The Care Act Consultation on guidance and regulations: Personalisation and care planning

1. The Care ActConsultation on guidance and regulations: Personalisation and care planning

2. Personalisation: the journey so far The Health and Social Care Act: update to the legislation and new regulations to expand direct payments A Vision for Adult Social Care: embedding personalisation firmly in Government policy The Care Act: mainstreaming personalisation into adult social care 2001 2007 1996 2010 2012 The future Caring for our Future: the White Paper announcing plans to legislate to provide personal budgets to all, supported by a draft Bill The Community Care (Direct Payments) Act: the first legislation for allow for direct payments to people from the local authority Putting People First: the concordat which enshrined the personalisation agenda and started the focus on personal budgets DH – Leading the nation’s health and care

3. Personalisation & the Care Act – Overview A new legislative focus on personalisation, increasing opportunities for greater choice and control: • Placing personal budgets into law for the first time, ensuring they will be provided to everyone as part of the care and support plan (also mandatory). • Duties to review care and support plans generally, and a new right for people to request a review of a care and support plan. • Clarifying the right to request a direct payment, with clear conditions to meet in primary legislation. • Improving the range of services on offer for people with a direct payment or personal budget by focusing on the local authority market shaping role. • Creating better information, advice and support for users of adult social care to inform their choices, including rights to independent advocacy. DH – Leading the nation’s health and care

4. Personalisation & the Care Act – Guidance • Aim: to aid interpretation of the Act and to set out the general policy intentions • People should be encouraged to self-plan, and supported to do so. • There should be no limitations (within reason) about how people choose to meet needs – flexibility and innovation should be encouraged. • People (and anyone else) should be involved throughout the planning processes. • The personal budget process should reflect the principles of: transparency, sufficiency and timeliness • Direct payments must be provided where requested, providing the conditions in the Act have been met, and Regulations do not state otherwise. DH – Leading the nation’s health and care

5. Personalisation & the Care Act – Regulations • Exclusions of costs from the personal budget • [Care and Support (Personal Budget Exclusion of Costs) Regulations 2014] • Where intermediate care/reablement is being provided to meet eligible needs (ie not being provided as a free universal service) the costs of this must be excluded from the personal budget. • The definition of intermediate care/reablement is defined in the regulations as: • “intermediate care (including reablement support) services” means care and support provided to an adult by a local authority under section 18 or 19(1) or (2) or 20(1) or 20(6) of the Act which— • consists of a programme of care and support; • is for a specified period of time; • has as its purpose the provision of assistance to an adult to enable the adult to maintain or regain the skills needed to live independently in their own home.” DH – Leading the nation’s health and care

6. Personalisation & the Care Act – Regulations • 2) Direct Payments • [Care and Support (Direct Payments) Regulations 2014] • Mainly carry on the legislative framework under existing regulations (2009) • Changes include: • Relaxing the ban on family members in the same household from receiving DPs, to allow LAs discretion to allow DPs to these groups for admin & management of the DP (but not care); • new rules that prevent the DP holder being forced to use the DP with one particular provider, and prevent the LA monitoring the DP excessively. • Bringing forward the first review of making the DP from 12 months to 6 months DH – Leading the nation’s health and care

7. Consultation questions • Care planning • Does the guidance on personalisation fully support and promote a care and support system that has personalisation at its heart? • Does the guidance on personalisation support integration of health and care (and any other state support)? • Does the guidance support care and support workers to do their job effectively?   • Personal budgets • Is this definition clear and does it conform to your understanding of intermediate care and reablement? Is there any way it can be improved? • Does excluding the cost of reablement/intermediate care from the personal budget as defined above: • Create inconsistencies with the way that reablement/intermediate care is provided in NHS personal health budgets? • Affect the provision of reablement/intermediate care for people with mental health problems? • Are the ways in which different personal budgets can be combined sufficiently clear? DH – Leading the nation’s health and care

8. Consultation questions • Direct Payments • Will the easing of the restriction to pay family members living in the same household for administration/management of the direct payment increase uptake of direct payments? Will this create implementation issues for local authorities? • The draft direct payment regulations decreases the time period to conduct a review of the direct payment from 12 months to 6 months – is this workable? • The draft regulations seek to ensure choice is not stifled and the direct payment is not monitored excessively – is it strong enough to encourage greater direct payment use, but workable for local authorities to show effective use of public monies? DH – Leading the nation’s health and care