Caring for our future and the draft Care and Support Bill Surrey Care Association AGM

1. Caring for our future and the draft Care and Support Bill Surrey Care Association AGM 9 October 2012

2. The reform timeframe Law Commission Report __________ May 2011 Engagement and pre-legislative scrutiny on draft Bill • Care and Support White Paper • Progress report on funding • Draft Care and Support Bill • __________ • July 2012 Legislation Caring for our future - engagement _________ Sept - Dec 2011 Social Care Vision _______ Nov 2010 Spending Review Engagement on funding reform Dilnot Commission Report ___________ July 2011

3. The Care and Support White Paper This means that, in the future, we expect people will be able to say: • Vision • To promote people’s independence and wellbeing by enabling them to prevent and postpone the need for care and support. • To transform people’s experience of care and support, putting them in control and ensuring that services respond to what they want. 1. “I am supported to maintain my independence for as long as possible” 2. “I understand how care and support works, and what my entitlements are” 3. “I am happy with the quality of my care and support” 4. “I know that the person giving me care and support will treat me with dignity and respect” 5. “I am in control of my care and support”

4. 1. “I am supported to maintain my independence for as long as possible” • To help people stay active, independent and connected in their communities we will: • Stimulate the development of schemes that help people share their time, talents and skills with others in their community. • Develop, in a number of trailblazer areas, new ways of investing in services that help people to stay independent for longer, such as Social Impact Bonds • Establish a new care and support housing fund, worth £200 million over 5 years to support the development of specialised housing for older and disabled people • Involve communities in decisions around health and care services, through local Healthwatch and health and wellbeing boards. • Support national care provider organisations to develop ‘open care homes’ that build links with their local community

5. 2. “I understand how care and support works, and what my entitlements and responsibilities are” • To help people understand and be confident about their options, we will : • Establish a new national information website across health, care and support • Support local authorities to develop better online information and advice services • Introduce a national minimum eligibility threshold for care and support • Make it easier for people to move across the country, by ensuring that no-one’s care and support is interrupted • Extend the right to an assessment to all carers, and introduce a clear entitlement to support to meet their eligible needs.

6. 3. “I am happy with the quality of my care and support” • To ensure that people are confident that their care and support will be of a high standard, we will : • Give people access to clear and comparative information about the quality of care providers and the options they offer • Legislate to ensure that local authorities, the NHS and the police work together at a local level to prevent abuse • Rule out crude ‘contracting by the minute’ that can undermine dignity and choice for those who use care and support • Consult on further steps to ensure service continuity for people using care and support should a provider goes out of business

7. 4. “I know that the person giving me care and support will treat me with dignity and respect” • To ensure that people are confident that the care workforce will be sensitive and compassionate to their needs, we will : • Place dignity and respect at the heart of new recommended minimum training standards and a code of conduct for those working in care. • Offer personal assistants (PAs), and their employers, greater support and training to improve recruitment, retention and the quality of the care and support they deliver. • Train more care workers to deliver high quality care, including an ambition to double the number of care apprenticeships to 100,000 by 2017. • Appoint a Chief Social Worker by the end of 2012 to provide a leadership role for the social work profession.

8. 5. “I am in control of my care and support” • To ensure that care and support focuses on meeting people’s individual needs and helping them to achieve their aspirations we will: • Legislate to give people an entitlement to a personal budget as part of their care and support plan, and strengthen our ambitions on direct payments • Increase the availability of independent advice and support to help people with eligible needs to plan and make choices about their care and support • Develop, in a small number of areas, the introduction of direct payments for people who have chosen to live in residential care, in order to test the costs and benefits • Invest a further £100 million in 2013/14 and £200 million in 2014/15 through joint funding between the NHS and social care to support better integrated health and care services

9. The draft Care and Support Bill 9

10. Reforming the statute:Our aims We want a new statute for adult care and support which: • consolidates all existing legislation into one, single statute, supported by new regulations and statutory guidance. • is built around people – their needs and outcomes – rather than based on disability, setting or types of service. • treats carers as equal to the person they care for – putting them in the centre of the law and on the same legal footing. • is clearer and easier to navigate – a simple legal framework which people who need care, carers and those who manage and work in the system can understand. • modernises the law to reflect the priorities and focus of care and support – shifting the balance away from institutional care and towards prevention and community capital. • is consistent – removing anomalies where people can be treated differently without a clear reason. 10

11. Reforming the legal framework The new structure will have three layers, of which the Bill is one part: Primary legislation – the Bill The most important duties and powers Secondary legislation – the regulations More detail on critical processes Statutory guidance Guidance on best practice in meeting legal obligations and delivering care and support

12. Key provisions:The story of care and support Clause No. 1 2-7 9-30 31-33 34-38 39-44 45-53 A new statutory principle which embeds individual well-being as the driving force underpinning the provision of care and support. Population-level duties on local authorities to provide information and advice, prevention services, and shape the market for care and support services. These are supported by duties to promote cooperation and integration to improve the way public authorities work together. Following the individual journey through the care and support system, clarifying rights and entitlements. Including putting eligibility framework in law (13), and new rights: to request local authority support (17), for carers to have needs met (19), and to plans and personal budgets (23). New provisions on portability, to ensure care needs are met when a person moves areas. The first statutory framework for adult safeguarding, setting out the key responsibilities of local authorities and their partners, and creating Safeguarding Adults Boards in every area. New provisions to support better transition from children’s services for young people, young carers and parent carers, including protections to ensure no gap in services over transition (43). Other legislative provisions, including powers to recover debts (45-46), re-enacting delayed discharges provisions (47), and a new power for LAs to delegate functions to a third party (51). 12

13. Clauses 1-7:General responsibilities Set out the general responsibilities of local authorities towards all people: The well-being principle underpins the entire legal framework. It sets a defining purpose for care and support, and influences the way all functions are carried out in relation to individuals. Universal obligations towards all local people: information and advice to help people understand the care and support system, access services and plan for the future services or other steps to prevent, reduce or delay needs for care and support promoting the market of providers so that there are high quality services to meet people’s choices Requirement to work collaboratively and cooperate with other public authorities, including duty to promote integration with NHS and other services.

14. Clauses 8-16:Assessments Start the person’s journey through the care and support system: Describe how needs can be met, to give an illustration for the clauses which follow. Single duties for assessment of people who may use services and carers. Focus of assessment on needs and outcomes – not other factors. Placing the eligibility framework in law for the first time, so that regulations establish what needs are “eligible” for local authority support. Clarifying powers for charging for certain types of care and support, and local authority duties in relation to financial assessments – so that is carried out transparently and consistently. Updated powers to offer deferred payment agreements, so that the person does not pay charges upfront.

15. Clauses 17-22:When must the local authority meet needs? Clarify who is entitled to have their care and support needs met by the local authority: Sets out the core entitlement for people to services – based on eligible needs, ordinary residence, and where relevant the outcome of the financial assessment. Includes a new right to request the local authority’s support for self-funders with eligible needs. The first right to support for carers – on the equivalent basis to the people they care for, and with clarity around how meeting those needs may include care directly for the person cared for. Broad powers for the local authority to meet needs in all other circumstances. Exceptions and prohibitions where the local authority may not meet needs – forming the boundary with the NHS (e.g. for Continuing Healthcare), housing and other public services.

16. Clauses 23-30:Care and support planning Describe what must happen after assessments to decide how needs should be met: Entitlement to a care and support plan, and requirement that local authority must help the person decide how to meet their needs. Duties to provide a record of assessment and information and advice on meeting and preventing needs to people who are not otherwise entitled to support. Right to a personal budget as part of the care and support plan. Entitlement to a choice of accommodation when someone is placed in a care home, with clear rules on the ability to make top-up payments for more expensive settings. Right to request a direct payment to meet some or all of needs in the care and support plan – including rules for people lacking mental capacity, and payments to another individual. New duties to review care and support plans, to ensure people’s needs and outcomes continue to be met over time, and re-assess when necessary.

17. Clauses 31-33:Moving between areas Enabling people to move between areas without the fear of losing care (“portability”): New duty to ensure continuity of care when moving between areas. Sending local authority must share the care and support plan and other information relating to the person and their carer. Receiving local authority must provide information before the move, assess the person’s needs, and then arrange to meet their needs on the day of arrival based on the previous care and support plan. Clarifying the deeming rules for ordinary residence for people placed in accommodation in another area, so that people cannot be left between areas with responsibility uncertain. Updating powers for the Secretary of State to resolve disputes between local authorities.

18. Clauses 34-38:Safeguarding The first statutory framework for protecting adults from abuse and neglect: New duty for local authority to carry out enquiries (or cause others to) where it suspects an adult is at risk of abuse or neglect. Requirement for all areas to establish a Safeguarding Adults Board to bring together LA, NHS and police to coordinate activity to protect adults from abuse and neglect. SABs to carry out safeguarding adults reviews into cases where someone who is experiencing abuse or neglect dies or there is concern about how authorities acted, to ensure lessons are learned. Removes the existing power (under NAA 1948) for local authorities to remove people from their homes – but see the separate consultation on whether a new power is needed to ensure local authorities are able to protect people effectively.

19. Clauses 39-44:Transition from children’s services New provisions to support better transition to adult care and support at the age of 18: New powers for local authorities to assess young people and young carers under the adult statute in advance of their 18th birthday, to prepare for transition. A new duty to assess the adult carers of children, to identify any support needs that could be met by adult services, and prepare for transition of the child. A power to provide support to meet the needs of carers of children – so that support can be provided from adults’ services in addition to that received by the family through children’s services. A new duty to ensure continuity of care around transition – so that if a young person is receiving services under the Children Act 1989 on their 18th birthday, but adult care and support is not ready to meet their needs, they must continue to receive the same service.

20. Clauses 45-53:Other provisions A series of other provisions to complete the legal framework: Restating existing powers for local authorities to recover debts – for instance where someone has failed to pay any charges due for their care and support. Re-enacting the provisions which focus the local authority and NHS on hospital discharges and reducing delays. A few small amendments to the provisions for people receiving after-care for mental disorder under the Mental Health Act. A requirement for local authorities to hold registers of blind and partially sighted people. A power to issue statutory guidance under which local authorities are to carry out their functions in the new statute. A new power for local authorities to delegate some of their functions to a third party – although they would still be legally responsible for ensuring duties are fulfilled.

21. Engaging on the draft Bill:Consultation and pre-legislative scrutiny We have published the draft Bill for consultation and pre-legislative scrutiny: Public consultation runs until 19 October for written responses – but engagement will be ongoing after that. We want to work with you to build on the Caring for our future engagement, and ensure stakeholder leadership through the consultation and beyond. Pre-legislative scrutiny will start later in the autumn. This is the process where a Committee of MPs and/or Peers discuss the draft Bill and make recommendations for its improvement prior to formal introduction. The Committee are likely to ask for written submissions from interested parties in the autumn. There will be public evidence sessions which stakeholders will be invited to over the autumn/winter. The Committee publishes a report at the end of the scrutiny period, early in the New Year.

22. Key milestones Now - April 2013 • Publication of White Paper & draft Bill (July 2012) • Consultation on draft Bill (to mid October 2012) • Pre-legislative scrutiny (autumn-early 2013) • Government response to PLS (Feb-March 2013) • Consultation on safeguarding intervention powers (July-October 2012) • Consultation on market oversight; and launch of support scheme for market shaping (Autumn 2012) • Care and Support Bill introduced to Parliament (from May 2013) • Consult on draft regulations and statutory guidance (over 13/14 and 14/15) • Implementation of new legislation (April 2015 onwards) April 2013 on

23. Commenting on the draft Bill For more information and to get involved in the consultation: Use the online portal to see and comment on each clause individually: http://careandsupportbill.dh.gov.uk See more information, factsheets and opportunities for discussion on the Caring for our Future website: http://caringforourfuture.dh.gov.uk Email us at careandsupportbill@dh.gsi.gov.uk by 19 October. Follow us on Twitter: @caresupportbill Please help us arrange meetings with your networks and stakeholders to discuss the draft Bill more widely.