1. The Care Act 2014: the new legal framework for care and support Tim Spencer-Lane INS Open Day – 4 July 2014

2. Statutory framework Health and Social Care Act 2001 Carer’s legislation NHS and Community Care Act 1990 NHS and Community Care Act 1990 Disabled Persons (Consultation, Recognition and Services Act 1986 Disabled Persons (Consultation, Recognition and Services Act 1986 Section 117 of the Mental Health Act 1983 Section 117 of the Mental Health Act 1983 Section 254 & Sch 20 of the NHS Act 2006 Section 254 & Sch 20 of the NHS Act 2006 Chronically Sick & Disabled Persons Act 1970 Health Services and Public Health Act 1968 National Assistance Act 1948 Adult social care

3. Section 29 National Assistance Act 1948: “welfare arrangements for blind, deaf, dumb and crippled persons etc” “ … persons aged 18 or over who are blind, deaf or dumb, or who suffer from mental disorder of any description and other persons aged eighteen or over who are substantially and permanently handicapped by illness, injury, or congenital deformity … ”

4. Section 47 National Assistance Act 1948: compulsory removal power Joint duty on health and social services to provide after-care services for people discharged from compulsory detention in psychiatric hospital under section 3, 37, 45A, 47 or 48  Suffering from grave, chronic disease or aged, infirm or physically incapacitated  Living in insanitary conditions and not receiving proper care and attention  Detention for up to 3 months  6 weeks before orders can be challenged

5. Care Act 2014

6. Section 1(2): promoting individual well-being 1. personal dignity (including treatment of the person with respect)2. physical and mental health, and emotional well-being2. protection from abuse and neglect3. control over day-to-day life (including over care and support)4. participation in work, education, training or recreation5. social and economic well-being6. domestic, family and personal relationships7. Suitability of living accommodation8. the individual’s contribution to society

7. Section 1(2): well-being checklist Individual well- being Assumption that the person is the best judge of their well-being The person’s views, wishes and feelings Have regard to all the adult’s circumstances Full participation in decision making Balance with well-being of carers Protect from abuse and neglect Minimum restrictions

8. General duties Preventing needs for care and support (s.2) Promote integration of health and social care (s.3) Information and advice (s.4) Promote diversity and quality in services (s.5)

9. Adult Social Care Project Specific duty to request co-operation with relevant partners (section 7) General duty to co-operate with relevant partners (section 6) Duties to co-operate

10. Assessment and eligibility

11. 2. The process for assessment Sections 9-12: assessing needs  Duty to assess where adult appears to need care and support  Right to refuse an assessment  Duty to consult adult, carers and any other named person  Assessment regulations

12. 2. The process for assessment Section 13: eligibility criteria  A single eligibility framework for all services  Duty on Government to set eligibility criteria in regulations  New national minimum threshold set at “substantial”  New regulations in place from April 2015

13. Funding reforms, and next steps after assessment

14. Adult Social Care Project Financial assessment £118,000 upper limit £17,000 lower limit Cap on care costs: £72, 000 for older people Lower for people of a working age £0 for 18 year olds Funding reforms Mandatory deferred payment scheme

15. Section 18: duty to meet needs Ordinary resident or no settled residence Accrued costs exceed cap on care costs No charge for service Resources fall below financial threshold Self-funder who makes a request

16.  Right to a care and support plan (s.25)  Personal budgets (s.26)  Care accounts (s.29)  Preferred accommodation provisions (s.30)  Direct payments (ss. 31 to 33) Next steps after assessment

17. Carer’s rights

18.  Duty to assess any carer who appears to have needs for support  No need to request the assessment  No need to be providing substantial and regular support  New eligibility criteria for carer’s services  Duty to meet a carer’s eligible needs (s 20) Sections 10-13: carer’s rights

19. Adult safeguarding

20. The local authority must make enquires it considers necessary (or cause enquiries to be made) care and support needs abuse or neglect unable to safeguard themselves Section 42: safeguarding enquiries

21.  Duty on local authority to establish an SAB  Objective is to help and protect adults at risk of abuse or neglect  SAB may do anything necessary or desirable to achieve this aim  NHS and police must nominate members with required skills and experience  Statutory safeguarding adults reviews (s. 44)  Duty to provide information to an SAB (s. 45) Section 43 and Schedule 2: Safeguarding Adult Boards

22. Adult Social Care Project No new power of entry to speak to a person at risk of abuse and neglect Repeal of section 47 of the National Assistance Act 1948 Safeguarding powers

23. Extended Human Rights Act protection Right to portable assessments Revisions to section 117 of the Mental Health Act A new appeals process against local authority decisions Rights to advocacy Duties in cases of business failure Care and support in prison Transitional assessments for young people Other reforms

24. My contact details: Emailtim.spencer-lane@lawcommission.gsi.gov.uk Websitewww.lawcommission.justice.gov.uk