The Care Act remains a valuable framework for modern care and support
The Care Act 2014 replaced a patchwork of previous legislation on adult social care and put at its heart a duty on councils to promote people’s wellbeing.
A decade on from when the act received Royal Assent, the LGA has published a new report that examines the extent to which the aims of the legislation have been achieved and, where they have not, what more is needed to deliver fully on its ambitions.
These two key questions are answered through more than 30 articles penned by senior experts from across the adult care and support sector. Crucially, this includes people who draw on social care and members of the care workforce.
The expert articles help inform the LGA’s conclusions and recommendations, many of which echo what lead members for adult services have reported in a new survey to accompany this publication (see p4).
They highlight: the consequences of funding pressures (including on other council services); the need to take a more preventative approach; the importance of tackling workforce challenges; and the need to change the way we talk about adult social care.
“The inherent value of adult social care and support in its own right comes to the fore”
With a general election approaching, we believe the report should be required reading for national politicians hoping to form the next government.
We will be using a variety of channels to promote the publication and its findings with organisations and people within the care sector, as well as decision-makers and the public.
In addition to the duty on councils to promote people’s wellbeing, the Care Act 2014 introduced a range of other duties on issues such as prevention, integration, market shaping, assessment, care planning and safeguarding.
The act also contained provisions for charging reform, including a cap on care costs, an extension to the financial means test thresholds, and the option for self-funders to ask councils to arrange services on their behalf – thereby accessing lower council fee rates in the process.
The LGA’s publication, ‘The Care Act 2014: Ten years on from Royal Assent’, charts the origins of the act, tracing its roots back to reviews by the Law Commission and the Dilnot Commission, and the Care Bill’s journey through Parliament following pre-legislative scrutiny.
We also highlight some of the important inquiries and reports that have followed and consequently shaped thinking on the future of adult social care.
Context, of course, is everything. The report therefore explores three key developments that have impacted adult social care over the past decade: funding, integration between health and social care, and the impact of the COVID-19 pandemic.
It also restates the LGA’s commitment to the importance of working with and alongside people who draw on care and support in debates about the future of care and support.
“The politicisation of adult social care by national parties is further hindering progress”
In addition, our report includes a helpful, longer exposition from the campaign movement Social Care Future on why a reimagining of social care based on people – all of us – is needed.
Over the past four years, Social Care Future has done invaluable and comprehensive work to understand what language resonates most with different audiences (and what does not) when we talk about adult social care.
We are delighted to have articles from so many prominent figures, from organisations across the sector, in our report, including the Association of Directors of Adult Social Services, Skills for Care, King’s Fund, Social Care Institute for Excellence, Ipsos, and Carers UK.
There are also articles from four former ministers from the period – Phil Hope (joint with Sir David Behan), Paul Burstow, Norman Lamb, and Alistair Burt.
The voice of lived experience is prominent, too.
The articles make for an absorbing read, and while each contributor comes at the questions from their or their organisation’s own unique perspective, there are some strong and common threads.
Throughout the publication, the inherent value of adult social care and support in its own right comes strongly to the fore.
Contributors across the board also feel the legislation remains broadly the right legislation and that the principles the act is based on – of personalisation, choice and control, independence and dignity, and wellbeing – are as important today as they were a decade ago.
Yet, overwhelmingly, the articles are clear that the full ambition of the legislation has not been achieved.
While the exact reasons differ, most acknowledge a significant funding shortfall as a core issue.
Other roadblocks are also widely recognised: a strained care workforce; overburdened and unpaid carers; unstable care providers; lack of investment in preventative measures; and unmet or wrongly met care needs.
The politicisation of adult social care by national parties is identified as further hindering progress.
However, contributors are generous in their suggestions of ways forward.
A number of articles underline the need to shift to a narrative of hope around social care, and consider a future for adult social care in which possibilities are imagined.
They underline the negative impact that a pervasive ‘crisis narrative’ or ‘doom loop’ has on the sector. For example, Skills for Care’s Oonagh Smyth highlights that this could hamper our efforts to find and keep people in the workforce.
The former ministers and others call for a kinder and more collaborative politics. Many highlight that the legislation was significant in the way that it was developed collaboratively. People drawing on care and support, and the wider sector, were genuinely able to shape the legislation and build a broad consensus of support.
The articles highlight compelling reasons why investment in adult social care for people drawing on care and support and their carers is vital.
It is imperative that social care is seen as an investment that strengthens the fabric of society and fuels future national prosperity.
The Care Act 2014 established a strong foundation, promoting a diverse care market, integration with health services, support for carers, and principles of user choice and control.
However, its full potential remains unrealised, and the full value of care and support untapped.
Drawing on the contributors’ views in the articles, we set out recommendations for change, which can be read in full in the report, but are broadly:
- Do not dispense with the Care Act – it remains a well-supported and valuable legal framework for modern care and support.
- Adult social care must be funded adequately, sustainably and with trust in councils as democratically accountable bodies.
- An immediate injection of funding is crucial to continue tackling the issues in social care.
- There is no such thing as a ‘standard care worker’ and a comprehensive, long-term plan for the care workforce must be developed.
- Be bold and ambitious with prevention. Pump prime preventative activity with significant new investment, but give local government and its partners the freedom to determine how investment will be used.
- End the politicisation of adult social care; put the national interest first, and work on a cross-party basis at relevant points to secure the future of care and support.
With the general election now taking place on 4 July, we look forward to continuing our work to influence, inform and better understand the priorities of all the political parties and the funding envelope they will set themselves.
We are clear that the future of adult social care must be at or near the top of the next government’s in-tray.
This publication serves as a starting point, offering evidence and insights on the past decade since the Care Act.
- Read ‘The Care Act 2014: Ten years on from Royal Assent’ in full.