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The Care Act Consultation on guidance and regulations: Personalisation and care planning
2 Personalisation: the journey so far DH – Leading the nation’s health and care 1996 2007 20102012 The future The Community Care (Direct Payments) Act: the first legislation for allow for direct payments to people from the local authority 2001 The Health and Social Care Act: update to the legislation and new regulations to expand direct payments Putting People First: the concordat which enshrined the personalisation agenda and started the focus on personal budgets A Vision for Adult Social Care: embedding personalisation firmly in Government policy Caring for our Future: the White Paper announcing plans to legislate to provide personal budgets to all, supported by a draft Bill The Care Act: mainstreaming personalisation into adult social care
3 DH – Leading the nation’s health and care 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 legislation. 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.
4 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.
5 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.”
6 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 months
7 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 problems? Are the ways in which different personal budgets can be combined sufficiently clear? DH – Leading the nation’s health and care
8 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 Consultation questions
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