The Care Act 2014 sets out the duty of local authorities to assess people’s needs for care and support, and to determine eligibility for public funding to meet those needs. It includes significant legislation to support carers, including the right to an assessment independently of the person they care for.

The Care Act 2014:

• Brings together into one place most adult social care law, making it simpler and easier to understand.
• Replaces key legislation and guidance, including the three Acts of Parliament which specifically related to carers:
  Carers (Recognition and Services) Act 1995
  Carers and Disabled Children Act 2000
  Carers (Equal Opportunities) Act 2004

Assessments and eligibility

• Introduces national care and eligibility criteria which all councils must use, ending a ‘postcode lottery’ on provision for carers and the people they are caring for.
• Gives carers the right to their own assessment, whatever the level of their need for support or their financial resources, or those of the adult that they care for.
• Previously carers had to provide a ‘substantial amount of care on a regular basis’ in order to be eligible. If carers have been refused an assessment in the past because they did not meet the eligibility criteria, they are now able to request another assessment.
• Provides a greater clarity about safeguarding responsibilities, and how the local authority and partners work to protect vulnerable people.

Information, advice and advocacy

• Everyone is entitled to advice and information on care and support services, even if they are self-funding or they have not been assessed as needing specific help.

Safeguarding

• Sets out a clear legal duty for local authorities to lead on safeguarding issues in their area. Adult safeguarding is the process of protecting adults with care and support needs from abuse or neglect. The local authority must set up a Safeguarding Adults Board (SAB) to work with other agencies such as the NHS and the police, to develop a joint safeguarding strategy.

Wellbeing

• Improves and clarifies a local authority’s duty to promote all people’s wellbeing (both adults and their carers) when providing support.

Paying for care

• Following assessment, the local authority may decide a carer needs support but is not entitled to financial help i.e. they pay for their own services – they are ‘self funding’.
• People who are self-funding have a right to ask councils to put services in place for them. These services should be charged at the same rates as the council pays for someone whose care is being funded.
• When someone has been assessed for social care support, they have a right to know the value of their ‘personal budget’. This is a summary of the estimated costs of their support services. It is particularly useful when someone is paying for their own care.
• If a person is awarded a personal budget for their care by the council, they can choose to have this money paid to them directly, as cash; this is known as a Direct Payment. If they would rather have someone else, such as a social worker, manage the money and buy services for their care, this is called a Managed Budget. A person can also choose to have the money paid to a third party provider organisation, who will manage the budget for them, and will source and buy care services with the person’s agreement. This arrangement is known as an Individual Service Fund.
• Deferred Payment Agreements (DPAs) are available from all councils across England. This arrangement enables people to use the value of their own home to pay for care home costs. The council will pay bills, recouping the cost when someone decides to sell their home or after their death. This means people will not have to sell their house during their lifetime in order to pay for care.

The government has announced that they will introduce changes to the way people pay for social care in England with an altered cap on care costs. This is planned to start from October 2023 but the time-frame may change.

The Health and Social Care Act has introduced significant reforms to the organisation and delivery of health and care services in England in order to improve collaboration between NHS and local authorities. The act includes:

• A duty on NHS England to consult carers when commissioning services and to consult carers around services relating to patients’ treatment and diagnosis
• The introduction of new powers for the Care Quality Commission to assess local authorities
• The introduction of a new duty for NHS and foundation trusts to involve patients and carers (including young carers) in hospital discharge planning if a patient is likely to need their care and the trust deems it appropriate. This should be done as soon as feasible when any discharge planning starts.

In September 2014, legislation was introduced which affects children and young people with special educational needs and disabilities (SEND) in England.
Local councils must draw up an education, health and care (EHC) plan instead of a statement of SEN, offering a more comprehensive education, health and care plan from birth to age 25. They must also publish a ‘local offer’ of the services children, young people and their families can expect. Families will be offered the option of a personal budget to pay for the services they need.

Regulations introduced in June 2014 under the Employment Rights Act 1996 give all employees a statutory right to ask their employer for flexible working arrangements, provided they have worked for their employer for 26 weeks continuously at the date the application is made. Employers are required to consider the request seriously.

Combines existing and new legislation relating to equality, including age, disability, gender reassignment, race and religious discrimination, setting out a new legal landscape for employers, services and goods providers. The Act notably outlaws discrimination against carers. For example, carers should not be treated differently because their employer or prospective employer thinks they may have to take time off to care for someone.

Amends the Mental Health Act 1983. Key areas include the definition of mental disorder, criteria for detention, ‘nearest relative’ rules, supervised community treatment (SCT), electroconvulsive therapy (ECT), Mental Health Tribunals and advocacy.

Empowers and protects vulnerable people who are not able to make their own decisions.
Importantly, carers have a legal right to be consulted regarding decisions for someone who may lack capacity. It also enables people to plan ahead in case they are unable to make important decisions for themselves in the future.

Major issues include the right to life and the right to not be subjected to inhuman or degrading treatment, the right to respect for private and family life, and, for example, the right to challenge social services on their provision of care.

• Ask for a copy of the official complaints procedures, which will tell you how your complaint will be dealt with (including written responses and agreed timescales) and what to do if you are not satisfied with the outcome. This guidance may also include a form which will help you focus on the facts you need to present relating to your complaint.
• Always make a note of dates, names, meetings, phone calls or correspondence relating to your complaint.
• Contact the organisation/staff directly involved first. Your complaint should never affect the manner in which you, or the person you care for, are subsequently treated.

Complaints should normally be made within 12 months of an incident, or of the matter coming to your attention. Time limits may be extended provided you have good reason for not having made the complaint sooner.

People want different outcomes when they complain – an apology, an explanation, an investigation or an improvement to the service. In setting out your complaint, you need to state clearly why you are dissatisfied and what result you would like to achieve.

Complaints can be made verbally, in writing, by email or via the relevant website. If you make a complaint verbally, a record of your complaint will be made and you’ll be provided with a written copy. If complaining on behalf of someone else you must include their written consent.

You cannot take legal action or receive financial compensation through the NHS and local authority social care services complaints procedure. If you are considering legal action, you will need to consult a solicitor. All NHS and social care services are insured to defend the actions of their employees. You can still go through the general local complaints procedure but this is a separate process and you must tell the relevant authority if you are also taking legal action.

You can complain about any aspect of NHS care, treatment or service that is arranged and financed by the NHS. Each service must be able to provide a copy of its own complaints procedure explaining how to proceed and who to contact.

Many issues can be resolved quickly by speaking directly to the staff at the place where care was received or the service accessed. Staff may be able to sort out the problem straight away or provide further information, clarification or advice to help you. If you feel satisfied with the outcome, you may decide no further action is needed.

Making a formal complaint

Contact the NHS service which has led to your complaint – a GP surgery or hospital, for example. If your complaint refers to hospital care you may wish to contact the Patient Advice and Liaison Service (PALS). If your complaint refers to a primary care service such as a GP surgery, the organisation Healthwatch provides a similar service to PALS.

Alternatively, you can take your complaint to the commissioner responsible for arranging and funding the service. This is your local Clinical Commissioning Group (CCG).

Contact details can be found on the NHS website or ask Carers’ Resource.

Referral to an ombudsman

If you are still unhappy with the response to your complaint, you can refer the matter to the Parliamentary and Health Services Ombudsman. This service is independent of the NHS. Tel: 0345 015 4033 or online: ombudsman.org.uk.

If care is provided, arranged or paid for by your local council, the director of social services and the local councillors have overall responsibility.

In these cases a complaint should be made using their complaints procedures.

You can contact your local council using the following numbers or online:
North Yorkshire County Council 01609 780780
www.northyorks.gov.uk/complaints-comments-or-compliments
Bradford Metropolitan District Council 01274 435400
www.bradford.gov.uk/compliments-and-complaints
Leeds City Council 0113 222 4405
forms.leeds.gov.uk/Complaints/

If you privately arrange or pay for your own care or get a direct payment from the local authority and use it to pay for care that you arrange yourself, you can make a complaint to the organisation that is providing the care (the care provider). They will have their own complaints procedure.

If you are still unhappy with the response to your complaint, you can refer the matter to the Local Government Ombudsman.
Tel: 0300 061 0614 or online: lgo.org.uk

Making a complaint about health and social care services can be daunting and you may feel in need of additional advice and support.

Services which offer free, independent, confidential help include:

• Citizens Advice can support with problems with the NHS or adult social care. Both complaints procedures are detailed on their website: citizensadvice.org.uk. Alternatively, contact the Adviceline on 0800 144 8848 for more information.
• Healthwatch can provide information to help you to make a complaint about adult social care services or NHS services. Call 03000 683 000 or visit the website: healthwatch.co.uk
• NHS Complaints Advocacy Service is a free, independent and confidential service available to anyone who wants support to make their complaint to the NHS. Call 0300 3031660 or visit the website: nhscomplaintsadvocacy.org
• NHS Website Complaints Process is detailed on the NHS website:
  https://www.nhs.uk/using-the-nhs/about-the-nhs/how-to-complain-to-the-nhs/
• Patient Advice and Liaison Service (PALS) (may also be called Patient Experience Teams or Patient Relations Teams) provide advice and support to NHS patients and their relatives and carers. The PALS is based in most local hospitals.

The following cannot be dealt with under the terms of The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009:

Independent health care
These are services provided by private companies. By law, they must have a formal procedure in place for dealing with complaints. The Independent Sector Complaints Adjudication Services (ISCAS) publication “Making a complaint about private and independent healthcare. Patients’ Guide to the ISCAS Code” is available online at:
iscas.cedr.com or call 020 7536 6091.

Patients detained under the Mental Health Act

If someone is in hospital or on community treatment orders under the Mental Health Act, the Care Quality Commission (CQC) can advise and support you in making a complaint. Contact: CQC Mental Health team: 03000 616161 or online: cqc.org.uk

Legal action – clinical negligence

If you consider you have been harmed, physically or mentally, because you consider you have not received a proper standard of care, you may feel you are entitled to financial compensation. Legal action must be taken within three years of treatment and you will need to involve a solicitor who is experienced in clinical negligence claims.

Details of where to obtain specialist legal advice can be obtained from:
AvMA (Action Against Medical Accidents) – a charity supporting people injured by inappropriate medical treatments. Tel: 0845 123 2352 or online: avma.org.uk
The Law Society can help you find a solicitor who specialises in clinical claims. Online: solicitors.lawsociety.org.uk.

Complaints about professional misconduct

If you think a medical practitioner is guilty of professional misconduct, you can make a complaint using the procedures outlined in the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009.
Information about complaining to a professional or regulatory body is available on the Health and Care Professions Council (HCPC) website at: www.hcpc-uk.org