Department of Health issues final Care Act regulations and guidance

The Department of Health has published final versions of the regulations for the Care Act and associated statutory guidance for local authorities ahead of implementation in April 2015.

Its formal response to consultation, which was held over the summer, said many consultation responses, in particular from local government, had highlighted concerns about adequate funding for social care, and for the specific reforms in the Care Act, as their primary issue.

The Department said it recognised the scale of these concerns and had made significant changes to the cost estimates in its impact assessment.

“Responding to particular concerns about the potential demand from carers to access new rights in 2015/16, we have revised our assumptions to reflect a larger number of potential recipients, and show additional costs in the first year and beyond – rising to an additional £100m per year,” it said.

“In order to ensure that funding is targeted most appropriately to meet this extra need, we will create a new grant to be paid to local authorities for carers and Care Act implementation in 2015/16. These new costs are balanced by reductions in other areas, where the evidence has shown that the impact is not likely to be as great as previously assessed.”

The Department added: “Overall, we believe that this presents the likely costs more accurately, and means that the new burdens in the Care Act can be met in 2015/16. We will work with local government to develop plans to monitor costs in the highest risk areas during the year.”

However, it added that managing risks associated with new costs was not a matter of additional funding alone, but also required local authorities to adopt efficient practices in delivering the Act. The Department said its (to be developed) national support offer would help councils address such risks.

An extra £22m per annum will be provided to support local authorities in handling higher volumes of assessments for carers from 2015/16. This will rise to £27.m from 2017/18 onwards.

Other key changes as a result of the consultation include changes to the national eligibility threshold. The regulations say that the eligibility criteria are met if:

“(a) the adult’s needs arise from or are related to a physical or mental impairment or illness;

(b) as a result of the adult’s needs the adult is unable to achieve two or more of the outcomes specified [in the regulations]; and

(c) as a consequence there is, or is likely to be, a significant impact on the adult’s well-being.”

The ten outcomes specified include: managing and maintaining nutrition; maintaining personal hygiene; managing toilet needs; being able to make use of the adult’s home safely; developing and maintaining family or other personal relationships; making use of necessary facilities or services in the local community; and carrying out any caring responsibilities the adult has for a child.

The Department has amended the regulations to make it clear that a person is eligible for care and support where they need support to achieve “two or more” outcomes.

A majority of local authorities argued that the regulations as originally drafted would have made more people eligible than was currently the case, and thus have increased costs associated with meeting needs.

Other organisations, in particular voluntary organisations, argued that the relative level described in the draft eligibility regulations was too high, and would have lead to a large number of people not receiving the care and support they needed.

Changes have also been made to the carers’ eligibility criteria, following feedback that these regulations were confusing.

The Department of Health meanwhile ruled out a delay to implementation in order to provide more time for preparation.

“We do not underestimate the challenge of implementing the Care Act from April 2015. This is a major reform programme,” it said. “But it is also an overdue one; and we must not delay change to improve the outcomes for people who need care and support, their carers and families.”

The revised regulations can be viewed here, while the guidance for local authorities can be viewed here.

Additional materials are available from a dedicated section on the Local Government Association’s website.

David Pearson, President of the Association of Directors of Adult Social Services, welcomed the publication of the Care Act guidance and regulations. 

He said: “Central government has taken into account local government’s own assessment of the costs which was completed at the end of August. While the application of the Care Act comes at a very challenging time for adult social care funding, the extra money for carers is a welcome contribution to the support of unpaid carers in this country who make an enormous contribution to the care and support of their family and friends.”