Topic 3 - Local authority provision Flashcards
What were the key reforms to the Care Act 2014 (key changes to adult health and wellbeing)
- Ensure and promote adult health in all respects, and safety of the cared for and carers. Wellbeing is the key principle throughout this Act.
- Create a clearer and more consistent care system
- Establish a system that delays/reduces the need to receive care
- Increase involvement for those receiving care
- Change system of charging for care
Care Act 2014 (implemented from April 2015) set lots of rules/guidance for care sector. Especially for the following:
- Promote wellbeing
- Providing advice and information
- Promote inclusion and diversity
- Assessing care needs of those that need it
- Assessing financial situation of those who need care (whether they need to contribute or not)
- Making payments to the individual’s so they can buy their services
- A cap on care costs was also implemented in the Act.
What are the charging reforms, and when were they announced
- In September 2021, the gov announced a reform to adult S care in England, known as the charging reforms.
- Designed to change charging structure to provide more care.
- More than £5bn was quoted by H&S care levy
When were the charging reforms cancelled and delayed to
- In September 2022, gov cancelled the levy and delayed the reforms, but instead capped care costs until 2025.
The Health & Care Act 2022 sought to improve the 2012 & 2014 Act, and the key changes were
Big changes to the NHS
- Gives the Health Secretary more authority over H services
- Formalises and removes competition between integrated care systems (ICSs). This means the 2 parts that make these up, integrated care boards (ICBs, which replace CCGs) and integrated care partnerships (ICPs) now have statutory powers and accountability on a local level over following areas – NHS finances and funding (ICBs) and strategy issues, public health, social care, population health issues (ICPs).
- Essentially, ICS brings together local authorities and third-sector bodies to the NHS and deliver care.
What does the following stand for:
* ICB
* ICS
* ICP
Integrated Care Boards
Integrated Care Systems
Integrated Care Partnerships
Health and Care Act 2014 states a number of key principles that should be considered by local authorities when carrying out care activities or functions:
- The importance of beginning with the assumption that the individual is best-placed to judge the individual’s wellbeing.
- The individual’s views, wishes, feelings and beliefs.
- The importance of preventing or delaying the development of needs for care and support and the importance of reducing needs that already exist.
- The need to ensure that decisions are made having regard to all the individual’s circumstances (and are not based only on their age or appearance, any condition they have, or any aspect of their behaviour which might lead others to make unjustified assumptions about their wellbeing).
- The importance of the individual participating as fully as possible.
- The importance of achieving a balance between the individual’s wellbeing and that of any friends or relatives who are involved in caring for the individual.
- The need to protect people from abuse and neglect.
- The need to ensure that any restriction on the individual’s rights or freedom of action that is involved in the exercise of the function is kept to the minimum necessary.
LAs must act to promote wellbeing and take steps to … the need for care
prevent and delay
Domiciliary care and Resi care where not provided by the NHS, is liable to the
Local Authorities
Under Care Act 2014, LA is required to carry out a … assessment (cared for) and … assessment.
Needs
Carer’s
When was the minimum threshold introduced for LAs to use when conducting a needs assessment
Care and Support (assessment) Regulations 2014.
What should a LA assessment consist of
- Needs assessment
- Financial assessment
- Creation of plan
Community care services (provided by local authorities) include:
- Home help/care
- Respite care
- Day care
- Night-sitting
- Provision of aids (devices etc.) to help
- Meals on wheels
- Care home
At what point should finances be consideres in the LA assessment
After initial assessment so outcome not swayed by finances
Before Care Act 2014, no national minimum threshold was in place, so each local authority created its own eligibility criteria. Guidance was issued under
Fair Access to Care Services (FACS).
Care assessment carried out by care specialist on behalf of
the local authority or the NHS.
Eligibility thresholds are based on how a person’s needs affect their ability to reach an outcome. LA must consider whether the person’s needs:
- Arise from impairment, disability or illness
- Make them unable to achieve two or more specified outcomes
- Are as a result of not meeting these outcomes and is affecting their wellbeing
An adult’s need are only eligible where they meet all three of those criteria points. The specified outcomes are as follows:
Eligibility thresholds & LA considerations
- Managing and maintaining nutrition
- Maintaining hygiene
- Managing toilet needs
- Being able to dress appropriately
- Being able to move around the home safely
- Keeping the home clean and safe
- Developing and maintaining family relationships
- Accessing and engaging in work, activities etc.
- Safely using facilities and services i.e. bus, shopping etc.
- Carrying out any necessary responsibilities i.e. childcare
In April 2004, a single assessment process (SAP) was introduced to ensure…
all agencies that are responsible for different areas of care (social care, health care, housing needs etc.) work together for one assessment.
Although the SAP complies to national minimum threshold and SAP guidance, local authorities can do it in different ways. SAP includes 4 types of processes that can be used:
- Contact assessment – contact with H&S care staff where basic info is given and identifying any significant needs.
- Overview assessment – wider looking at needs in the context of domains. Domains include user’s:
* Perspective
* Clinical background
* Disease prevention
* Personal care and physical wellbeing
* Senses
* Mental health
* Relationships
* Safety and immediate environment
* Resources - Specialist assessment – more detailed examination of specific need
- Comprehensive assessment – more detailed than overview assessment, may be carried out by multiple people
- Specialist assessment
more detailed examination of specific need
- Comprehensive assessment
more detailed than overview assessment, may be carried out by multiple people
No national rules on how quick care assessment needs to be completed, but performance indicators state LA’s should
start assessments within 48 hours, completing them within 28 days and implementation within next 28 days.
After care needs have been determined, a care and support plan is drawn up. A written record of the plan should be drawn up and agreed, and include the following:
- Details of eligible needs
- Objective of the service provision and agreed outcomes and how they will be met
- Contingency plans (emergencies)
- Risk assessment to identify potential risks
- Details of services offered and if contributions are necessary and how much
- Support that others (voluntary agencies etc.) are willing to provide
- Support to be provided to address any needs
- Review date
First review for new claimants will be within … months of commencement, and at least … thereafter.
3
once a year
LA must provide necessary provisions if assessed as eligible as per national minimum threshold. This could be in … Where there is more than one option, … option usually chosen. Some LA’s … the care given in home support or sheltered accom before advising to go to a care home.
- sheltered accom, home support or care home
- cheapest
- limit
