Presentation giving an overview of the Care Bill and the upcoming consultation. Presented on 2 May 2014 by Simon Medcalf, Deputy Director Social Care Policy and Legislation at the Department of Health at the Local-Central Government Discovery Day on the Impact of the Care Bill hosted by the Department for Communities and Local Government.

1. Local
Digital
Campaign
Overview of the
Care Bill &
Forthcoming
Consultation
#LocalDigital
@LocalDigitalGov
Simon Medcalf, Deputy Director Social Care Policy
and Legislation, Department of Health

2. The Care Bill:
Reforming care and support
2 May 2014

3. National
Assistance Act
1948: established
the welfare state
and abolished the
Poor Laws
1948 1960… 1970…
Chronically Sick and
Disabled Persons Act
1970: reforms to key
entitlements to
community services
A brief history of care and support
NHS and Community Care
Act 1990: first major set
of reforms, including first
right to assessments and
start of commissioner/
provider split.
1980… 1990… 2000… 2010…
Carers (Recognition
and Services) Act
1995: the first Act
to recognise carers
Community Care
(Direct Payments)
Act 1996: new
powers to make
direct payments
Carers and Disabled
Children Act 2000:
extending direct
payments to carers
Health and Social
Care Act 2001:
updates on direct
payments
Social care law and policy has evolved over more than 65 years, incorporating around 30
Acts of Parliament, but reform has usually been piecemeal.
As a result, the current system, and the law which underpins it, are not fit for purpose to
respond to the future challenges faced by care and support.
The Care Bill: reforming care and support

4. • Promote people’s wellbeing
• Enable people to prevent and postpone the need
for care and support
• Put people in control of their lives so they can
pursue opportunities to realise their potential
The care and support White Paper was published in July
2012 and set out the Government’s vision for the future
system.
If adult care and support in England is going to respond to
challenges it must help people to stay well and
independent:
Caring for our Future
The Care Bill: reforming care and support

5. The Care Bill: reforming care
and support
The Bill is built around people, it:
• ensures that people’s well-being, and the outcomes which matter to them, will be at the
heart of every decision that is made;
• puts carers on the same footing as those they care for;
• creates a new focus on preventing and delaying needs for care and support, rather than
only intervening at crisis point, and building on the strengths in the community;
• embedding rights to choice, personalised care plans and personal budgets, and ensuring
a range of high quality services are available locally.
The Bill makes care and support clearer and fairer, it:
• extends financial support to those who need it most, and protects everyone from
catastrophic care costs though a cap on the care costs that people will incur.
• will ensure that people do not have to sell their homes in their lifetime to pay for
residential care, by providing for a new universal deferred payments scheme;
• provides for a single national threshold for eligibility to care and support;
• supports people with information, advice and advocacy to understand their rights and
responsibilities, access care when they need it, and plan for their future needs;
• gives new guarantees to ensure continuity of care when people move between areas, to
remove the fear that people will be left without the care they need;
• includes new protections to ensure that no one goes without care if their providers fails,
regardless of who pays for their care.
What does the Care Bill do?

6. The Care Bill: topic by topic
Clause No. Topic
1-7 General responsibilities of local authorities (well-being, prevention, integration, information
and advice, market shaping)
8-13 Assessment and eligibility
14-17 Charging and the cap on care costs
18-23 Meeting needs
24-33 Care and support planning (personal budgets, direct payments)
34-36 Deferred payment agreements
37-41 Moving between areas
42-47 Safeguarding
48-57 Provider failure and market oversight
58-66 Transition from childhood
64-73 Other provisions (inc. debt recovery, hospital discharge, prisons)
Part 1 of the Care Bill provides the legal framework for the reform programme, with numerous
individual reforms provided for over 79 clauses. Some of the key reforms are highlighted in the next
two slides.
The Care Bill: reforming care and support

7. The Care Bill: reforming care
and support legislation
Progress in Parliament
1 2 C R 3 1 2 C R 3 A
Royal
Assent
Draft Care &
Support Bill
The Care Bill has almost completed its passage through Parliament,
after nearly five years’ development and engagement.
• Law Commission 3-yr
report on adult social
care published in May
2011.
• Draft Care and
Support Bill published
in July 2012.
• Public consultation to
mid October 2012.
• Pre-legislative scrutiny
report in March 2013.
• Bill introduced to
Parliament in May 2013
• Lords Second Reading on
21 May 2013.
• Lords Committee stage
from June-July 2013.
• Lords Report stage and
Third Reading in October
2013.
• Commons Second
Reading on 16 December
2013.
• Commons Committee
stage in January 2014.
• Commons Report stage
and Third Reading in
March 2014.
• Ping-pong planned for
May 2014.
• Royal Assent expected
in May 2014.

8. The Care Bill: reforming care
and support
Implementing the reforms
Primary legislation – the Care Bill
The legal duties and powers
Secondary legislation – the regulations
More detail on critical requirements, often related
to processes. The scope of regulations will depend
on the powers specified in the Bill.
Statutory guidance
Guidance on how to meet legal obligations in the Bill.
Will set out at a high-level the expectations of local
authorities when exercising their functions. These are
not mandated requirements, but the LA must have
“cogent” reasons that it can legally justify if it wants to
take another course.
Practice guidance/implementation support
Best practice guidance, toolkits and other products
which help support implementation. These do not
have any legal status, so may be used by LAs, or not.
They will vary from one area to another, and should
be agreed/co-produced with stakeholders to ensure
buy-in.

9. The Care Bill: reforming care
and support
Regulations and guidance
• Major programme of work underway
to produce the regulations and
statutory guidance.
• Being produced in partnership with a
wide range of stakeholders – in the
same collaborative approach used to
produce the Bill.
• Draft regulations and guidance for
2015/16 will be published for public
consultation in May 2014.
• Final publication of regulations and
guidance in October 2014.
There will be around 20 sets
of regulations, including:
Assessment
National eligibility criteria
Charging
Financial assessment
Care planning
Direct payments
Continuity of care
Ordinary residence
Choice of accommodation
Deferred payments
Market oversight

10. The Care Bill: reforming care
and support
Implementing the reforms: management
• The reforms will involve significant changes to how local
authorities operate currently.
• Wide-ranging engagement with local government and other key
stakeholders to shape and guide reforms.
• DH, LGA and ADASS has established a joint programme office to
support implementation and understand LA readiness and risks
to delivery. Now looking to add provider and voluntary sector
support to the office.
• Range of implementation tools being co-produced covering
practice guidance, IT, workforce training, commissioning
standards, and financial modelling.

11. Stakeholder engagement groups
Assessment &
Eligibility
Information &
Advice
Quality &
Safety
Prevention Care MarketsPaying for Care
Care Planning
&
Personalisation
ADASS
Housing
Network
TLAP Info, Advice
& Brokerage
working group
Paying for Care Task & Finish Group
(with input from ADASS Resources
network)
DCMQC
Project Board
Market Oversight
& Provider
Failure working
group
Charging for
Care
Cross-border
placements
Virtual reference
group
Care planning &
personalisation
Working Group
Care & Support Programme Board
Law Reform
Delegation
Virtual Advice
Network
A&E Task &
Finish Group (TG)
Integration
Implementation
Board
C&S in Prisons::
Health & Justice
Partnership Board
Inter-
departmental
Ministerial Group
(IDMG)
NHS key
Stakeholder
Groups
InformaticsPaying for the Reforms WorkforceCommunications
Outcomes &
Information
Development
Board
Adult Social Care Workforce
Development Board
Mkt shaping &
commissioning
sub-group of
TLAP’s National
Market Forum
Info and Advice
Core Advisory
group
Safeguarding
Adult Advisory
Group (SAAG)
National
Informatics
Board
Care and Support Reform Comms Group
ITF Ministerial
Board
Continuity of care
Virtual Advice
Network
X-Government
carers’ strategy
Board
Prevention
Task and
Finish Group
Ordinary
Residence
Virtual reference
group
Advocacy Core
Advisory Group
4x Stakeholder
T&F Groups:
• Family and
Community
• Safeguarding
Adults
• Multi-agency
• Practice
Cross-
Governmental
officers Group
Virtual reference
groups:
• Advocacy
• Info & Advice
Working Age
Adults working
group
Choice of
accommodation
Virtual reference
group
Standing
Commission on
Carers
Transition
working group
ADASS
IMG
CSA Bill Group
Virtual reference
group –
Transitional
Provision
Virtual reference
group – Sight
Registers
Paying for Care Task & Finish Group (with
input from ADASS Resources network)
Longer-term
group (TBC)
LGA/ADASS
Working group
The Care Bill: reforming care and support
Work-streamsGroupsEnablers

12. • Scale and complexity of the task facing local authorities and the demands on
capacity, and competition for attention.
• Need to maintain engagement in key areas of policy, regulation and guidance,
and consider further support needs for implementation.
• Communications challenge to ensure public awareness and local readiness for
reforms.
• Great deal of the context for the Bill clear, but some key policy yet to be
finalised – e.g. working age cap.
• Links to Better Care Fund and Integration which are a key part of delivery of
social care reform.
• IT – meeting the requirements of the Bill but also the future challenge of
integration, shared records and customer access.
• Workforce – developing the skills, ensuring capacity, at the pace required to
meet local needs and respond to local challenges.
Implementing the reforms: challenges ahead
The Care Bill: reforming care and support

13. New web site – http://www.local.gov.uk/care-support-reform
Implementing the reforms: more information
The Care Bill: reforming care
and support

14. Next steps
• Governance and assurance:
• Ongoing review and revision to approach to risks across the programme.
• First LA stocktake survey of readiness in April/May.
• MPA Gateway Review in May/June.
• Regulations and guidance:
• Consultation on 2015/16 regulations and statutory guidance from May
2014.
• Finalise 2015/16 regulations and guidance by October 2014.
• New statute will come into force in April 2015 (funding reforms April
2016).
• Implementation support:
• Ongoing work to identify priority areas and develop practice guides,
toolkits and implementation support over 14/15.
• Engagement to increase the level of awareness among council chief
executives and council leaders in implementation of these reforms.
The Care Bill: reforming care and support