The Care Act is welcome, but there’s plenty of unfinished business

Post from Caroline Hawkings, Public Policy Advisor at Scope.

This week, we’ve reached a significant milestone for adult social care in England.  After many months of debate, the Care Bill has become the Care Act through Royal Assent, meaning that the primary legislation is complete.

In the words of the Minister Norman Lamb, the Act’ represents the most significant reform of care and support in more than 60 years and at least on paper, there are many things to welcome about the new Act.

  • For the first time adult social care law has been brought into a single Act, replacing disparate and sometimes outdated laws
  •  Local authorities have a duty to promote a person’s well-being, which is comprehensively described in a ‘well-being principle’ covering different aspects of life
  • The Act introduces a national minimum threshold for getting care and support, which all local authorities must adhere to, aiming to end the post-code lottery of the current system where local authorities decide their own level. Currently, eligibility for support is assessed against a framework called Prioritising Need, also referred to as the Fair Access to Care Services criteria (FACS). There are four levels ‘critical, substantial, moderate and low’, the majority being at substantial or above.

Other positive features include: an emphasis on providing personalised services, prevention, personal budgets, improvements to care planning and access to advocacy in certain circumstances

But, the key question for disabled people remains whether they will be able to get the care and support they need to as live independently as possible?  Social care is vital to promoting a person’s dignity, well-being and independence and one in three people using social care are working age disabled people. Increasing access to social care is a key part of improving disabled people’s living standards.

There are two crucial inter-linked decisions which have yet to be finalised, which will determine the success of the Government’s landmark piece of legislation.

Firstly, although the Act establishes a national minimum threshold for social care, the level at which it is set will be determined by eligibility criteria contained in regulations (secondary legislation). These criteria will decide whether a person is in or out of the formal system.  The criteria have yet to be finalised and are due for public consultation at the end of May.

The Government has stated that their intention is to maintain eligibility at ‘substantial’ under the current Fair Access to Care (FACS) criteria.  So, the worrying prospect is one of a more uniform threshold which is consistently too high, where care continues to be restricted. This means that thousands of disabled people are likely to be shut out of the benefits which the new Care Act brings.

Secondly, the Act sets out the legislative framework, but the funding allocated to actually implement and apply what it says, is largely dictated by the Treasury. The tight rationing of care is largely due to historic underfunding and budget cuts.  Due to funding pressures, research from the Care and Support Alliance shows that 97,000 fewer disabled people who would have received social care five years ago, now receive no support.

The most frustrating thing is that it needn’t be like this. A lower eligibility threshold is good for disabled and older people and has benefits for the economy. Modelling by Deloitte, in the Ending the Care Crisis report, has shown that a £1.2 billion investment in establishing a lower national eligibility threshold would lead to £700 million saving to Central Government and £570 million saving to the NHS and local government.

Scope, working with other members of the Care and Support Alliance have been consistently urging the Government to introduce a lower eligibility threshold, backed up by sufficient funding to so that local authorities can afford to implement it properly.

If the Government is to realise the bold and welcome ambition of the Care Act, it’s essential that disabled people up and down the country get the support they need to live independently and live well.

2 thoughts on “The Care Act is welcome, but there’s plenty of unfinished business”

  1. Really good blog and I think all credit to Scope for leading the way on the debate about what social care should be, and its underfunding, as opposed to what it now is – something I think was recently called no more than a “residual service” by the King’s Fund.

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