The Care Bill

23 September 2013

House of Commons

Photo by Alan Cleaver via Flikr. Licensed under Creative Commons.

As the Assembly continues its scrutiny of the Social Services and Wellbeing (Wales) Bill England has been deliberating its own Care Bill in the House of Lords.  Like the Welsh Bill the Care Bill is large and broad in scope, and will reform the legal framework for social services in England, although it does not include children’s services.

Some of the key provisions in the Bill are similar to those in the Social Services and Wellbeing (Wales) Bill and reflect the recommendations of the 2011 Law Commission report on adult social care in England and Wales.

These include introducing a national minimum eligibility threshold for accessing social care services, strengthening adult safeguarding arrangements, improving assessments for carers, maintaining continuity of care and support when an adult moves (but also applying to carers, unlike in Wales), duties on local authorities to offer preventative services and promote wellbeing and to provide information and advice.

Most of the Care Bill’s provisions around local authority social services duties apply only in England, although other aspects will impact on Wales.  The Welsh Government will be studying the proposed cap on care charges with interest as it considers its own approach to paying for care.

There are also a number of provisions that are different to those in the Welsh Bill, including some that reflect the English approach to care services such as a duty to provide personal budgets.

A significant feature of the Care Bill is the introduction in England of a cap on the lifetime costs of care.  This would prevent local authorities from charging people for social care services once their spending had reached a ceiling of £72,000.  Regulations would allow for different levels of cap for different groups, such as younger disabled people.  Importantly, the costs that are taken into account in calculating the cap do not include “daily living costs” such as accommodation, food and heating.

The UK Government is also planning to extend means-tested support for residential care to people with assets that include property.  This would see an increase in the current level of £23,250 to £118,000, or to £27,000 if the assessed assets do not include property.  Again, this would apply in in England only.

The provisions in the Bill for adult safeguarding include duties on local authorities to make enquiries where abuse of an adult with care needs is suspected, and the establishment of adult safeguarding boards to undertake reviews of cases of adult abuse or neglect.  Unlike the Welsh Bill the Care Bill will not give social workers powers to enter the homes of people who are believed to be experiencing abuse.

Another significant feature of the Bill is its provisions to address the issue of business failure by providers.  This includes duties on local authorities (including those in Wales) to provide continuity of care where services fail, and duties on the Care Quality Commission to develop a new ‘market oversight’ regime to identify significant providers who may be at risk of failure and to require them to take steps to mitigate the risks. 

Other parts of the Bill provide for changes to inspection and regulation, particularly of NHS Foundation Trusts, and the establishment of Health Education England and the Health Research Authority.

The Bill is still some way from becoming law; it will have its First Reading in the House of Commons in the autumn when the Lords have completed their scrutiny.  Stakeholder responses so far have reflected concerns about the greatly increased number of assessments local authorities will have to undertake when the charging cap is introduced, the lack of powers of entry in the Bill to investigate adult abuse, the proposed minimum eligibility threshold which is believed to be too high, and worries that the government is allocating no new money to local authorities for the proposed prevention duties.

Article written by Stephen Boyce.