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LGA report published: The Care Act 2014: Ten years on from Royal Assent

We were pleased to contribute an article into this report published today by the LGA which marks 10 years since the Care Act received Royal Assent in 2014.

 

The LGA’s report outlines what has happened over the last 10 years, including the repeated announcements and then scaling back of social care reform and the unimplemented aspects of the Care Act. It includes a useful timeline and overview of the context. In particular, the report offers reflections on three key themes: funding, integration and Covid-19 and has several recommendations: 

  • Do not dispense with the Care Act as it remains a well-supported and valuable legal framework for modern care and support. 
  • Fund adult social care adequately, sustainably and with trust in councils as democratically accountable bodies. The LGA points to the Health Foundation’s work to understand the different uplift options available to government.  
  • All options for raising revenue and the approach to allocations should be on the table, including: 
  • All disparate funding streams for adult social care to be brought together into a single pot, allocated directly to councils and with no (or only limited) conditions, and put into the funding base to provide certainty and the ability to plan for the long-term. 
  • Funding to be more much more outcomes-focussed, linking back to the duties, intent and ambition of the Care Act. 
  • End the reliance on council tax and the social care precept as key means for funding adult social care and instead look to national taxation. Formalise national funding for adult social care but with delivery remaining local and frame this positively (for instance fulfilling the ambitions of the legislation) rather than negatively (for instance ‘bailing out councils’). 
  • Explore the potential for better alignment between adult social care and the benefits system, including for instance Attendance Allowance. 
  • Commit to a review of NHS Continuing Healthcare. 
  • Consider a different funding model for younger adults and older people to reflect the different life situations faced by people aged 18-64 and those aged 65 and over. 
  • Provide an immediate injection of funding to continue tackling the issues set out in the Health Foundations’ work.  
  • Recognise there is no such thing as a ‘standard care worker’ and develop a comprehensive long-term plan for the care workforce building on the work Skills for Care are leading on. This must include increases to pay, terms and conditions. 
  • Be bold and ambitious with prevention.  
  • Make an early decision on Part 2 of the Care Act with a realistic assessment of its costs set against the need to invest heavily in the system itself.  
  • To ensure progress and improvement across the system, maintain the momentum on gathering better data about outcomes and value for money. 
  • Commit to sustained and authentic coproduction with people who draw on care and support. 
  • End the politicisation of adult social care.  

 

NCF’s accompanying article builds on the main report, outlining the implications to providers in the failure to adequately fund and implement the Care Act’s provisions as well as some aspects the Act overlooked. We argue that the focus on market oversight and the responsibilities within the Act for local authorities to manage the market is based on an assumption that market forces will deliver efficiency, quality and innovation, as well as providing capable and empowered consumers with greater choice. It also relies on a balance of purchasing power, enabling consumers to choose the price point to suit them for the service they need/ want/ can afford. This can work for the well informed, rational consumer, who is not making the purchase in a crisis and who has sufficient funds to buy their own care, but since 60%- 70% of care purchased is paid for by the public pound, often in crisis, it is not how it works out in reality.    

It is telling that more visionary approaches, such as the introduction of ‘self managing teams’ in homecare delivery, household approaches to residential care, shared lives and homeshare and even government backed approaches to the implementation of personal budgets have not universally gathered pace.  Operational constraints driven through restrictions in available funds mean these changes are often viewed through the lens of pilots or innovations rather than ongoing approaches to tackle communities with changing needs, and generally investment in transformation is led and sustained by providers.   

Market shaping did not have the workforce in scope, an oversight allowing the lack of strategic focus on the social care workforce to roll forward a further ten years. Action is needed to improve the pay, terms and conditions of care workers, help us all celebrate and recognise their value and ensure we have the size of workforce we will need to deliver consistent, high-quality care & support to the increasing numbers of people who need it (and their families) now and in the future. Current and future governments must work with us to achieve this.   

You can read our full article here. 

 

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