Government guidance on the Care Act 2014: supporting change or the status quo?

Tue, Oct 14, 2014 14:00 CET

UK government guidance on the Care Act 2014 appears to contradict the revolutionary aim of the Act itself – to put people in control of their own support – claim two academics from Brunel University.

Writing in the journal Disability and Society, Colin Slasberg and Peter Beresford dissect the draft guidance issued in June, and which is expected to form council policy and practice across the country.

Instead of guiding councils to take the person-centred approach enshrined in the legislation, Slasberg and Beresford conclude that the guidance simply encourages councils to perpetuate the current approach: a ‘system of eligibility that leads to practices that are resource-led, not person-centred or needs-led’.

Chief among the pair’s objections to the guidance is the lack of a strategic outcome for service users. The guidance explicitly refuses to define a ‘standard of wellbeing’ that should be aspired to by a care service; controversially, in their view, the guidance also rejects the established concept of ‘independent living’.

While the guidance confirms the Act’s view that individuals are best placed to judge their own wellbeing, it also reinforces the fact that final decisions about a person’s care continue to remain with the council. The guidance also neglects to provide help to councils in making difficult decisions about which of its residents’ needs it can support (and which it cannot) while trying to stay on budget.

The authors conclude: ‘Wittingly or otherwise, the effect [of the guidance] is to create a smokescreen for the continuation of a system that has served short-term political objectives well, but has been anathema to the person-centred system that government claims to want.’

There is, however, an alternative. Slasberg and Beresford believe that it is possible to create a person-centred, needs-based system – but only if the 2014 Care Act is interpreted and enacted in such a way that brings about real, systemic change. They outline their vision for such an approach, complete with strategic outcomes, holistic assessments of needs and transparency from councils about resource limitations. They also suggest that councils hoping to create an ‘alternative future’ for their care services could refer to the Act directly, and disregard the guidance.

This article provides substantial insight into both the current reality and future of our overstretched care system. It also highlights significant differences of opinion about what that future of care could – or should – be.

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