The Care Act Consultation on Guidance and Regulations

The Care Act
Consultation on guidance and regulations:
Personalisation and care planning
Personalisation: the journey so far
The Health and Social
Care Act: update to the
legislation and new
regulations to expand
direct payments
The Community Care
(Direct Payments) Act:
the first legislation for
allow for direct
payments to people
from the local authority
A Vision for Adult Social
Care: embedding
personalisation firmly in
Government policy
Putting People First:
the concordat which
enshrined the
personalisation agenda
and started the focus
on personal budgets
DH – Leading the nation’s health and care
The Care Act:
personalisation into
adult social care
Caring for our Future:
the White Paper
announcing plans to
legislate to provide
personal budgets to all,
supported by a draft Bill
The future
Personalisation & the Care Act – Overview
A new legislative focus on personalisation, increasing opportunities for
greater choice and control:
Placing personal budgets into law for the first time, ensuring they will be provided to
everyone as part of the care and support plan (also mandatory).
Duties to review care and support plans generally, and a new right for people to request
a review of a care and support plan.
Clarifying the right to request a direct payment, with clear conditions to meet in primary
Improving the range of services on offer for people with a direct payment or personal
budget by focusing on the local authority market shaping role.
Creating better information, advice and support for users of adult social care to inform
their choices, including rights to independent advocacy.
DH – Leading the nation’s health and care
Personalisation & the Care Act – Guidance
Aim: to aid interpretation of the Act and to set out the
general policy intentions
People should be encouraged to self-plan, and supported to do so.
There should be no limitations (within reason) about how people choose to
meet needs – flexibility and innovation should be encouraged.
People (and anyone else) should be involved throughout the planning processes.
The personal budget process should reflect the principles of: transparency,
sufficiency and timeliness
Direct payments must be provided where requested, providing the conditions in
the Act have been met, and Regulations do not state otherwise.
DH – Leading the nation’s health and care
Personalisation & the Care Act – Regulations
1) Exclusions of costs from the personal budget
[Care and Support (Personal Budget Exclusion of Costs) Regulations 2014]
Where intermediate care/reablement is being provided to meet eligible needs (ie not
being provided as a free universal service) the costs of this must be excluded from
the personal budget.
The definition of intermediate care/reablement is defined in the regulations as:
“intermediate care (including reablement support) services” means care and support
provided to an adult by a local authority under section 18 or 19(1) or (2) or 20(1) or
20(6) of the Act which—
– consists of a programme of care and support;
– is for a specified period of time;
– has as its purpose the provision of assistance to an adult to enable the adult to
maintain or regain the skills needed to live independently in their own home.”
DH – Leading the nation’s health and care
Personalisation & the Care Act – Regulations
2) Direct Payments
[Care and Support (Direct Payments) Regulations 2014]
Mainly carry on the legislative framework under existing regulations (2009)
Changes include:
– Relaxing the ban on family members in the same household from receiving
DPs, to allow LAs discretion to allow DPs to these groups for admin &
management of the DP (but not care);
– new rules that prevent the DP holder being forced to use the DP with one
particular provider, and prevent the LA monitoring the DP excessively.
– Bringing forward the first review of making the DP from 12 months to 6
DH – Leading the nation’s health and care
Consultation questions
Care planning
• Does the guidance on personalisation fully support and promote a care and support system
that has personalisation at its heart?
• Does the guidance on personalisation support integration of health and care (and any other
state support)?
• Does the guidance support care and support workers to do their job effectively?
Personal budgets
• Is this definition clear and does it conform to your understanding of intermediate care and
reablement? Is there any way it can be improved?
• Does excluding the cost of reablement/intermediate care from the personal budget as
defined above:
• Create inconsistencies with the way that reablement/intermediate care is provided in
NHS personal health budgets?
• Affect the provision of reablement/intermediate care for people with mental health
• Are the ways in which different personal budgets can be combined sufficiently clear?
DH – Leading the nation’s health and care
Consultation questions
Direct Payments
• Will the easing of the restriction to pay family members living in the same household for
administration/management of the direct payment increase uptake of direct payments?
Will this create implementation issues for local authorities?
The draft direct payment regulations decreases the time period to conduct a review of the
direct payment from 12 months to 6 months – is this workable?
The draft regulations seek to ensure choice is not stifled and the direct payment is not
monitored excessively – is it strong enough to encourage greater direct payment use, but
workable for local authorities to show effective use of public monies?
DH – Leading the nation’s health and care

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