Cautious praise for care system shake-up from the National Audit Office

National Audit Office report says department consulted carefully on Care Act, but sounds warning over whether local authorities will be able to cope with demand

By Civil Service World

11 Jun 2015

The first phase of the government’s major shake-up of social care has been given a cautious welcome by the spending watchdog.

The Care Act has been described by ministers as the “most significant reform of care and support in 60 years”, replacing most of the laws governing the support given to adults with physical disabilities, learning disabilities, or physical or mental illness, with a new system aiming to help those in need of care to live more independent lives.

Among other changes, the act places new duties on local authorities, including requiring them to promote a vulnerable person’s wider “wellbeing”, asking councils to carry out a “carer’s assessment” looking specifically at support needed by carers themselves, and bringing in a nationwide eligibility standard for care and support.

Related articles
For better or worse? CSW explores the ins and outs of the Better Care Fund
Policy in action: CCGs
Frontline: Social care commissioner
Performance Management 2020: Looking to tomorrow

In a report published this morning, the National Audit Office praised the way the  Department of Health had worked alongside the Local Government Association and the Association of Directors of Adult Social Services to implement the changes, saying “innovative joint governance” arrangements had “provided the support necessary to carry out this challenging piece of legislation”.

“The main innovation is that stakeholders are partners, taking on responsibility and not just giving advice,” the NAO said. “This has been well received by local government and stakeholders”.

The NAO said that the department had “consulted carefully” on the act, with “almost all” of the responses to its consultation backing the act’s objectives.

“There are many positive elements in the way the department has worked collaboratively with the adult social care sector to carry out the Care Act, which should provide lessons for future policy changes,” the watchdog says.

It adds: “The department has managed the introduction of phase 1 of the Care Act well, with an innovative joint approach with the sector, ongoing involvement of stakeholders and open sharing of data and documents. Consequently, 99% of local authorities were confident that they would be able to carry out the care Act reforms from April 2015. We judge therefore that the programme has been implemented well and the approach shows good practice from which other programmes could learn.”

However, the NAO also says that the department “may have underestimated” the financial impact of the required reforms on local authorities - which are already under significant financial pressure - and sounds a note of caution over its data-gathering and contingency planning.

“If demand or costs exceed expectations, pressures will fall first on individual local authorities,” it warns. “The department may not have sufficient information and does not have a contingency fund to avoid impacts on services. The department is working with the sector to monitor and respond to actual demand coming from the Care Act in 2015-16.

“However, the metrics do not cover fully costs incurred by local authorities. The department plans to use data collected in the first three months to support its bid for the next spending review. 

“Otherwise, options for the government could include changes to the regulations, additional guidance, peer-to-peer support and sector-led improvement. In the short term local authorities may have to cut or reduce services.”

The watchdog says the department will need to keep a close eye on how local authorities are coping with the new requirements, and says it must “work with the sector to monitor both the cost of, and demand for, services”.

“The department should also set out the options to help local authorities minimise the effect of increased demand and cost on service quality,” the NAO says. “We expect that the department will need to continue to monitor both phases from 2015-16 until the pattern of demand stabilises.”

The Department of Health said it was “pleased the NAO has confirmed that we are implementing the Care Act well”, with a spokesperson saying the department would “continue to work with local authorities to ensure our improvements to care are funded”.

Share this page