Care sector campaigners keep their fingers crossed, as councils become bound to the Care Act

The Care Act 2014, one of the Coalition Government’s truly historic pieces of legislation, which the Association of Directors of Adults Social Services (ADASS) describes as 'the most significant development in services for older and disabled people since the implementation of the Beveridge Report in 1948', is now officially in place.

Notable changes coming into force include a national eligibility criteria for care needs, that all local councils have to adhere to rather than setting their own levels; while further duties on councils include a commitment to giving carers the same right to assessment and support as the people they care for; and a duty to offer loans for those who need residential care that is then paid back from their estate.

A care cap on individual assets will also come into force next April, currently set at £72,000 for adults aged over 65 and with the level yet to be set for younger people.

Stressing the importance of the Act coming into force, ADASS president David Pearson says: “The 60-odd intervening years have seen vast social changes, particularly in the roles of women and societal attitudes generally towards disability and disabled people. And it is nothing less than tremendous that progress on a number of fronts have led to older people living longer and living better.

“Inevitably, legislation had to change in order to reflect these momentous times. Think tanks and other agencies began focusing our minds on the strategic shift from welfare services to services organised around well-being and personalisation, and began to make serious improvement in our wider understanding of good practice.

“The Care Act at last promises to bring social services and social care firmly into the twenty first century. It is a modern Act for a modern service.”

A new landscape

While the Care Act 2014 is one of the most celebrated achievements of this Parliament, inevitably its progress will lead to greater scrutiny of care sector performance and higher expectations. Key issues that critics are already focusing on include the ever-present issue of funding, as well as the stamping out of 15-minute care visits.

George McNamara, head of policy and public affairs at Alzheimer’s Society, wants to see pressure on whatever government is formed in May to commit to more funding that can assure the Act’s measures are successful.

He says: “Our social care system is on the brink of crisis. All political parties must commit to funding the social care black hole or risk letting down the most vulnerable in society – they must not become scapegoats by politicians in the pursuit of populist votes. Failure to do so will only result in higher costs to the NHS.

“The human and economic impact of dementia is truly staggering. It costs the UK in excess of £26 bn a year, which equates to £30,000 per person with dementia every year. Most striking of all is that people with dementia, their carers and families shoulder two-thirds of this cost themselves. In this country we have an army of unpaid carers – wives, husbands, daughters and sons – holding up a social care system on its knees. If you have cancer or heart disease you can quite rightly expect that the care you need will be free on the NHS, but this just isn’t the case for people with dementia who often require basic care in the community.

“While the reforms in the Care Act are a step in the right direction, unless properly funded they will still not help the vast majority of people and do nothing to alleviate the enormous burden on unpaid carers. The failure of successive governments to invest in resources to help our most vulnerable is seen in the strain put on families, and these changes don’t do enough to change that.”

Local government commitments

Leading learning disability charity, Leonard Cheshire Disability, is particularly keen that an increased level of scrutiny on local authority performance will result in the lancing of 15-minute care visits, widely criticised as being far too short to make a real impact on the life of a vulnerable adult.

Its campaigns director, Andy Cole, says: “As the Care Act comes into force we are still waiting for flying 15-minute care visits to be relegated to history.

“Our recent research has revealed how widespread these visits still are, with over 70 per cent of councils carrying out 15-minute visits. Over the last two years we have found the numbers have barely reduced.

“No disabled or older person should have to face the daily reality of making an undignified choice between a cup of tea or going to the loo in these rushed visits.

“For the years we have been campaigning to end 15-minute care visits our campaign has received overwhelming public backing.

“The Care Act today rules out flying 15-minute visits for intimate care needs, but we know that many councils, facing massive budget pressures, are still delivering them.

“This is the moment all commissioners and government should seize this opportunity to put a stop to the scandal once and for all. Disabled and older people will be watching the situation closely over the coming year.”

Early discontent

Even on the day the Act comes into force, there are already signs of central and local government clashing over eligibility criteria, with West Berkshire and Wokingham councils being two authorities that have launched a judicial review against the Department of Health, claiming they have not been given enough funds to implement the measures.

The West Berkshire challenge has been made on the grounds that a ‘process which resulted in inadequate funding is unlawful’, although the Department of Health points out that a £28m fund provided as part of a Better Care Fund was secured in order to help councils implement the criteria, while a further £470m has been set aside for 2015–16.

Mr Pearson, of ADASS, adds: “We have still not fully agreed with central government the additional costs that we shall have to incur in order to implement the legislation fully and successfully. There is no doubt that part of that success would lie in ensuring that the £4.3bn gap in funding between now and 2020 is addressed. There is a mismatch between rising demand and reducing resources.

“But ongoing discussions about these issues should not detract from the importance of the 2014 Act, the significant changes it will wrought in our services, and the important benefits it will bring older people and adults with disabilities in the coming years and decades.”