wolverhampton.gov.uk our mission: working as one to serve our city what does the care act mean for...

wolverhampton.gov.uk

Our mission:Working as one to serve our city

What does the Care Act mean for Carers?Presenter: Christine Rowley

Care Act 2014 – General principles• Care Act applies mostly to adults and to adults who

care for adults• Also applies to groups ‘in transition’ from children to

adult services• All parts of Act apply equally to adults and to carers• Underpinning duty to consider people’s wellbeing• Duty to maintain an Information and Advice service• New rights to independent advocacy • National eligibility criteria for adults and, for the first

time, for carers • Assessed eligible needs must be met


The small print• Equal legal rights for carers is certainly a major step forward

but:• Many authorities were already using the powers given to

them under previous legislation to do much of what they now have a duty to do so many carers will not see much difference in support available to them

• Although local authorities must meet assessed eligible unmet needs, they can exercise discretion in how they meet these needs

• Local authorities have no duty to meet needs which can be met in some other way.

• Local authorities must take people’s preferences into consideration but they are the final decision makers – although they must explain their reasoning throughout the process


Wellbeing• The Act’s underlying principle is that LAs should

promote a person’s wellbeing in the way it carries out all its functions

• Concept of wellbeing applies to all aspects of a carer’s life

• As part of determining eligibility for services there is a duty to consider whether a carer’s inability to achieve certain outcomes has a significant impact on their wellbeing


Wellbeing domainsThese are the areas which the Act says should be considered

• a) personal dignity (including treatment of the individual with respect);

• b) physical and mental health and emotional well-being;• c) protection from abuse and neglect;• d) control by the individual over day-to-day life (including over

care and support / support, and the way in which it is provided);• e) participation in work, education, training or recreation;• f) social and economic well-being;• g) domestic, family and personal relationships;• h) suitability of living accommodation; • i) the individual’s contribution to society


Delegation of Responsibilities• The Care Act does not require local authorities to

carry out all functions themselves but allows to ask other organisations to carry out many functions on their behalf

• This may of course include carers’ and other voluntary organisations

• In these cases, the organisations must also consider a person’s wellbeing in carrying out their tasks and must ensure that they carry out their work in line with Care Act guidance and eligibility criteria


Information and Advice• Local authorities must maintain an adequately funded Information and Advice service

about social care support for the whole population – not just those who already use or need it

• They do not have to provide all elements but are expected to understand, coordinate and make effective use of all available resources

• They must recognise and respond to the specific requirements that carers have for both general and personal information and advice.

• A carer’s need for information and advice may be separate and distinct from that of the person they are caring for

• The Act envisages that much information should be provided before first contact with Adult Services

• The Act is saying that other parts of the local authority as well as other organisations also have duties to provide information – its not all about social services


What is Information and Advice?


New Right to Independent Advocacy• In certain circumstances adults and carers have a right to

Independent Advocacy to help them participate in social care processes: assessment, care and support planning, reviews – even in some cases, Information and advice

• This is not aimed at people who ‘lack capacity’ – they still have rights to advocacy under the Mental Health Act

• This is not a right to advocacy in order to challenge a decision, this is about advocacy for people who have substantial difficulty in understanding, retaining and acting on information.


Supporting a person’s involvement


Duty to arrange for

independent advocate

Is there an ‘appropriate

individual’ – a carer, friend or

relative – that can facilitate their involvement?

Agree ‘appropriate individual’

Provide support and

make adjustments

Yes

Yes

No

Might this person have difficulty in

being involved?

Can they be better supported to enable their

involvement? [Reasonable

adjustments under the Equality Act 2010]

Yes

Do they still have

‘substantial difficulty’ in

being involved?

Yes

Right to a Carer’s Assessment• Where is appears that carer may have needs for support (or is likely to

do in the future ) Local authority must assess whether carer has needs (or is likely to do in the future) and if so what those needs are or are likely to be in the future.

• A much broader right than under previous legislation: however local authorities have considerable discretion as to how these assessments may be carried out.

• With the repeal of earlier carers legislation, local authorities no longer have a general duty to advise carers of their right to assessment ( although should do as part of the Information and advice function)

• They do have a duty to assess any carer identified while assessing an adult and a duty to refer any identified young carer to the appropriate service


Transition Rights to a Care Act Assessment• An assessment must be carried out where it appears to

the LA that the child or young carer is likely to have needs as an adult and the LA thinks it would be of significant benefit to assess

• An assessment must be carried out where it appears to the LA that a disabled child’s carer is likely to have needs after the child becomes 18 and the LA thinks it would be of significant benefit to the carer to assess

• The concept of significant benefit of assessing is largely about timing.


Young carers and carers of disabled children• Children Act 1989 remains in force but is amended by the

Children and Families Act 2014 to place additional duties on local authorities. Young carers are explicitly identified for the first time as people entitled to assessment and, where eligible, to support.

• Carers (with parental rights) of children with disabilities also have rights to assessment under this legislation

• Recognising that this excludes a child carer without parental responsibility a section of the 1995 Carers Act has been retained to give the right to an assessment to such carers


Carrying out assessments (1)• Assessment begins as soon as local authority starts collecting

information about the adult or carer• Care must be taken not to signpost people out of system too

soon. If carer is not proceeding to assessment, LA must be sure that enough questions have been asked, and enough information given, so that a determination of non-eligibility could be reliably made

• Local authorities may pause the assessment process to see if other interventions might work but it cannot refuse assessment to someone who refuses to try out a reasonable suggestion

• But on the other hand, if the authority believes that it has that information, there is no reason why, if the carer agrees, that process cannot be completed at ‘first contact’


Carrying out assessments (2)• Guidance talks of the need for proportional and appropriate

assessment which can be provided online, on the phone or face to face

• Assessments may be carried out jointly with other agencies • Carers, adult and child’s assessments may be combined to facilitate a

whole family approach• ‘supported self assessment’ has a particular meaning: local authorities

must offer this option to people with capacity but there is detailed guidance as to how it may be carried out so that a determination of eligibility can be made – it is not intended to be a tick box exercise

• There are no restrictions on who may assess but they must be properly trained


Right to be involved in assessment of person(s) cared for• Act gives this right- does not mean that they need to be there for

whole process but they must be allowed to give their opinions • Assessment of adult must be ‘carer blind/neutral’ ie it must record all

of person’s needs even if met by a carer or other provision so that there is a good information of what person would need if such support were unavailable for whatever reason

• However local authority has no duty to meet any needs which are met by a willing and able carer so if there is care which you cannot provide or can only provide with support then you need to say so

• Care Act does however expect assessors to use own experience to identify situations which are not sustainable


Carers eligibilty criteria3 part process to determine eligibility for a personal budget:

Must be providing necessary care for an adult with needs arising from a mental or physical impairmentandHealth must be deteriorating or is at risk of doing so or they are unable to achieve any of a list of outcomesand as a result of this there is, or is likely to be, a significant impact on their wellbeing

Note that even if carer does not meet all of these criteria they may still be entitled to other types of support.


Interpreting the carer’s eligibility criteria


A carer meets the eligibility criteria if:Their needs are caused by providing necessary care for an adult. As a result:their health is at riskor they are unable to achieve specified outcomesAs a consequence there is or is likely to be a significant impact on the carer’s well-being

The specified outcomes are:Carrying out any caring responsibilities the carer has for a childProviding care to other persons for whom the carer provides careMaintaining a habitable home environmentManaging and maintaining nutritionDeveloping and maintaining family or other personal relationshipsEngaging in work, training, education or volunteeringMaking use of necessary facilities or services in the local community including recreational facilities or services Engaging in recreational activities

Interpreting the carer’s eligibility criteria

wolverhampton.gov.uk 19

A carer meets the eligibility criteria if:Their needs are caused by providing necessary care for an adult. As a result:their health is at riskor they are unable to achieve specified outcomesAs a consequence there is or is likely to be a significant impact on the carer’s well-being

A carer is to be regarded as being unable to achieve an outcome if the carer:is unable to achieve it without assistance;is able to achieve it without assistance but:

doing so causes them significant pain, distress or anxiety

doing so endangers or is likely to endanger health or safety

Outcomes in detail (1)(i) carrying out any caring responsibilities the carer has for a childLocal authorities should consider any parenting or other caring responsibilities the carer has for a child in addition to their caring role for the adult. For example, the carer might be a grandparent with caring responsibilities for their grandchildren while the grandchildren’s parents are at work.(ii)providing care to other persons for whom the carer provides care Local authorities should consider any additional caring responsibilities the carer may have for other adults. For example, a carer may also have caring responsibilities for a parent in addition to caring for the adult with care and support needs.(iii)maintaining a habitable home environment Local authorities should consider if the condition of the carer’s home is safe and an appropriate environment to live in and whether it presents a significant risk to the carer’s wellbeing. A habitable home should be safe and have essential amenities: ie water, electricity and gas.(iv) managing and maintaining nutritionLocal authorities should consider whether the carer has the time to do essential shopping and to prepare meals for themselves and their family.


Outcomes in detail (2)(v) developing and maintaining family or other significant personal

relationshipsLocal authorities should consider whether the carer is in a position where their caring role prevents them from maintaining key relationships with family and friends or from developing new relationships where the carer does not already have other personal relationships.

(vi) engaging in work, training, education or volunteeringLocal authorities should consider whether the carer can continue in their job, and contribute to society, apply themselves in education, volunteer to support civil society or have the opportunity to get a job, if they are not in employment.

(vii) making use of necessary facilities or services in the local communityLocal authorities should consider whether the carer has an opportunity to make use of the local community’s services and facilities and for example consider whether the carer has time to use recreational facilities such as gyms or swimming pools.

(viii) engaging in recreational activitiesLocal authorities should consider whether the carer has leisure time, which might for example be some free time to read or engage in a hobby.


Consequential significant impact• Local authorities will need to decide how much an inability to achieve

an outcome matters to carer and what would happen if need not met. In many cases this will be quite apparent from what carer says during assessment

• If local authority agrees that the carer cannot achieve an outcome or that their health is at risk, but thinks that it has no significant impact it must give reasons for finding that the carer is not eligible.

• If no eligible needs, carer must be informed in writing of reasons for this determination as there is no duty to produce a support plan in these circumstances

• If there are eligible needs and carer wants these to be met, the local authority must check Ordinary Residence of the adult(s) they support as there is no duty to support carers looking after people ordinarily resident in another area


Support planning• LA may pause the assessment process to see if other

interventions work In the case of a carer’s assessment this may be necessary if carer has identified that, they need more support ( replacement care) for the adult

• an accurate assessment of eligibility of carer’s unmet needs could not be made until this replacement care was agreed ( if it was)

• If carer’s assessment showed carer not able or willing to provide further care and their needs met by support to adult then carer not entitled to a budget of their own – although may still benefit by other types of support


How carer’s needs might be met• If the carer has no eligible needs, they must still be provided with

advice and information and details of what to do if situation changes• Eligible needs might be met by:

• Advice and information• Referral of adult and / or carer to a health, preventative,

universal or community service – there is a big emphasis in the Act on looking at what is available in the community generally

• Replacement care for adult following the adult’s own assessment

• A personal budget for the carer• ‘Social work’ activities – this recognises that the assessment

itself and any further support offered by the assessor may well meet the carer’s needs

• A combination of the above


Setting the carer’s budget• The carer’s personal budget must be sufficient to meet the carer’s

own eligible unmet needs• Needs to be a clear focus on what outcomes the carer has identified• The local authority has a duty to meet needs but not wants• No-one can be forced to take their personal budget as a Direct

payment( although in reality most carers will probably opt for this)• Most carers won’t need ‘social care services’ to meet their own needs• Replacement care costs are included in adult’s budget and, if

charging applies, only the adult can be charged• Local authorities have the power to charge carers for their own

needs, in practice very few authorities are doing so.


A reminder• Local Authority’s duty is to meet assessed eligible unmet needs

not wants• Local Authority does not have to meet needs that can be met

in another way• Local Authority has discretion in how eligible needs are met

but not whether they are met: it may choose cheaper option if assessed outcomes met.

• Needs to consider a person’s reasonable preferences but the Local Authority is the final decision maker

• Local Authority may use power to meet non eligible needs• Local Authority must explain its reasons for determining non-

eligibility


For further information

Wolverhampton Carer Support TeamCarer’s Centre, Blossoms Fold, Off North Street, Wolverhampton, WV1 4HJCall: 01902 553409Email: [email protected]: www.wolverhampton.gov.uk/carers

Adult Social Care01902 551199


mailto:[email protected]

http://www.wolverhampton.gov.uk/carers

wolverhampton.gov.uk our mission: working as one to serve our city what does the care act mean for...

Documents