Market Position – National Policy Context

National Policy Context

Implementation of the Care Act 2014

The implementation of the Care Act 2014 phased in from April 2015, seeks to overhaul Social Care and Support legislation into a single statue consolidating existing requirements and introducing new duties.

The implications of the Care Act 2014 are far reaching and significant, imposing duties on Local authorities including responsibilities to:

  • Shape Markets
  • Support Individuals Where Their Provider Fails
  • Protect Adults at Risk of Abuse
  • Support Prevention
  • Further Develop Personalisation
  • Implement a New National Funding and Charging Policy
  • Support Carers Better
  • Apply a National Eligibility Criteria
  • Provide independent advocacy, where required

Market Shaping

In order to facilitate and shape markets for adult care, whether arranged or funded by the council or by the individual themselves, Wakefield Council will continue to:

  • Develop framework agreements in place of block contracts, encouraging a variety of providers and types of services facilitating wider choice and a sufficiency of provision which can also be accessed by self-funders.
  • Implement a range of commissioning approaches including grant making funding agreements and formal contracting as appropriate to each service and market.
  • Co-produce the development of service specifications through stakeholder involvement to meet individual’s needs.
  • Develop and implement more outcome focused specifications, for example the procurement of domiciliary care reflected the Adult Social Care Outcome Framework (ASCOF)
  • Undertake robust contract monitoring and management activities to promote high-quality and safe services.
  • Develop and implement “fair rate for care” arrangements for the significant areas of spend i.e. care homes and home care, in an attempt to balance local market conditions and organisational pressures.
  • Develop a Market Position Statement to enable providers to make informed commercial and service planning decisions within the context of the Council’s strategic intentions and the resource pressures which it faces.
  • Work with commissioners across health and the council to prioritise preventative services

Whilst the Care Act guidance requires Local authorities to develop markets for care and support, the guidance also recognises that individual providers may exit the market from time to time including for reasons of business failure.

Although Wakefield Council is the single largest purchaser of social care services within the district, an increasing number of individuals pay for their own care and support, for example, approximately 22% within care homes. Therefore the council’s influence and leadership within the local markets

to promote optimum levels of quality, safety and affordability for everyone who needs them is restricted but nonetheless important.

Provider Failure

As a consequence of the Southern Cross national business failure of its care home provision, the Care Act 2014 introduces a responsibility for the Care Quality Commission (CQC) to monitor the financial “health” of certain care and support providers. The Care and Support (Market Oversight Criteria) Regulations 2014 set out the entry criteria for

a provider to fall within the regime. These are intended to be providers which, because of their size, geographic

concentration or other factors, would be difficult for one or more local authorities to replace. CQC will determine which providers satisfy the criteria.

Where CQC is satisfied that a provider in the CQC’s monitoring regime is likely to experience a business failure, it will inform the relevant local authorities who will be required to assist in reprovision where necessary.

The Care Act also provides a temporary duty for each local authority to meet all adult’s and carer’s needs for care and support relating to those registered care providers who become unable to carry on the regulated activity in a Local Authority’s area because of business failure outside of those providers monitored by CQC above. This duty applies to all adults including those whose needs the local authority is not already meeting, i.e. those who are self-funders, and those whose services are funded by another local authority. If the provider’s business has failed but the service continues to be provided then the duty is not triggered e.g. continued

operation of the service under an administrator. The guidance is clear that Local Authorities should, insofar as it does

not adversely affect people’s wellbeing, support efforts to maintain service provision (by, for example, not prematurely withdrawing people from the service that is affected, or ceasing commissioning arrangements).

Autism

Traditionally, autism has not been identified as an individual service area. People with autism who are eligible for care services have usually been identified as having either a learning disability or mental health problem. However, this has now begun to change following the production of the National Autism Strategy “Fulfilling and Rewarding Lives: The Strategy for Adults with Autism in England (2010)”.

This national strategy and subsequent statutory guidance, sets out to improve access to services and ensure that adults with autism are able to benefit fully from mainstream public services and across all agencies and partners especially so for those individuals on the autistic spectrum who may not fall into learning disability or mental health pathways. While this does not necessarily mean providing specialist autism services, this means that providers of all levels of support need to understand the needs of people with autism, be autism aware and train their staff appropriately so that adults with autism are able to access their support or services.”