1

The Care Act and Social Care Markets

June 2014

2 The Care Act: adult social care markets

Market oversight & provider failure Sections 48 - 56

Market shapingSection 5

Entry criteria

Group companies

Definitions of business failure

LA action on provider failure

Market shaping and commissioning

Summary of regulations and guidance

• Act introduces number of reforms concerned with adult social care markets

• Consulting on three draft packages of regulations and two packages of statutory guidance in particular.

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3 The Care Act: market shaping

Local authority

Market

ALL LOCAL PEOPLE

Market shaping and commissioningDuty on local authorities to promote a sustainable, diverse and vibrant market for care and support that delivers high quality services for all local people.

– Focusing on outcomes and promoting wellbeing

– Promoting choice to drive quality– Supporting sustainability– Working with partners and people

who use care/carers– Approaches to market intelligence

and facilitation– Importance of workforce

development and pay– Securing quality and outcomes

through contracting

4 The Care Act: provider failure

Continuity of care when a provider fails

Local authorities manage small scale provider failure effectively, and that most exits from the market are handled responsibly by providers.

Duty to step in to ensure that no vulnerable person is left without the care they need if their service closes because of business failure.

•Emphasis on contingency planning.•Relationship with new CQC regime for certain providers.•Determining the most appropriate support for the person.

5 The Care Act: Market Oversight

CQC oversight of ‘ difficult to replace’ providers

Southern Cross demonstrated potential effect of a large provider failing financially.

CQC to begin monitoring the financial sustainability of those 50-60 providers local authorities would find difficult to replace were they to fail from April 2015.

Aim is ensuring continuity of care and early warning, not propping up failing providers.

CQC will engage with stakeholders to develop its operating procedures for the new regime. Consultation on CQC’s proposed approach in autumn 2014.– Regulations specify which “difficult to replace” providers are included – the entry criteria– Requirement for CQC to assess financial sustainability – regulations allow CQC to look at

finances of organisations in providers group to assess sustainability– Powers for CQC to require contingency plans, or an independent business review– Requirement to inform local authorities when failure is imminent for a provider in CQC regime,

and to support local planning.

6 The Care Act: Market Oversight

Consultation Questions

7 The Care Act: reforming care and support

Developing Care Markets for Quality and Choice

DH has funded the Developing Care Markets for Quality and Choice (DCMQC) programme, delivered through the Institute for Public Care.

More information available at:http://ipc.brookes.ac.uk/dcmqc.html

Support available to local authorities to develop capacity to shape local markets through:

Market intelligenceMarket structuringMarket interventions

8 The Care Act: reforming care and support

Developing Care Markets for Quality and Choice – outcomes…

•126 local authorities have either published or are about to publish a Market Position Statement (MPS)

•Facilitated provider engagement events

•A better understanding of self-funder market through development of a toolkit for estimating self-funder use of home care services

•Identification of potential future implementation support programmes

9 The Care Act: reforming care and support

Commissioning Standards

• DH funded; ADASS/LGA led through Think Local Act Personal group

• Delivery by Birmingham University Health Services Management Centre

• Co-production with local government & sector• Set of standards to be used as part of sector-led

improvement process led by LGA• Aim of understanding and spreading best practice for local

government commissioning of social care• Standards will be tested with local authorities later in the

year; final delivery by end of 2014.

10 The Care Act: reforming care and support

Further work on implementation

• Beyond Developing Care Markets for Quality & Choice and Commissioning for better outcomes project… what support would be helpful?

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The Care Act and Social Care Markets

June 2014

Dean.Morgan@DH.GSI.GOV.UK

Stephen.Airey@DH.GSI.GOV.UK