Service users give mixed verdict on Care Act’s impact.
Survey finds most people don't feel care has improved since the legislation's introduction
By Andy McNicoll on June 28, 2017 in Adults
Most people using social care feel the introduction of the Care Act 2014 has not improved the quality of help they get, a government-commissioned survey suggests.
The poll of 1,100 service users and carers found just 29% felt their care had improved in the first year of the act coming into force. A quarter felt things had got worse.
The Department of Health asked personalisation charity Think Local Act Personal (TLAP) to carry out the research, as a means of gauging the impact of the act since it came into force in April 2015
The results paint a mixed picture. While more than half of respondents (56%) said they were still satisfied with the quality of their support and 69% felt the care they received made a positive difference to their wellbeing, TLAP said other findings raised “major” concerns over how councils are implementing key planks of the Care Act in practice:
Only a quarter of respondents felt councils had frequently listened to their views when drawing up support plans.
Just under half (49%) felt their choices were always or frequently respected.
More than half (51%) found it difficult to access information and advice about care options.
There was “low uptake” of Care Act advocacy, with more than two-thirds of respondents saying they had never been offered an advocate.
Clenton Farquharson, chair of the TLAP board, said the results sent a “clear message” that more needed to be done to embed the act’s principles in practice.
He said: “We particularly need to draw attention to what we describe as the ‘rhetoric vs reality’ gap, between what people with care needs are experiencing, and what council colleagues perceive and say is happening when they work to embed personalisation”.
TLAP warned the findings showed a “marked difference” between council and service user opinions on the act’s implementation. The most recent Local Government Association stocktake – the main official survey of council views on Care Act progress – found 81% felt the Care Act had made a positive difference on practice.
Margaret Willcox, president of the Association of Directors of Adult Social Services, said councils were seeking to offer personalised social care “in a very difficult financial climate”.
She said: “Many local authorities have worked hard in challenging financial circumstances to give people greater choice and control. Despite the growing financial pressures, there is consensus that the principles of personalisation should be supported.
“Individuals should be in charge of their own care and support and have control and choice over the key decisions that affect them. However, despite challenges there are still some excellent local initiatives such as, Barnet, Derby, Shropshire and North East Lincolnshire.”
The association’s latest annual budget survey, published today, reveals the pressure to make significant cuts means just 29% of directors were fully confident they would meet their statutory duties this year. ADASS warned that some savings targets had proved “impossible” to deliver.
A severely disabled man has launched the first Court of Appeal battle of its type following 'savage' cuts in care funding vulnerable people say they are suffering across the country.
Wheelchair users joined a protest outside the Royal Courts of Justice in London as Luke Davey, 41, challenged Oxfordshire County Council's decision to reduce his weekly personal budget by 42 per cent.
Three appeal judges were told Burcot resident Mr Davey, who has quadriplegic cerebral palsy and is registered blind, faces "a significant risk to his well being" because of the reductions.
The case is being seen as an opportunity to clarify whether provisions of the Care Act 2014 are being properly applied by local authorities.
Mr Davey, who was in court in his wheelchair, says in his case the law is being breached by Oxfordshire council.
Even after he agreed to modifications, his reduced budget is still not enough to fund the team of personal assistants who have cared for him for nearly 20 years, the judges were told.
Critics are blaming the problems severely disabled people report facing on the Government's decision to axe the independent living fund (ILF) which previously enabled thousands of claimants to live independently through ILF money plus assistance from their local authorities.
After the ILF was abolished in 2015, the money and sole responsibility for care funding were transferred to the local authorities.
In court, the judges heard Mr Davey requires assistance with all of his personal care needs and was helped by a team of personal assistants funded by a 24 hours-a-day care package costing £1,651 per week.
The Independent Living Fund provided £730 of that total.
When the ILF closed, Oxfordshire council proposed reducing his personal budget to £950 per week.
Jamie Burton, appearing for Mr Davey, said he had essentially the same team of personal assistants for nearly 20 years who knew him very well and contributed to his sense of well being.
The local authority decided he could spend 6.5 hours alone each day and he could reduce the amount he paid to his carers.
That posed the risk of Mr Davey suffering anxiety when left alone and also losing his care team.
He had since agreed to spend four hours alone and negotiated with his team to accept some, but not all, of the proposed reductions in their terms and conditions of employment.
But this still left a shortfall in his budget and his mother, Jasmine, who is aged 76 and has cancer, was having to fill the gaps in providing his care, said Mr Burton.
Oxfordshire County Council said it would not comment while the case is on-going.
A disabled man who took his legal fight over cuts to his care to the Court of Appeal has had his case dismissed.
Luke Davey, 41, challenged a ruling upholding Oxfordshire County Council's decision to cut his package by 42%.
Mr Davey, who has quadriplegic cerebral palsy, argued it threatened his well-being and breached the Care Act.
Campaigners said the case could have led to a landmark ruling, but the appeal judge said the council had not acted unlawfully.
Mr Davey, from Burcot, is registered blind and uses a wheelchair, requires help with all of his personal care needs.
A county council spokesman said: "We will continue to work with Mr Davey and his family to ensure he gets the provision of essential services he needs.
"The Court of Appeal has confirmed that the Council's assessment of Mr Davey's care needs and the allocated amount for his personal budget is appropriate and lawful.
"All local authorities who provide adult social care services against a background of financial constraints in the public sector are having to make difficult decisions."
Critics of the Government say Mr Davey’s case illustrates how disabled people are suffering because ministers axed the independent living fund (ILF) in 2015 but failed to ring-fence sufficient money for the disabled under the new Care Act 2014, which makes cash-strapped local authorities responsible for funding all care needs.
Svetlana Kotova, disability justice coordinator at Inclusion London, said the decision was “very disappointing” and illustrated the “devastating impact” of government policy.
She added: “Many people like Luke Davey, who were supported by the Independent Living Fund, had their support packages cut to the bare bone. With those cuts went their independence, choice and control and the opportunity to live a normal life. Today the Court of Appeal confirmed that local authorities can get away with doing this.
“Without adequate levels of support, disabled people are existing not living. This case has destroyed any hopes that the Care Act 2014 will transform our experience of social care.
“It is time the government recognises and urgently addresses the huge crisis in social care, through ensuring adequate funding and the introduction of an appeals system, which would give disabled people a fair chance to challenge the views and decisions of social workers.”
Care plans should be reviewed more than once a year, says watchdog.
Healthwatch England made the recommendation in a report on the experiences of people who use home care services
It also found that care workers were frequently unfamiliar with their clients’ care plans and when it was a staff member’s first visit, there was often not enough time to read the plan. In some cases, this was leading to “serious problems”, such as medication being missed.
A survey of 363 people in Newcastle, found one in seven had experienced medication being missed because of the home care provider. One in six respondents also said they felt the provision of medication was either “partly” or “never” safe.
The report recommended that automatic notification systems could be introduced to update staff about important changes to care plans, or prompts could be left around people’s homes as a reminder of their preferences.
The report also said local authorities needed to be more realistic in care plans about how much is achievable in the limited time available in most home care visits.
It found that only half (56%) of 73 people responding to Healthwatch Blackburn with Darwen’s survey felt there was sufficient time to complete all tasks set out in the care plan.
A service user told Healthwatch Redcar and Cleveland: “Sometimes they give me a shower but they go over their time but most of the time they haven’t got time to give me one so I go a couple of weeks without one and that’s not right, I feel dirty.”
Home care workers in Torbay also reported “unrealistic staff rotas” that left them exhausted and having to carry out double-handed care tasks on their own.
Some service users also reported that staff lacked basic skills such as being able to boil an egg or make a bed, which resulted in poor care.
Neil Tester, deputy director of Healthwatch England, said: “We heard examples of compassionate care from dedicated staff, but people also talked about care that doesn’t meet even basic standards. Given the challenges facing the social care sector, it’s more important than ever than ever that people’s voices are heard.”
Margaret Willcox, president of the Association of Directors of Adult Social Services, said: “Most adult social care services in England are providing people with safe, high quality and compassionate care. That they are doing this in the context of rising demand and inadequate funding is a tribute in itself, but there is always room for improvement.”