Consultation outcome

Supporting local preparation: draft guidance

Updated 16 January 2023

Applies to England

1.1 Government has developed guidance to support local authorities with preparation for the introduction of reforms, prior to October 2023. An updated version of the below will be published following the consultation.

Understanding the likely demand

1.2 People can only accrue costs towards the cap if they have been assessed as having eligible care needs, in line with the Care Act 2014. It is therefore anticipated that a significant number of people who would previously not have had any contact with the local authority may now approach the local authority to access the cap. Additional demand will also be generated by changes in the means test capital limits.

1.3 Local authorities should therefore take steps to understand the additional likely demand as a result of charging reform, as far as possible. This should form part of the local authority planning process to prepare for charging reform implementation.

1.4 Local authorities should work with other partners who may be well placed to understand these population groups, including provider organisations, local NHS services and the voluntary sector. In understanding the likely demand, local authorities should consider specific groups who may be more likely to approach the authority as they may benefit most from the introduction of the cap on care costs and increased upper capital limit, who may be most likely to approach the authority – for example:

• current self-funders who arrange their own care and support and would be likely to have eligible needs if assessed by the local authority. These may be reasonably estimated using Care Quality Commission (CQC) registration data or information available from providers themselves
• people with assets under £100,000 (new upper capital limit), who would benefit from the rise in the upper capital limit and may become eligible for financial support from the local authority
• working-age adults whose needs for care and support are likely to meet the eligibility criteria

1.5 In taking steps to estimate additional demand, local authorities should consider how other system-wide organisations may be useful sources of information. For example, provider organisations hold information on people who arrange their own care and who may be eligible to access care through the local authority.

1.6 Information on current use of other services by self-funder populations, for example, a universal reablement service or advice service, may provide an indication of the willingness of such groups to contact the local authority. Other local services (for example, local GPs) may also have information and experience with the same groups.

Awareness-raising

1.7 There is a new national government campaign on ‘Transforming social care’ to help individuals and their families understand the reforms and how they will benefit from them.

1.8 This campaign includes the provision of a new website with a Q&A, case studies, and downloadable resources on charging reform.

1.9 Local authorities must take steps to raise awareness of the reforms, in line with the duty to establish and maintain information and advice services relating to care and support for all people in its area (see Chapter 3 ‘Information and Advice’ of CASS guidance and Section 4 of the Care Act, 2014).

1.10 In order to predict and manage additional demand, local authorities should seek out groups, for example those identified above, for targeted communications and the local approach to implementation. Local authorities should consider how to contact any specific groups who may benefit from earlier information, for example individuals who lack mental capacity or may be at risk of losing mental capacity in the near future. In targeting information and communications, local authorities should follow the same factors of proportionality and appropriateness as in providing any other information and advice.

1.11 Communications which raise awareness of charging reform should in particular reflect the aims of the reform to support people to plan for future care costs and make more informed decisions which reduce needs over time. Earlier contact with professionals who may support financial planning, for example, could support local authorities in managing demand over the longer-term. Information should include helping those targeted to access different types of support, including those options available in the local community, to prevent needs, delay deterioration or prepare for the future wherever possible.

Carrying out early assessments

1.12 To help local authorities manage demand for assessments and ensure people can benefit from charging reform at the earliest opportunity from October 2023; local authorities should conduct needs and financial assessments of self-funders (newly captured for the means test or seeking to access the cap) where appropriate 6 months in advance of ‘go live’, from April 2023 onwards.

1.13 Local authorities should consider where conducting early assessments is most appropriate. One example may be those self-funding in residential care, where local authorities will have easier access to information and where needs are less likely to change before October 2023. However, groups that are difficult to reach or particularly vulnerable may also benefit from early assessment; and it may be helpful for local authorities to understand the practicalities of these assessments well in advance of October 2023 to ensure that they have robust processes in place.

1.14 If a person’s needs change, the local authority must carry out a further assessment, and therefore authorities should consider when would be an appropriate time to carry out assessments, bearing in mind the likelihood of needs changing. However, this must not lead to a refusal of an assessment where the local authority would be under a duty to carry out an assessment under the usual provisions of Section 9 of the Care Act, 2014.

1.15 Needs and Financial assessments must meet the statutory obligations as set out in Chapter 6 (Assessment and Eligibility) and Chapter 8 (Charging and Financial Assessment) of the CASS guidance. Local authorities should continue to follow the CASS guidance and ensure assessments are ‘appropriate and proportionate’, making use of self-supported needs assessments, and light-touch financial assessments where it is ‘appropriate and proportionate’ to do so.

1.16 Specifically, for cap purposes, needs and financial assessments pre-determine a) that a person has eligible care and support needs and therefore can accrue costs towards the cap and b) the costs that will accrue towards the cap.

1.17 The development of care and support plans is considered separate to the assessment and eligibility process as per the CASS guidance. As per chapter 10 (Care and support planning) of the CASS guidance, care and support plans are only required where the local authority is meeting eligible care and support needs.

1.18 Where the local authority has carried out an assessment and pre-determined eligible needs, it should contact the person around October 2023 to satisfy itself that the needs or other circumstances of the person have not changed.

1.19 A person may ask the local authority to review their needs, and the local authority should respond to such a request. If the needs or circumstances have not changed, or if no request for a review is made, then the authority may take the record of the needs and costs as accurate and provide an independent personal budget and start the care account on that basis.

Capacity requirements

1.20 Local authorities should develop an understanding of their current and future workforce needs to inform their approach to managing demand and delivering additional assessments. This includes managing present demand and reducing backlogs in assessments and reviews, if applicable, as well as managing additional demand for support that will result from charging reform, beginning with early assessments from April.

1.21 Local authorities should consider the change management and transformation capacity required to deliver charging reform and plan accordingly for the impact on wider local authority operations.

1.22 Local authorities should consider the steps that could be taken to address potential capacity issues, through increasing the supply of the workforce, reducing demands on the workforce and improving efficiency. This could include, for example:

• using supported self-assessment where appropriate to help people identify their own needs
• using technology to create greater efficiencies in the assessment process
• adopting a more proportionate approach to the financial assessment for those people with assets substantially above the upper capital limit
• entering into ‘trusted assessment’ arrangements with other organisations undertaking or contributing to needs assessments, such as care providers or the NHS
• considering a delegated role in the assessment process for partners in other organisations, such as the voluntary sector, or provider organisations, who may be open to being trained to carry out certain types of assessments or assessments for certain population groups on the authority’s behalf

1.23 Where a person carries out a self-assessment, the local authority should consider how the self-assessment is verified and how this links with subsequent steps, such as calculating the cost of meeting eligible needs. Where assessments are commissioned or delegated to external organisations, there should be clear protocols in place for professional oversight, quality assurance and ongoing monitoring.

1.24 Local authorities should consider the training needs of staff, and in particular the needs (including technology needs) of those who carry out the relevant assessments. Where local authorities propose to commission or delegate some activities to other organisations, they should ensure that staff are trained to the same standard and have access to supervision and advice from social workers and occupational therapists.

Systems requirements

1.25 The introduction of charging reforms will place new requirements on local information systems and processes. IT systems for ongoing case management should be revised to incorporate the additional requirements for care accounts (including statements) and changes to charging and metering. It is the local authority’s responsibility to have this capability in place to meet its statutory obligations in this regard.

1.26 As set out in new chapter on care accounts in the Care and support statutory guidance, from October 2023 local authorities will be responsible for maintaining a care account that will allow local authorities to keep track of a person’s progress towards the cap and when they are approaching the cap. Local authority IT systems should be adapted to include the care account minimum functionality as set out in paragraph 3.5 in the accompanying document ‘Implementing the cap on care costs: draft operational guidance’.

1.27 Local authorities will also be required to provide regular care account statements which should be digital by default. Regulations will set out the requirements of a care account statement, which are included in paragraph 3.7 in the draft operational guidance.

1.28 Local authorities should be prepared to implement the required system updates ahead of October 2023 and build in time for this in their implementation plans. To support this, the government will co-produce, working with local authorities and IT system suppliers, a detailed technical specification(s) building on these minimum capabilities.

1.29 Government’s system ‘discovery’ work indicates that updates to existing IT systems will offer solutions to meet these new regulatory requirements.

1.30 Local authorities should consider whether business processes need to be reviewed and changed in parallel to changes in IT systems. Local authorities should consider the wider data strategy for health and care when making decisions in this area.

1.31 Local authorities should engage with relevant partners such as local authority IT system suppliers, other local authorities and health and care providers to identify and plan for digital opportunities to successfully deliver capability for the introduction charging reforms.

1.32 In addition to the minimum capability, which must be in place by October 2023, there are other areas where technology can support but might be delivered over a longer time frame. The government will work with local authorities to explore the need for, and where appropriate develop:

• guidance for how technology can support financial and needs assessment to understand where there is existing good practice that could improve efficiency
• a standardised national data terminology for assessment to support portability between local authorities
• a standardised minimum reporting dataset to enable validation of care provision and spend
• advice and guidance on how to track eligible spend and activity to enable validation of care provision and spend
• interoperability standards to ensure data can flow between digital social care records and case management systems to enable automated reporting of care provision
• a central registry of people receiving care to ensure that a single care account is created for each person regardless of which local authority they are in so that it is easy for them to transfer between areas

1.33 When procuring or reprocuring case management systems, local authorities should consider the best approach to reflect future requirements within scope of procurement activity.

1.34 Local authorities should consider how digital approaches can put people in control by making systems open and accessible, including online assessment, care planning, online access to records and care accounts. Local authorities should also consider how systems can be made open and accessible to people where digital internet systems are not accessible, or even not permitted, such as in prison. Local authorities should consider how digital solutions can mitigate potential administrative burdens on their workforce, such as the use of IT systems to manage the increased number of needs and financial assessments, and what training might be required to implement this.