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Government publishes adult social care white paper, says reforms to be based on Care Act 2014

The Department for Health and Social Care (DHSC) has published its long-awaited white paper on adult social care reform, which it claimed sets out "an ambitious 10-year vision for how we will transform support and care in England”.

It added: “Our vision puts people at its heart and revolves around 3 objectives:

  1. People have choice, control and support to live independent lives.
  2. People can access outstanding quality and tailored care and support.
  3. People find adult social care fair and accessible.”

Person-centred care is a key theme running through this vision, the white paper, People at the Heart of Care, said. “Genuine choice and control about personalised care and support can enhance quality of life and promote independence in a way that matters to individuals. We know that there are already strong examples of our vision in action, where people can choose the type of care and support that really works for them, happening in pockets across the country. Therefore, an important part of what we want to do is make this happen more consistently, so that everyone – no matter where they live – can benefit.”

The white paper said the Care Act 2014, particularly with its focus on wellbeing, would provide a strong foundation for its vision. “We recognise that the ambition of the Care Act has not consistently been achieved in the way we would have liked. New measures currently going through Parliament will strengthen how care and support is delivered. and give us the tools to ensure we deliver on both the letter and the spirit of the Care Act."

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The white paper sets out a range of policies that the Government will work with the sector and those who draw on care and support to implement over the next three years. These include:

  • at least £300m to integrate housing into local health and care strategies, with a focus on increasing the range of new supported housing options available. “This will provide choice of alternative housing and support options.”
  • at least £150m of additional funding to drive greater adoption of technology and achieve widespread digitisation across social care. “Digital tools and technology can support independent living and improve the quality of care.”
  • at least £500m so the social care workforce have the right training and qualifications, and feel recognised and valued for their skills and commitment. “We want the workforce to also have their wellbeing prioritised.”
  • a new practical support service to make minor repairs and changes in people’s homes to help people remain independent and safe in their home, alongside increasing the upper limit of the Disabilities Facilities Grant for home adaptations such as stairlifts, wet rooms and home technologies.
  • up to £25m to work with the sector to kick-start a change in the services provided to support unpaid carers
  • £30m to help local areas innovate around the support and care they provide in new and different ways, “providing more options that suit people’s needs and individual circumstances”.
  • a new national website to explain the upcoming changes, and at least £5m to pilot new ways to help people understand and access the care and support available.
  • more than £70m to increase the support offer across adult social care to improve the delivery of care and support services, including assisting local authorities to better plan and develop the support and care options available.

The DHSC said these proposals were backed by the new Health and Social Care Levy announced in September this year.

Responding to the publication, Cllr David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board, said: “This much-anticipated white paper sets out a positive vision for the future of adult social care and it is right that it has been co-produced with and alongside people who draw on care and support. It is also encouraging to see the Care Act is the foundation upon which these reforms will be built, particularly the emphasis on housing, greater recognition of the workforce and skills, and prevention, action on all of which will improve the quality and experience of people who draw on social care.

“We need to balance the aspirations and expectations set out in this paper against the wider reality of the funding backdrop against which councils and care providers are operating, which is insufficient to meet current and rising demand. While councils share the Government’s ambition and want nothing more than to deliver it, they will need a substantially bigger share of the new Health and Social Care Levy for that to happen.”

Cllr Fothergill added: “Addressing unmet and under-met need, tackling rising pressures, retaining hard working care staff, and investing more in prevention are all areas which need investment now, if we are to significantly bolster core services. This is the essential platform which is needed to fully realise the long-term positive vision set out in this white paper.

“Unless these can be urgently addressed as an immediate priority, any long-term proposals for social care – including those in the white paper backed by funding to kick-start change and innovation – will be set up to fail because core services themselves will not be available or sustainable. Without such investment, public expectations will be unfairly raised.

“Questions also remain about whether the funding allocated for the various major charging reforms, including for the introduction and running of the care cost cap and councils paying providers a ‘fair rate of care’, will be enough. Funding shortfalls impact directly on those who draw on care and support now, as well as those who will do so in future. The Government has been ambitious with its vision and now needs to match this ambition with the necessary funding, to turn it into reality.”

Stephen Chandler, President of ADASS (the Association of Directors of Adult Social Services), said: "I am really pleased to see this publication, it represents a foundation stone for which we have been waiting for 20 years or more.

“By its own admission the white paper is just a starting point and I look forward to continue to work with government to make its ambitions a reality”
ADASS said it was pleased that the white paper reflected contributions, including many of its own, to the engagement exercise that helped shape the white paper.

Chandler added: “This is going to be a 10-year programme of transformation and its success will depend on the continued and growing involvement of groups representing all those who commission, provide and, most importantly, draw on care and support. 

“The white paper sets out strong values and principles and has great ambition. But there is much detail to fill in and much more funding to find. Clearly the sums identified so far can be no more than pump-priming.”

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