The Care Act 2014: Social Care Providers - May 2014
Published 30 May 2014
The Care Act 2014 came onto the statute books on 14 May 2014. It sets out a new framework of local authority duties in relation to the arrangement and funding of social care, along with a number of changes to the regulation of social care providers. It will have a very significant impact on the market for social care and providers operating on that market. The Act will start to come into effect from October 2014, although provisions on the Dilnot care cap will not be in force until April 2016.
The final version of the Act is now available here.
A new framework of duties on local authorities in relation to the provision and funding of social care, covering assessment of care needs, duties to arrange care, funding and the Dilnot care cap. This includes:
- New requirements to assess and meet the needs of carers and new provision for a single national test of eligibility for local authority involvement in arranging and funding care;
- A new focus on promoting individual wellbeing and on services to prevent needs for care and support from arising, as well as a duty to promote integration of health and social care services;
- Provisions which will greatly increase transparency about costs of care and impact on the current market balance between self-funded care and local authority funded care.
- New provisions on financing care, including wider provision for direct payments for care and for deferred payment schemes managed by local authorities, under which individuals can borrow against the value of their home to fund their care;
- New powers for local authorities to delegate many of their social care functions, to organisations of any type;
- A duty on local authorities to manage and develop the market for care in their area
- A number of new provisions regarding quality of care and regulation of providers, including:
- The legal basis for the duty of candour, applying to all health and social care providers regulated by the CQC;
- A new criminal offence for some care providers of giving false or misleading information;
- Changes to the CQC regulatory regime, including new powers to monitor the financial sustainability of providers;
- Provision for the Human Rights Act to apply to some private sector care providers;
- New duties on local authorities with regard to safeguarding of adults receiving social care.
The Act creates some significant market opportunities for providers. In addition to new demands for services for carers and preventative services, the ability for local authorities to delegate most of their social care functions opens up the prospect of significantly increased outsourcing.
At the same time the Act tightens the regulation of care provision and aims at a new focus on quality and sustainability of care, following events such as the Francis Report, the Winterbourne View scandal and the failure of Southern Cross. The duty of candour, the provisions on safeguarding and the extension of the Human Rights Act to private sector providers are likely to increase public scrutiny and expectations of independent care providers, while the new powers for the CQC to monitor financial sustainability create a new element in the regulatory relationship involving much greater financial transparency for some providers.
The Act also contains provisions which could have a major impact on the commissioning approach of local authorities and the financial profile of services within the care market.
For example, the requirement on authorities to promote individual wellbeing when fulfilling their social care functions is intended to alter the commissioning behaviour of local authorities market by restricting their ability to commission 15 minute domiciliary care visits and other minimal provision.
Even more fundamentally, there is a new duty on local authorities to arrange care for individuals with eligible needs even if they will not be receiving any financial support with the costs of that care. The government guidance on this provision confirms that this is intended to allow those individuals to benefit from the lower prices available through local authority frameworks. This duty is accompanied by requirements as to transparency about the costs of care commissioned by local authorities. These provisions raise the prospect of an end to the split markets for local authority and self-funded care, or at least of a self-funder market which is greatly reduced in size.
Ultimately this may result in a much more open and productive discussion between providers, local authorities and the public about the actual cost of providing social care and the relationship between cost/fees, quality and sustainability. However in the short term there may be a challenging period of change in the social care market, with uncertainty as to how local authorities will manage the change in the context of continuing resource limitations.
Providers need to understand the new framework to enable them to:
- Understand the new duties applying directly to them;
- Identify and respond to market opportunities;
- Anticipate the types of information and other assistance which local authorities may seek from them as their approach to commissioning changes.
The duty of candour in particular needs to be understood at every level of a provider organisation, from care workers providing care day-to-day, through managers and those responsible for organisational policies and procedures.
Much of the detail of the new framework will be contained in regulations and guidance: it will be very important for providers to review consultation versions of these documents and contribute to the consultations so that central government has clear information on the practical impact.