After a lengthy parliamentary process, the Care Act 2014 came into force from April 2015. Launched as the most radical reform of the care and support system since the emergence of the welfare state, it overhauls the responsibilities of local authorities for the planning and delivery of care and support services. Implementation, however, has been adversely affected by the spending restraints on local authorities.

The Care Act 2014 shifts the role of the local authority as a provider of services even further away than the NHS and Community Care Act 1990, which it effectively replaces, to one of providing information, creating care markets and service commissioning.

The Act is lengthy and is comprised of five parts, some of which have separate chapters. It includes legislation affecting parts of the NHS and the Care Quality Commission.

Care providers are not directly affected by much of the Act, particularly as the sections concerning the funding of long-term care, the charging “caps” based on the Dilnot Report recommendations, are not being enforced, and will be replaced by new proposals, due sometime in 2018.

The Act certainly has implications for both care home and domiciliary care providers. It clearly promotes the idea of prevention and community models of care, which should benefit domiciliary care providers. The application of national eligibility criteria and high eligibility thresholds is resulting in care homes being used even more as “last refuges” than before the Act, taking only the most dependent and vulnerable people.

An equivalent Act for Wales — the Social Services and Well-being (Wales) Act 2014 came into force in April 2016. The Wales Act makes similar reforms to local authorities’ responsibilities for assessment, care, support and safeguarding as the Care Act (England), but is wider in scope in that it includes children’s services and there are some important contextual differences that affect local authorities’ strategic functions.

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