Adult social care plans don’t have longevity
A single, modern act for adult social care is welcome, but the consultation paper feels some way short of a framework that could serve another 60 years, or even 30, says David Brindle.
Perhaps we should have been more careful what we wished for. The future of long-term care is at last making headlines, but the more politicised the discussions become, the less likely seems a consensual solution. But if the prospect of a landmark settlement on reform of long-term care does not look good, at least any time soon, there is a real possibility of a historic settlement on reform of social care law in England and Wales. Proposals for consultation published today by the Law Commission could form the basis of flagship legislation in the next parliament, leading to a single statute for adults, to rank alongside the seminal Children Act.
Goodness knows, reform is long overdue. Most services are still delivered under the National Assistance Act 1948, although there are in all 38 relevant acts, plus a veritable forest of guidance. A social worker assessing a person with mental health problems needs to have regard to three separate pieces of legislation, four sets of government assessment guidance and two sets of guidance relating to mental health services and directions.
Then there is the question of language and terminology: while professionals, and sometimes even the media, strive to ensure that older and disabled people are treated with due respect in 21st-century Britain, the relevant legislation still talks in terms of ”mentally disordered”, “handicapped”, and “congenital deformity”.
Creating a single, modern act would both perform a valuable service to humanity and realise considerable savings in time and expense on the part of those who currently have to wrestle with unwieldy and often overlapping statutes. It might even reduce inconsistency of assessment and service allocation. The commission, which has been working on its proposals for more than 18 months, deserves great credit for tackling such an important and ambitious agenda.
But for all that, today’s consultation paper feels some way short of a framework that could serve another 60 years, or even 30.
What’s good about it? Apart from the rationalisation of existing law, greatly to be welcomed are the proposed establishment of core principles of decision-making; introduction of explicit duties on councils to assess individual needs, provide community services to all those deemed eligible, and assess the needs of any carer who might appear to need a service; and imposition of a duty on councils to investigate suspected abuse or neglect of vulnerable adults – though there would be no new powers of intervention.
More debatable is the intention to dispense with any central definition of a disabled person or service user. While the principle that anyone should get a service if deemed eligible is surely right, many people do value the existing opportunity to register with their council as disabled, and repeal of section 21 of the 1948 act would, as the commission acknowledges, expose some groups to potential loss of residential accommodation if their needs were judged low or moderate.
Above all, though, the proposals do not seem to have taken on board the implications of the personalisation drive in England. Things are changing fast, albeit faster in some councils than in others, and the target is that almost one in three service users will by next year have a personal budget. In an emerging era of flexibility, choice and self-direction, it feels regressive for the commission to propose a duty on councils to produce a care plan for each service user.
The commission has taken a snapshot of adult social care and constructed, admirably, a single piece of legislation to suit. The problem is that the sector is more like a film, with new and developing storylines. With fully four months of consultation on the proposals in store, there’s every opportunity to animate today’s print.
David Brindle is the Guardian’s public services editor.