 42 to 47 of the Care Act 2014 seek to place safeguarding on a statutory footing.
Under the act safeguarding duties apply to an adult who:
The view of what constitutes abuse or neglect should not be limited, as abuse or neglect can take many forms and the circumstances of the individual case should always be considered. Domestic abuse is specifically listed in the Care Act 2014, and it is clear in the act that the abuse or neglect can be inflicted intentionally or unintentionally.
The aims of adult safeguarding are to:
The Care Act 2014 requires local authorities to set up a Safeguarding Adults Board (SAB) in their area, giving these boards a clear basis in law for the first time.
The act says that the SAB must:
The act also requires local authorities to make enquires, or ask others to make enquiries, when they think an adult with care and support needs may be at risk of abuse or neglect in their area and to find out what, if any, action may be needed. This applies whether or not the authority is actually providing any care and support services to that adult.
Full version of the Care Act 2014
The government created 13 factsheets about the Care Act: