The implications of the Care Act put new obligations on service providers and the local authority. The Act will mean that person-centred care is more of a priority. A concerted move away from task-based care to a focus on outcome-based care will combine with the introduction of health and social care ratings, effectively opening the door for a scoring system of care provision and care providers. Those receiving care or making decisions on their behalf will not only have more choice over the care they receive and how they receive it but also from whom they receive it. Providers therefore must be able to support this personalisation of care and demonstrate their effectiveness in delivering quality.
The new Act also means that people have personal budgets and access to mixed funding. There will be a funding cap, revised financial needs-based assessments and a limit on the amount paid on care in a lifetime. Receivers of care will end up with a personal budget and may be paying for services themselves or getting funding from the local authority. The implication of a proposed clearer statement of an individual’s ‘personal budget’, may see a shift in perception, with the individual no longer considering themselves a recipient of care, but a customer of care. As a customer, they have choice, and choice decisions are based on both cost and quality, potentially posing some big challenges to service providers.
Inevitably, increasing quality creates cost pressures. Put simply, it costs more to carry out personalised care, with a focus on delivering quality and agreed outcomes, than it does to deliver task-based care (going through the motions of just delivering the tasks that are needed). With limits set on the amount of money an individual will be required to pay on care in their lifetime, it would seem inevitable that the financial burden on local authorities will increase.
With many local authorities already making their selection of care providers based to a substantial degree on price, squaring the circle of improving quality for the same or less money will fall to the charitable and private care providers themselves.
According to reports on the adult care system carried out by the National Audit Office (NAO), whilst care requirements have risen, in real terms funding has fallen by 8%between 2010-2011 and 2012-2013. Providers are going to be asked to do more for less and if they are continuously driven down on cost the quality of care is not going to improve without operational changes.