What does the Care Act mean and how will it work?

What are the most significant changes that the Care Act will bring? *

Everyone is entitled to a free care needs assessment, even if they are not likely to be entitled to free care
For the first time, there will be a cap on the maximum amount of money one individual will be expected to pay for their own care including care home fees. The cap is set at £72,000 (Currently on hold on 29/04/19)
You can defer selling your home to pay for care home fees until after your death

What you need to know about the Care Act: what it means for individuals and how it works

The needs assessment

From April 2015, everyone is entitled to ask their council for a free needs assessment. You cannot be refused this assessment because the council believes your needs won’t be high enough, or because you are not likely to qualify for social services financial support. If you are likely to be paying for your own care (now or in the future), the needs assessment is essential because it enables the council to set up your care account which becomes a record of how much money you have spent on your care and ultimately, whether you reach the care cap of £72,000. (Currently on hold on 29/04/19)

Who is eligible for the needs assessment?

The first criteria is that your needs arise from or are related to a physical or mental impairment or illness.

The assessment then considers what is called your care outcomes. Are you unable to do at least two of the following:

Manage and maintaining nutrition (cook, eat and drink sufficient fluid)
Maintain personal hygiene
Managing toilet needs
Be appropriately clothed and keep clothes clean
Be safe in your home
Maintaining a habitable home environment
Develop and maintain family or other personal relationships
Access and engaging in work, training, education or volunteering
Make use of necessary facilities or services in the local community
As a consequence of being unable to achieve these outcomes there is, or there is likely to be, a significant impact on the adult’s wellbeing.

How a ‘significant impact on wellbeing’ is judged?

It is not enough to show that you have some difficulties doing some things. The judgement is whether your difficulties have a major impact on your overall well-being and quality of life. Well-being covers different areas and will include:

Your relationships (for example, are you unable to get out of your house and meet other people?)
Your physical and mental well-being and safety
Your housing situation

How is this different to what happened before?

This new system introduces consistent national minimum eligibility threshold for the first time. In other words, everyone will be assessed in exactly the same way. Under the previous system, each local authority set its own eligibility threshold. This means that the amount – and type – of care that is provided by the council varied depending on where a person lives and was often based on the services available in that area, rather than the person’s individual needs.

Now, there is a single threshold to be applied throughout England to all who apply for a needs assessment, regardless of financial situation. Even if you are told you do not meet the eligible needs threshold, the council are still responsible for advising you on how to meet your needs and what local services you could access.

If you have ‘eligible’ needs, what happens next?

Developing a support plan

The next step is to formulate a support plan to meet your needs. You should be closely involved in developing this support plan, together with your family member, friend or advocate. Your support plan should include:

What your needs are (including emotional needs)
Any free services that you could use to help meet your needs
Adaptions that could be made in your home and minor aids up to a cost of £1,000

The personal budget to meet your support plan

A personal budget is the amount of money needed to meet your eligible social care needs. If you pay for all the care yourself (self-funding), it is called an independent personal budget. This is really important because all the money you spend on your personal budget counts towards the care cap.
In other words, money you spend for care in your own home and perhaps subsequently on care home fees is recorded – this is called your care account. Once the money spent within your care account reaches the cap £72,000, the council will become eligible for most of your care costs. (Currently on hold on 29/04/19)

* check with your local authority for updated rules and regulations

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