leavingcare.org

NHS and Community Care Acts

The NHS and Community Care Act 1990

Key points of the NHS and Community Care Act 1990:
  • Local authority social services departments have overall responsibility for community care.
  • Local authorities must produce and publish community care plans.
  • Local authorities must assess people who they think may be in need of community care services.
  • Local authorities must arrange for the provision of care.
  • Local authorities must encourage and promote the development of private and voluntary agencies by purchasing care and/or services from them.
  • Local authorities must establish a complaints procedure.
Key Objectives of the NHS and Community Care Act 1990:

Community services - where possible services should be provided in the home or local community.

Services for carers - family, neighbours or friends provide most community care. The work that they do often goes unrecognised. Many need financial help and need to be considered when an individual's needs assessment is being made.

Assessments for care - there was concern that large sums of money were being spent on residential and nursing home care without a proper assessment of need. The government thought that this kind of care was not always the best use of resources. Your local authority is now solely responsible for assessment of need.

A "mixed economy of care" - the government takes the view that better services will result from increased competition from a variety of providers. Your local authority must show, in their Community Care Plan, that they will encourage the independent sector to provide these services. Because of differing local circumstances, between inner city and rural areas for example, the mixed economy of care will look very different in different local authorities.

A clear demarcation of responsibilities - from April 1993, local authorities have the responsibility to assess people's needs and care management. This includes the allocation of funds for places in nursing and residential homes as well as other services such as domiciliary care.

Value for money - one of the government's principal policy objectives was to remove the financial incentive for people to be placed in care homes when they were able to claim benefit from the Department of Social Security. Now they cannot.

The Community Care (Direct Payments) Act 1996

The Community Care (Direct Payments) Act 1996 empowers local authority social services departments to make direct cash payments for the community care services. In April 2003, it became mandatory to offer the direct payments scheme to people who fall within certain rules in England, although in Wales direct payments are discretionary. Direct payments are available to carers and disabled people over the age of 16 who have been assessed as needing services. Local authorities must consider every application for a direct payment on its own merit. They may make a direct payment as well as arrange some services themselves. Any person who receives direct payments must be willing and able to manage them (alone or with assistance). Day-to-day control of the money and the care package passes to the person who is best able to ensure that it is spent properly on the most appropriate services for the person. People receiving direct payments can ask a carer or another person to manage them and to act as the person’s agent.