Subject: Care Package Assist to Get Financial Help for Dementia Care
For FAQs about Changes brought about by the Care Act see below
What is the Care Act?
The Care Act replaces over 60 years of law for Local Authorities regarding carers and people being cared for. It outlines the way in which local authorities should carry out carer’s assessments and people’s needs assessments;
The Care Act applies to England. The Care Act is mainly for adults in need of care and support, and their adult carers.
The Care Act changes a number of things – will they all happen at once?
No, the Care Act will come into force in two stages:
In April 2015 most of the Care Act came into force.
In April 2016 the remaining parts of the Care Act will come into effect, including how local authorities should charge for both residential care and community care, the new capital limits for financial eligibility and the introduction of rules surrounding the ‘care cap’.
Are the eligibility criteria for community care services changing?
Yes, since April 2015 there has been national eligibility criteria for both carers and the person being cared for. This introduced a minimum threshold and if a carer or the person being cared for meets this threshold, they will have eligible needs. Following a financial assessment, the local authority will then have to agree with the person assessed which of their eligible needs they will meet and how.
This will be the first time that local authorities will also be required to meet carer’s eligible needs directly, and a national eligibility criteria should make assessments for both carers and the people being cared for more consistent around England.
What are the ‘wellbeing’ principles which have been introduced?
The Care Act introduces a general duty on local authorities to promote an individual’s ‘wellbeing’. This means that they should always have a person’s wellbeing in mind and when making decisions about them or planning services.
Wellbeing can relate to:
- personal dignity (including treatment of the individual with respect)
- physical and mental health and emotional wellbeing
- protection from abuse and neglect
- control by the individual over day-to-day life (including over care and support)
- participation in work, education, training or recreation
- social and economic wellbeing
- domestic, family and personal relationships
- suitability of living accommodation
- the individual’s contribution to society
The wellbeing principles are also part of the eligibility criteria. Local authorities have to consider the impact of your role as a carer on your wellbeing. Similarly, they have to consider the impact of a disabled person’s needs on their wellbeing. If the impact is significant then the eligibility criteria are likely to be met.
What are the difference between needs assessment and eligibility and financial assessment and eligibility for a personal budget?
The Care Act 2014 has brought changes to needs assessments for care packages to determine if a person is eligible for a publically funded care and support package, if so, there will be a financial assessment to work out if the local authority can provide financial help towards the cost of the care package.
Local authorities must:
- carry out a needs assessment of anyone who appears to require care and support, regardless of their likely eligibility for state-funded care
- focus the assessment on the person’s needs and how they impact on their wellbeing, and the outcomes they want to achieve
- involve the person in the assessment and, where appropriate, their carer or someone else they nominate
- provide access to an independent advocate to support the person’s involvement in the assessment if required
- consider other things besides care services that can contribute to the desired outcomes (e.g. preventive services, community support)
- use the new national minimum threshold to judge eligibility for publicly funded care and support.
The Care Act 2014 aims to strengthen the voice of people using services, and their carers, over the process of assessing, planning and safeguarding.
Local authorities provide free of charge, an independent advocate to facilitate the involvement of a person in their assessment, in the preparation of their care and support plan and in the review of their care plan, if the person has substantial difficulty in being fully involved in these processes and there is no one appropriate available to support and represent the person’s wishes.
The person I care for has a care plan from the local authority, will this change?
As the eligibility criteria for community care services are changing from April 2015, the care plan of the person you care for may change when they are re-assessed, or when they ask for a review.
This will depend on whether or not they are assessed as having eligible needs according to the new criteria.
Currently there are four categories of need: critical, substantial, moderate and low). Local authorities only have to provide services to those who fall within the critical band, (but can choose to provide services for people who fall into the other bands).
Obviously no decisions have yet been made under the new eligibility criteria, but it is considered by most ‘experts’ that the new criteria most resembles what is currently classed as ‘substantial’ need. If this turns out to be the case then many more disabled people could be eligible for care and support.
Do I have any new rights as a carer? Do I lose any rights as a carer?
Yes, you have new rights as a carer.
From April 2015 you will be entitled to a carer’s assessment where you appear to have needs, which matches the rights of the person being cared for. This is different to the current situation where you have to show you provide ‘regular and substantial’ care to be entitled to a carer’s assessment. From April 2015 carers will also be entitled to support if they meet the eligibility criteria, unlike the current situation where the local authority have a ‘power’ to provide support to carers (which means it doesn’t have to).
No, you do not lose any rights you currently have as a carer.
Can I still get a carer’s assessment? Can the person I care for still get a community care assessment?
Yes, you can still get a carer’s assessment from April 2015. In fact, if you have been refused help in the past you can ask for an assessment again, as the criteria for getting help are different under the Care Act.
Yes, the person you care for can still get a needs assessment from April 2015 instead of a ‘community care assessment’.
Is there anything in the Care Act that means the person I care for might be charged more for services?
There will be no changes until a planned date in 2016, when the financial assessments for both residential care and community care will be very similar to the current situation – with the same upper capital limit of £23,350 and the same lower capital limit of £14,250.
It is proposed that the upper capital limit for residential care where the value of someone’s home is included will rise from £23,250 to £118,000. The upper capital limit for residential care where the value of someone’s home is not included will rise from £23,250 to £27,000. The upper capital limit for community care will rise from £23,250 to £27,000.
The lower capital limit for both residential care and community care will rise from £14,250 to £17,000.
These changes mean that from April 2016 people who have capital and who were previously receiving some help from the local authority might receive more help, and people who have capital and who were previously self-funders might receive help for the first time.
The person I care for is a self-funder at the moment. Will the local authority have to provide them with any help?
From April 2015 self-funders can ask the local authority to arrange domiciliary services, on their behalf (not care home services until a date in 2016). One advantage of this is that the local authority may be able to get cheaper rates than self-funders arranging care themselves. One disadvantage is that the local authority can charge an arrangement fee for this.
Also, from April 2015, the local authority has more responsibility for self-funders, such as providing information and advice.
The person I care for is self-funding. Is there anything we need to do to prepare for the changes coming in?
There is nothing that you or the person you care for need to do to prepare for the changes coming in from April 2015.
However, when the cap on care costs is introduced in 2016, and the person you care for is self-funding their own care, they could ask the local authority for a fresh needs assessment at some point before April 2016. Local authorities are expecting to start carrying out these needs assessments from November 2015. This is so that any permitted care costs from April 2016 can be added onto their care account towards the cap as early as possible. Until they gat a review, they may not be entitled to activate the cap.
I have heard there is going to be a cap on care costs. Is this part of the changes from April 2015?
No, the Governments plan is to introduce this in April 2016.
It is proposed that from April 2016 there will be cap on the maximum amount of care costs someone has to pay during their lifetime. As things stand, the government have announced that the cap will be set at £72,000 for those of retirement age, but regulations confirming this have not yet been published, so this may be subject to change.
The cap will apply to the cost of care received either at home or in residential care.
The local authority will carry out an assessment for the person being cared for. This will determine what their eligible needs are. The local authority will then calculate a personal budget, which will outline the cost that it thinks is sufficient to meet these eligible needs. The local authority will then carry out a financial assessment to work out whether the person will need to contribute towards this cost and if so how much. This figure (the amount the person contributes) will be recorded in their ‘care account’.
If the person choses care services which are more expensive than the local authority thinks is sufficient, the extra money the person pays will not be recorded in their ‘care account’.
When the cap is reached, the local authority is responsible for all further costs which are sufficient to meet the person’s eligible needs. Again, if the person choses care services which are more expensive then the local authority would not be responsible for these extra costs.
Note: The ‘care account’ excludes ‘daily living costs’ if the individual is in residential care. It has been announced that £250 per week of care home fees in 2016-17 will be treated as ‘daily living costs’ for this purpose. Therefore, only contributions to care costs in excess of £13,000 and within the local authority’s cost-of-care estimate will get credited to the individuals ‘care account’. Also, people will be liable for charges for ‘daily living costs’ even when their accrued care costs pass the cap.
Will I have to pay for services provided to me as a carer?
Most local authorities don’t charge carers for services, including services which give them a break from caring. They recognise that charging carers for services is not in the interest of carers, the disabled person or the local authority.
However, local authorities will still have a power to charge for any services provided to carers. What this means is that local authorities are allowed to charge carers for any services provided, however they can choose not to. If the local authority does charge carers for any services provided then they have to follow the same guidance they have to follow when charging the person being cared for.
However, if a service is provided to the cared for person, in order to benefit the carer, the carer cannot be charged for this. Instead the cared for person may be charged, as it will be a service provided to them. For example, if the cared for person spends some time in residential care, in order to give the carer a break, the residential care would be a service provided to the cared for person, and therefore the cared for person may be charged.
If I disagree with a decision social services have made, what are my options to challenge it?
From April 2015 the complaints procedure will continue. .
From April 2016, a new appeal system will be implemented. This new appeal process has not been decided on or written into law yet but the government are expected to start the consultation on this by the end of this year (2014). More detail about this should be expected asap. There are concerns that an appeals system will cause delay in getting care packages.