Topic 3 - Local Authority Care Provision Flashcards
What are the key aims of The Care Act 2014
Before the Act there was no single, modern statute of area
Act reformed law around adult social care aiming to put well-being of people at heart of care system. Aims to:
- Ensure physical, mental, emotional well-being of cared for and carers
- Clearer, more consistent, fairer care system
- Delays and prevents need for those to recieve care
- Increase involvement & control for those being cared for
- Make changes to the system of charging for care
What were the changes that The Care Act 2014 bought about?
Key Changes the Care Act made:
- Assessment of care needs.
- Responsibility of local authorities to provide information on care services.
- Local authorities must establish and maintain service for providing people with information on adult care and support.
- Establishing national minimum threshold for assessing care needs
- Establishing eligibility for care and care planning
- Ensuring there is continuity of care when adult being cared for moves home.
What key points are related to the delivery of care by local authorities?
Delivery of Care
- Must act to promote well-being and take steps to prevent, reduce or delay need for care.
- Local Authorities may set limits on range of services, which they will charge for and what rate.
- Services can be delivered by them or outsourced privately.
- Funding can be directed to care provider or to claimant to purchase care themselves
What the Legal Responsibilities of a local authority when carrying out a needs assessment?
Local Authority Legal Responsibilities:
- Must carry out needs assessment for cared for and carer’s assessment for carer.
- Assessment must take account of effects of their needs on their well-being.
- Must provide informationa nd advice relating to care and support to adults and their carers
- Must have regard to national minimum threshold to judge eligibility.
What should a Care Needs Assessment involve?
Care or needs assessment should involve:
- Assessment of needs and circumstances to identify which needs to be met by local authority (social care) and NHS.
- Financial assessment
- Creation and implementation of a care plan
- Each part of the process should be carried out seperately
What are the different Community Care Services are provided by the local authority?
Community Care Services provided by the local authority include:
- home help or home care;
- respite care;
- day care;
- night-sitting services;
- provision of aids to help with everyday tasks;
- meals on wheels;
- care in a care home.
What conditions must be met to be eligible for care under the local authority assessment?
- Before Care Act 2014, local authorities could set own criteria.
- Criteria had to meet guidance under Fair Access to Care Services (FACS).
- Assessment done by care specialist on behalf of the local authority or NHS.
Must consider whether the person’s needs:
- arise/related to a physical/mental impairment/illness;
- make them unable to achieve 2+ specified outcomes;
- result of being unable to meet these outcomes and likely to significantly affect their well-being.
An adult’s needs are only eligible where they meet all three of the conditions above.
Specified Outcomes
The specified outcomes measured include:
- Managing & maintaining nutrition i.e preparing/consuming food and drink.
- Maintaining personal hygeine
- Managing Toilet needs
- Able to dress appropriately i.e during cold periods
- Move around home safely and accessing the home
- Keeping home clean and safe
- Develop and maintain family/relationships to avoid isolation and loneliness.
- Accessing and engaging in work, training, education or volunteering including physical access
- Able to savely use necessary facilities or services in community i.e public transport, recreational
- Carrying out caring responsibilites i.e for a child
If eligible for care needs, the local authority doesn’t have to meet needs already being met by carer.
What are the four parts of the SAP assessment process and what do they typically involve?
Single Assessment Process (SAP) introduced in April 2004.
Local authorities must comply with SAP and minimum threshold but can apply their own approach.
4 Parts of SAP carried out by different specialities:
Contact Assessment - Contact with health & social services where basic personal information given and significant needs identified.
Overview Assessment - Wider ranging looking at needs in context of domains such as clinical background, well-being, senses, mental health, relationship, resources, safety etc.
Specialist Assessment - More detail examination of specific need.
Comprehensive Assessment - More detailed than overview and may be carried out by more than one specialist
Care Assessment Timing
What timelines should the assessment start, be completed by and services be implemented in?
No national rules of how quick local authority must carry out assessment. But performance indicators that should be worked towards.
- All assessments start within 48 hours
- Completing them within 28 days.
- Care services in place in next 28 days
Assessments should have regard to well-being and carried out in way that individuals:
- Gain better understanding of their situation
- Identify options available for managing their own lives
- Understand basis on which decisions are reached
- Should also account of emotional and psychological and physical needs
Care and Support Plan
What is included in a care and support plan?
How often are reviews of care plans carried out?
After care needs determined, care package is arranged with written record of plan agreed.
It includes:
- Details of eligible needs
- Objective of service provision, agreed outcomes and organisation of support to meet objective and outcomes.
- Contingency plans for managing any emergency developments
- Risk assessment detailing agreed actions to manage identified risks
- Details of services and financial contributions the individual will pay
- Support carers and others willing to provide
- Support to be provided to address needs identified through assessment
- Review date. For new claimants reviews are normally done within 3 months and at least annually thereafter.
Financial Assessment
What possible outcomes could result from a financial assessment?
- Assessment process includes financial element.
- Assessment includes all assets
- Also includes share of joint income/capital
- Income assessed net of housing costs
Outcome could be:
- Entitled to services free of charge
- Has to make financial contribution towards costs
- May have income/capital so LA not obliged but can still be requested to arrange services on their behalf.
- Charges only applied to patients, cannot be on carers
Charging for Care Services
What are the capital thresholds for care funding?
How is income related to the capital thresholds?
What is the personal expenses allowance?
If financially able, can still ask LA to provide non-residential (domiciliary) care services and will be charged accordingly.
- First agreement on what services and costs
- Next assess persons savings & assets (capital)
- Next assess income. For every £250 part between capital thresholds, claimant treated as £1 per tarriff income per week.
Capital Thresholds:
- Upper capital limit for residential charging since £23,250 so if capital higher than this may need to pay full amount.
- Those with £14,250 and £23,250 expected to make contribution from capital and income.
- Regional differences. In Wales single limit of £40,000 and Scotland lower limit of £17,500 and higher limit of £28,000.
Regardless of outcome, LA must factor in a personal expenses allownace.
Those in care home fully funded by LA entitled to personal expenses allowance of £24.90 per week.
If LA Funded non residential care then allowed basic living allownace which is level of guaranteed element of state Pension Credit plus 25%
Once this has been calculated, the local authority charges an amount from income and capital above the protected amount.
Disregarded Income
What income is partly disregarded?
What income is fully disregarded?
Partly Disregarded Income:
- £10 a week War Widow’s/Disablement Pension
- 50% of private/occupation pension if pension recieved by married person in a care home.
- Savings credit up to a maxmimum amount.
- Flat rate disregard when income too high to claim pension credit or awarded less than certain amount.
Fully Disregarded Income:
- Mobility component’s of DLA/PIP
- Earnings from employement/self employement
- First £10 War Widowers/Disablement Pension
- Guardian’s Allowance and Child Tax Credit
- Christmas Bonus
- Winter Fuel Payment
- Housing Benefit
- Income from savings as this is added to the capital
- Income from mortgage PPI
- Certain charitable & voluntary payments
- Intended to be used for a specific item not covered by care home fees.
What capital is Disregarded in the local authority assessment?
- Surrender value of:
- Life policies
- Investment Bonds written as life contracts/annuities
- Value of funds held in trust or administered by court that derive from personal injury
- Capital held in discretionary trust
- Value of claiman’ts home if a spouse, partner or realtive resides there permanently. Property is always disregarded for first 12 weeks.
Case Study:
John and Mary are 80 and 78 years old, respectively, and have lived in their home in Derbyshire for eight years. Mary, a retired nurse, was diagnosed with vascular dementia six years ago and John is no longer able to provide for Mary’s care needs at home. It has been agreed that residential nursing care would be most appropriate.
Apart from their home, which has a market value of £230,000, John and Mary have £20,000 in savings with a building society, £15,000 in investments and Mary receives a pension of £140 per week from her former employer, which is paid to John. John and Mary receive basic State Pensions of £95 and £100 per week, respectively.
Their home is disregarded from Mary’s financial assessment as John is continuing to live in it. Half their savings and investments are allocated to Mary, giving her assets of £17,500.
This means Mary’s capital is assessed as falling below the current £23,250 threshold for care support and she will receive some funding from her local authority. The position is assessed as follows:
- State Pension - £100
- 50% of occupational pension - £70
- Tariff income from savings/investments - £13 ie (£17,500 – £14,250) / £250
Total - £183
Less personal expenses allowance - £24.90
FINAL TOTAL - £158.10
If the local authority sets a weekly budget of £680 to meet Mary’s assessed care and support costs then Mary will fund £158.10 of the costs with the local authority funding the balance of £521.90.
