The Care Act 2014
Top Tips for Family Carers. By Gail Hanrahan (Oxfordshire Family Services Network – OXFSN)
Gail was our speaker at the New Forest Mencap and Minstead Trust Carers’ Workshop on 5th July at the Nedderman Centre.
Gail raised funds from Comic Relief to establish a Project – Em-Bold-en. She had recognised that many older carers were still caring at home for their adult sons and daughters and siblings with a learning disability. The purpose of the Project was:
to give a strong voice to family carers and to influence and hold decision makers to account within health and social care services.
Several coffee mornings were held with family carers to find out what health and social services were available to them; what did they need; what plans were in place to protect and plan for their loved ones where funding is reducing; how will services meet the needs of older people with a learning disability. Family members met with ‘senior people in health and social services in November 2016 and asked for some simple guidelines to The Care Act 2014 so that they could understand their rights and those of their loved ones.
These are some of the main points that Gail made. You can see more information about the Em-Bold-en project and the Care Act 2014 – ‘top tips for families carers’ at: www.oxfsn.org.uk
- The Well-being Principle
There is a new fundamental duty in the Care Act (Section 1); in everything a local Authority does under the Act: they must promote the well-being of the individual. This involves personal dignity and being treated with respect and well-being in relation to every area of a person’s life.
- Getting an Assessment
A request for an assessment cannot be refused if a person fits the eligibility criteria. The local authority cannot reduce support to your relative without a reassessment of their needs and a new support plan must be produced.
- Eligibility
The Care Act has identified a single National Eligibility Criteria Framework for all local authorities. The assessment should identify all needs but usually only those that are eligible will be funded.
There is a list of eligible outcomes and a person must meet three criteria to be eligible for support:
- their needs must result from a physical or mental impairment
- they must be unable to achieve two or more of the outcomes
- as a consequence, there is likely to be a significant impact upon their well-being
Gail suggested that people keep a diary, for a week, of the support provided by the carer, to inform eligibility. For example: if a person takes ½ hour to bathe, that is not the support time needed. It may take ¼ hour to prepare for a bath and ¼ hour to dry and dress, so the support time required for a bath is 1 hour. Gail also advised that carers ask the question what if?.. – what would be the consequence if a person was doing this task unsupported.
- What must be included in a Care and Support Plan
The Care Act states that all identified needs should be included, even those that do not meet the eligibility criteria and will not be funded – aspirational support needs, e.g. college, respite etc.
Support that the family carer is willing and able to provide should be identified and what you are not able or willing to do. This is particularly of relevance during transition.
The most important elements of a Care Plan are that it identifies:
- What a person really needs to survive
- What is needed to make life worth living
- Define specifically how frequently specific support should be given
Families need to pass on as much knowledge about the person as they can. Gail said that family carers should know when something an assessor says is wrong and be able to challenge it. She was asked for an example where an assessment has been successfully challenged. She spoke of one situation in which the Care Act was not adhered to. The Social Worker undertook a review but not a full assessment. She called it a ‘cuts review’ and then reduced the support to the individual. OXFSN’s family advocate challenged the outcome as contravening the Care Act and a full reassessment had to be undertaken. The person was assessed correctly and then identified as needing a higher, not lower, level of support. However, Gail said that unfortunately there have not been enough cases where challenges have been successful, so there is little Case Law at present.
- Direct Payments
If families are opting for Direct Payments, they need to make sure that all costs are included:, not just salary, but all employer-related costs. These also need to take into account training, brokerage, advocacy, insurance etc. Gail suggested that families talk to local providers to find out all their costs.
- Local Authorities Responsibilities
They must adjust provision to suit your needs, not the other way around.
They cannot say they don’t have local provision to meet the needs of an individual, so the family will have to arrange something themselves. If there is nowhere in the local area that can provide a service, to meet eligible, assessed needs, local authorities must find a service out of area or provide the funds for the family to find a service.
If you are unsure that a service will safely meet the needs of your loved one, ask that Safeguarding risks are addressed.
- Carers’ Needs and Eligibility for Support
If you have needs that arise as a consequence of providing necessary care to an adult you will be eligible for support, as long as:
Your physical and/or mental health is deteriorating or is at risk
You are unable to undertake one of the caring activities that is an identified outcome and as a consequence there is likely to be a significant impact upon your well-being.
- Going to Panel
Once an assessment has been completed it will go to a Panel of senior people in the local authority. The Panel should not refuse to approve the proposals put forward by the social worker, based on detailed assessment of need, just because of the cost.
You can ask for a response from the Panel to ask how any eligible assessed need will be met. If you think the decision is not justified, you can make a formal complaint.
- Advocacy
Gail stressed that families do not have to do everything alone. Under the Care Act, carers who need support with the process of the assessment and planning can access Family Advocacy. People can have independent advocacy arranged for them by their local authority.
One family member advised others to take the Advocate to meetings, copy them into emails and ask for write-ups of any telephone conversation.
Family members can see more of what Gail and her colleagues do at: www.offsn.org.uk
‘A Guide to the Care Act – Top Tips for Family Carers of People with Learning Disabilities’ can be found on the website.
On the back of the Guide is a list of Community Care lawyers.
Under resources on the care act guide there is a short film called ‘Peace of Mind’. This focuses on the experiences of family carers.