The Care Act

The Care Act 2014 is a large and significant act of parliament in the UK that combined various existing pieces of legislation in order to shape how social care in the UK is arranged and combine it into a singular, and more simplified Act. This is easy to understand for those in need of care and their caregivers. Many of us will require care at some point in our lives; whether this is elderly care or care due to mental or physical disability. The Care Act 2014 was introduced to assist those in need of care and to help them to have more say in what sort of care is best for them, as well as how they might pay for the care that they need. The Care Act 2014 is significant for many reasons, but one of these reasons is that it is the first Act of Law to provide support for the carers of those in need of care, as well as those in need of care themselves.

So, what is the Care Act 2014? Why was it introduced? And what wellbeing and safeguarding principles does it adopt? Here’s everything you need to know:

What is the Care Act?

The Care Act was introduced into law in 2014, and the intention of this large and significant act was to make it easier for the people who needed it to access care. The Care Act 2014 provided a clear pathway for the ways in which people in need of support, and their carers, could access help and assistance. The Care Act clearly outlined what an individual’s journey through the care and support system would be, so that individuals can work out what their entitlements will be. These are consistent, meaning the chance of being exposed to any discrimination or mistreatment when accessing care is reduced.

Some of the main principles that the Care Act 2014 introduced include:

• Nationwide care and support criteria for both eligible adults and their carers in the UK. The eligibility criteria for support were consistent across the UK so that it is easy to calculate what your entitlements are.
• Ease of access to information and advice when it is needed. This will enable adults and carers to make good choices about the care and support they need.
• The allocation of personal budgets and the right to request direct payment from the relevant authorities to reduce the possibility of financial restrictions or abuse.
• New rules were introduced to make the transition from children’s services to adult social care easier for children who have lifelong additional needs or care needs.
• New responsibilities relating to provider failure, for example, if a care home closes, and what will happen to those residents within that home who are still in need of care.
• Support for people who move between local authority areas, to ensure that those with additional needs or in need of care don’t have their movements restricted as a result of those needs.

In 2015, one year after the Care Act 2014 was introduced, the Department of Health carried out a survey to investigate the impact that the act had had on the lives of those individuals making use of its services. This was a relatively small survey that only received 1,181 responses from individuals aged 18 and over. 391 of those respondents were people who need care and support themselves whilst 643 of those respondents were carers. The overall response to the Care Act 2014, when assessed at this early stage of just one year after it was introduced, was positive. The survey found that:

• 69% of respondents felt that the care and support they had received made a positive impact on their health
• 25% of respondents felt that their council listened to their wants and needs on a frequent basis
• 49% of respondents felt that their choices are always or frequently respected
• 48% of respondents felt that receiving care and support via the Care Act increased their feelings of being safe and secure
• 58% of respondents felt the support they received made their daily lives better

When looking specifically at the responses received from carers, the survey found that:

• Only 42% of carers felt the support they received via the Care Act made their daily lives better. By contrast, 74% of those in need of care or support responded positively when asked the same question.
• Only 29% of carers felt the quality of care or support they received had improved in the year since the Care Act was introduced.
• Finally, 21% of carers said that they wanted better-quality care, more flexibility with the care that was available or less complexity in arranging support.

Why was the Care Act Introduced?

The Care Act 2014 was introduced to simplify how social care is arranged in the UK. Before the Care Act 2014 was introduced, the laws that dealt with care in the country were convoluted and complicated. They tended to focus on what service should be provided, rather than on what the person actually needs or wants.  The needs of the individual were never at the heart of the Law; the Care Act 2014 was introduced to change this and to move care into the 21^st century. The laws that are now obsolete because they have been absorbed into the Care Act 2014 are:

• The National Assistance Act 1948.
• Health Services and Public Health Act 1968.
• Chronically Sick and Disabled Persons Act 1970 (but only for adults).
• Health & Social Services and Social Security Adjudications Act 1983.
• Disabled Persons (Services, Consultation and Representation) Act 1986.
• Parts of the NHS and Community Care Act 1990.
• Parts of the Health and Social Care Act 2001.
• The Delayed Discharge Act 2003.

How Many Principles Does the Care Act Have?

The Care Act 2014 introduced six principles that guide the way in which care is provided to those that need it. These six principles form the basis of the work of all professionals and other staff members who work with adults with care needs. There is no limit on the sectors in which these principles apply, but common settings where the principles of the Care Act are introduced include high education institutions, care, support, and health and care services, social and healthcare settings, and wider council services such as access to benefits, housing, and the criminal justice system.

The six principles outlined in the Care Act 2014 are:

• Empowerment. The individual in need of care should be given the support and empowerment they need to make their own decisions about their care. After all, no one should know the unique nuances of their own care needs than themselves. For this reason, when decisions are being made about an individual’s care, their wants and wishes should always be taken into account. If the individual doesn’t have the capacity to give consent or make their own decisions (as outlined by the Mental Capacity Act 2005) then their current feelings, belief system, and any wishes that they outlined before their mental capacity was reduced should be considered before a decision is made on their behalf.
• Protection. The first thing that you should do when working with individuals with additional physical or mental care needs is to ensure that you protect them from abuse and neglect. It is not enough simply not to be abusive or neglectful: the Act clearly states that if you have concerns about abuse and neglect from other parties then you should raise these concerns. You have a responsibility to report this to the relevant authorities and those authorities must act immediately. The protection of the person in need should always be your primary concern.
• Prevention. Reducing the need for care by improving an individual’s wellbeing is not possible in all circumstances but it should be the focus for professionals where possible. This is because local authorities have a legal duty to prevent, reduce and delay people’s needs from worsening. The idea is that this will encourage local authorities to meet the care needs of their citizens at the earliest possible stage and that this will prevent the likelihood of those people ending up in crisis situations which can be difficult for the individual and more costly for the council.
• Proportionality. The care that is provided to an individual must be proportional and appropriate to the needs of the individual. To ensure that proportionality is maintained, extensive assessments should be carried out to establish the full extent of the person’s needs. Any decisions that are made about an individual should always be centred on the needs of the person and take all of their individual circumstances into account
• Partnership. Healthcare providers and caregivers should never work in isolation. Instead, they should consider any decisions they make in a partnership with the individual who should always be involved in the decision-making process. Any involved family members or friends may also wish to be included in this partnership. The overarching approach should be a multi-agency collaboration in which everyone works together to support the needs of the individual
• Accountability. Finally, it is important to note that safeguarding a vulnerable person is everyone’s duty, and everyone involved in their care should take some accountability for this. Professionals have a responsibility to ensure that any actions taken to support a person receiving care affect their rights and freedom as little as possible.

Wellbeing and Safeguarding Principles

The Care Act 2014 includes core well-being and safeguarding principles that are essential for the care of those who need it and are considered to be the two key responsibilities of the local authorities that provide care. Inextricably linked to wellbeing and safeguarding is the prevention and protection from harm.

The specific text from the Care Act 2014 that relates to promoting wellbeing states that “Promoting wellbeing does not mean simply looking at a need that corresponds to a particular service. At the heart of the reformed system will be an assessment and planning process that is a genuine conversation about people’s needs for care and support and how meeting these can help them achieve the outcomes most important to them.” In short, this means that the local authority and the caregivers that they employ should focus on the well-being of the individuals that they care for by involving them in any decision-making processes wherever possible. This is a broad concept, but it involves treating individuals with respect, focusing on their physical, emotional and mental wellbeing, and helping them to make meaningful contributions to society.

We already know how important safeguarding is within the Care Act 2014 and the vital importance of protecting those with additional care needs. Caregivers have a responsibility to protect those in their care from abuse, and the view of what constitutes abuse or neglect should not be limited, as abuse or neglect can take many forms and the circumstances of the individual case should always be considered. Adult safeguarding rules within the Care Act framework are intended to:

• Stop abuse wherever possible
• When adults with care or support needs are supported, those providing that support or care should prevent harm and reduce the risk of abuse or neglect
• Adults should be safeguarded in a way that supports them in making choices and having control over how they want to live, but those decisions should be safe and controlled where possible

The Care Act 2014 was designed to help to improve people’s independence and well-being. Its main aim is to help those in need of care or additional support to access the support they need, and it is also the first UK Act to provide specific support to those caring for individuals with additional needs. The Care Act 2014 promotes fairer, more personalised care for those who need it, and assesses their needs to ensure care is provided to the right people at the right level. The aim of the Care Act 2014 is to focus on the needs of the individual. It moves the focus of local authorities from providing services for specific groups, to supporting individuals to achieve the outcomes that matter to them. Its aim is to remove the ‘one size fits all’ approach to providing care, and instead focus on giving people what they really need.