Post the Care Act 2014 – what

difference is it making and what is the contribution of social

work?

Jill Manthorpe

Jill.manthorpe@kcl.ac.uk

@scwru

No worries? (source

http://qz.com/192475/how-no-worries-became-a-thing-surfers-crocodile-dundee-and-the-lion-king/

All change and no change

• New in law, policy and practice

• New in law but not in policy or practice

• Consolidating or modernising existing law

• Re-branding

• Kennedy ‘Care Act –What Care Act?’ (Sept 2015 Care Knowledge)

Back to SW contribution:

A coming Golden Age? • The Care Act contains some

revolutionary ideas (that are) really very important (Brindle 2014)

• The Act provides a script for modern social work with adults (Cattell 2014)

• Who assesses? SW uniquely placed to be involved in complex assessments

Comparison with 1990 NHS and Community Care Act 1990 • Implementation – over 3

years

• Social Work great hopes eg social work with a cheque book & care/case management; no great awareness of outsourcing

• FACS /thresholds develop

• NHS not much aware of CCA

How NHS CCA evolved

• Case law eg need to unmet want

• Contracts & small print

• Guess-estimates of costs

• Care management not necessarily SW

• Assessment much stronger than monitoring/review

• Less NHS safety net as LT hospitals close

Care Act 2014

• A legal tidy up (more to come re DoLS)

• Dilnott – (Care Cap) not now/postponed – but changes to self-funding

• The knotty problem of CHC funding (+ NHS)

• Personal budgets & PHBs

The new Care Act glossary

• Wellbeing

• Adult at risk

• Safeguarding concern

• Safeguarding Adult Review

• Market sustainability

• Prevention • In sign language

https://www.youtube.com/watch?v=Yv9_LdwA8Eg

Local Authority Stocktake (LGA, ADASS, DH Aug 2015)

• 57 % very confident

• 42% fairly confident

• Who were the 1%?

• No such thing as problem – just potential need for support or caution eg Rise in carers assessments, concern re general cost pressure, some still to engage with prisons…

• And Workforce R&R

Challenge 1: Fears

• Of unmanageable demand

• Of bearing bad news

• Seeming to be negative

• Of getting it wrong

• Of not knowing the answers

• Of change

Challenge 2: tackling the ‘priority thickets’

• ‘how to discern, and continually regenerate a fresh sense of what to do and how to do it in the teeth of an unremitting barrage of conflicting demands for change emanating from a generally hostile environment’ (Waddington, 2003).

What makes for a psychologically informed environment (PIE)?

A PIE

• Focussed discussion

• Democratic

• Facilitated

• Time limited

• Commitment

Elements of peer supervision?

Social work inspired?

Challenge 3:

• Wandsworth Council’s budget for 2014/15 = £189,961m

• How is it calculated?

• How is it spent?

• What do residents think of Wandsworth? (Residents’ Survey due 2015)

• What is set to change?

Challenge 4: first case under Care Act : R(SG) v Haringey LBC and SSHD (4/8/15) –

more will come – also appeals High Court judgement against

the Council in favour of a destitute asylum seeker with mental health problems. Claimant maintained that as she had a need for accommodation related care and support she should be accommodated by the Council pursuant to the CA and not by the Secretary of State under the asylum support regime.

Interim concluding words • Economic squeeze

contexts – what to measure?

• Law (cf MCA) – change

• How to describe and evaluate SW contribution? (eg IBSEN comparisons)

• What outcomes to measure?

• Jill’s 17 year principle – back here in 2031

Thank you for listening

Disclaimer & Acknowledgements

This presentation draws on the work of the SCWRU for the Department of Health’s Policy Research Programme. The views expressed are those of the author and not necessarily those of the Department of Health.