Care Act 2014 | Key points

The Care Act 2014 came into force in England in April 2015. It replaced several older pieces of legislation with the aim of unifying and modernising adult social care law.

Key points

• The Care Act 2014 was introduced to unify, modernise and clarify old laws on adult social care.
• The Act introduced new, national frameworks for local authorities to ensure fair and consistent access to care and support.

Summary – What are the main points of the Care Act 2014?

• The Care Act brought in a new, national framework for assessing whether or not a person has eligible needs. This promotes continuity of care, wherever you live in England and if you move to a different county.
• When making decisions about any individual, local authorities must consider how the decision will affect their wellbeing. This requires councils to act in the best interests of each person according to their individual needs and circumstances.
• Unpaid carers have the right to a Carer’s Assessment and support.
• Local authorities must establish safeguarding boards to help prevent and respond to adult abuse.

Principles of the Care Act 2014

The main principles of the Care Act are that local authorities have a legal duty to take steps to:

• Promote individual well-being.
• Prevent need for care and support.
• Promote integration of care and support with health services.
• Provide information and advice.
• Promote diversity and quality in provision of services.
• Co-operate generally and in specific cases.

Responsibilities of local authorities

Local authorities have responsibilities under the Act to provide services that prevent, slow and meet the care and support needs of local people.

• Buy and arrange care and support services that are sustainable, of good quality and support the wellbeing of the individuals using them. They should consult local people to find out what sorts of care and support are needed now and in the future.
• Give clear and accessible information about care and support available, including:
  • The types of care and support available locally.
  • Who provides these services.
  • How people can access these services.
  • How funding works and where to find independent financial advice.
  • How to complain or raise concerns.
• Provide services for local people, such as community groups, that help to prevent or slow care and support needs. These should help people with:
  • Independence
  • Socialising and feeling part of the community
  • Keeping or regaining skills

Eligibility for support

The Act changed the criteria for who was entitled to support into one, consistent process, replacing a number of old and complicated rules.

• Every person who is ‘ordinarily resident’ and shows signs of needing support is entitled to a free care needs assessment to see if they have ‘eligible needs’.
• If they do have ‘eligible needs’, the local authority has a legal duty to meet these needs through appropriate care if the person wants support (the person can use private care services instead if they wish). This might be through home care or moving to a care home.

Needs assessments

Needs assessments now follow a clear framework under the Care Act. This change brought continuity and fairness across counties, and a new focus on the person’s goals, choices and preferences.

Needs assessments must be provided to anybody who requests one, free of charge, as long as they are ordinarily resident in the areas and show signs of possible needing care and support.

A needs assessment is carried out by a trained assessor, who will come to the home of person being assessed. Sometimes assessments are by telephone.

They should include:

• What the person is finding difficult to do independently and how this impacts their wellbeing.
• What the person aims to achieve in getting support.
• An overall picture of the person’s health, lifestyle and support network.

The local authority then uses an eligibility framework to decide if the person has eligible needs.

Care plans

Care plans are drawn up after a care needs assessment shows that the person has eligible needs. The Act brought in new priority for the care plan to centre around the person’s wishes and wellbeing.

The care plan should include:

• What the person can do themselves and what they need support with.
• The type of care and support that would most benefit the person.
• How and when this care and support should be delivered.
• The responsibilities of those providing the care and support.
• How much local authorities will pay towards their care.

Financial assessments

The local authority must offer a financial means test. If this shows that the person qualifies for funding, the local authority must fund some or all of their care and support.

The financial assessment looks at how much money the person has in capital, investments and assets. If they are planning to get home care, rather than moving into a care home, then the value of their home won’t be taken into account.

Where the person’s total wealth is below £14,250, the local authority must fund all of their care. If it is over £23,250, the person must pay for their care themselves. If they have between these amounts, the local authority will provide funding for some of their care.

Funding for care and support

Once it has been established whether a person is eligible for funding, the local authority must decide how much funding they will offer. They take into account the person’s financial means, care needs and what is best for their wellbeing.

Personal budgets and direct payments

The person should be given a personal budget. This is how much money the local authority will provide to pay for their care each week.

The person can choose how this money is allocated. They can ask the council to manage the money and pay care providers or relevant organisations on their behalf.

Alternatively, they might prefer to hire carers, support workers or personal assistants themselves and use the money to pay them. This is called a direct payment.

Direct payments offer more flexibility and choice over who provides care and support.

Hospital discharge

If somebody has a stay in hospital and NHS teams think they might not be safe to discharge, they have duties under the care act to inform the person’s local authority (or the hospital’s if the person has no fixed address).

The local authority must then arrange a needs assessment for the patient and act accordingly.

This is to minimise the risk of unsafe discharge, such as the person not having a clear medication or discharge plan, or with no plan for care that they now need.

Read more about unsafe hospital discharge.

Safeguarding adults

Safeguarding adults is keeping them safe from abuse (including physical, emotional, financial and sexual abuse), and neglect.

The Act introduced a framework for safeguarding adults, the first clear set of guidelines that local authorities and other relevant health and social care organisations are legally obligated to follow.

The Care Act requires:

• That every local authority set up a safeguarding board (SAB), which meets regularly to discuss any safeguarding issues, publish a plan on how they will act on the issues, actually act on the issues and then publish reports on their progress. This has to include police and NHS staff.
• Local authorities must make enquiries and take action if an adult is at risk of abuse.
• SABs must organise safeguarding adults’ reviews if there is a failure that results in somebody being abused or harmed.
• Anybody who is the subject of a safeguarding adult review or enquiry has the right to have an independent advocate arranged for them by the local authority.
• Health and social care organisations must share relevant information with safeguarding boards in a timely manner.

New rights for carers

The Care Act 2014 brought in new rights for carers to access support of their own.

Those who regularly provide unpaid care for one or more adults who are elderly, disabled or ill can apply for a carer’s assessment.

The carer’s assessment looks at the person’s regular care duties and how the volume and nature of these duties affect the person’s wellbeing and managing the rest of their life. After the assessment, the local authority should offer the carer any practical, financial or emotional support that both they and the carer feel would be beneficial and appropriate.

Carers can also be entitled to personal budgets for this support, or have the council arrange and pay for it.

Continuity of care

The Care Act includes a set process for councils to follow if somebody receiving care moves from one local authority district to another.

This is to promote continuity of care, ensuring that the person receives the same standard of care and support in their new home with minimal change.

• The old local authority must provide the new one with relevant information. They must communicate throughout the transition.
• The second local authority (where the person is moving to) must conduct a fresh care needs assessment. They can do this before the person moves to make sure everything is ready for when they arrive.
• The new local authority must take into consideration the person’s new location and home because it may change their needs. For example, moving to a bungalow from a two-storey house would change mobility support needs.

What happens when providers fail their duty

Care providers in England have regulated by the Care Quality Commission (CQC) since 2009. The Care Act 2014 gave the CQC an additional responsibility – assessing the financial sustainability of care providers that are considered difficult to replace due to their size or specialism.

If a care provider does fail, it is the local authority’s duty to prevent people who were using that service from missing out on care or having gaps in care while they change providers.

Prisoners

Under the Care Act, prisoners are entitled to care needs assessments, financial means assessments, care and support, and funding if they are eligible.

The Act also made it clear under which local authority prisoners fell under, including for continuity of care if they move prisons.