Social care reforms could trigger deluge of legal disputes, MPs warn

Impact of capped social care on local authorities not adequately thought through, says cross-party group of MPs and peers

Ministers have not fully thought through the implications of their social care reforms, a hard-hitting report has found.

The draft care and support bill, designed to create a single law for adult care and support in England, could leave local authorities open to a “deluge of disputes and legal challenges”, a cross-party group of MPs and peers said.

The report says the introduction of a capped care-cost scheme is likely to lead to an increase in challenges against decisions made by local authorities. It states: “The introduction of a capped cost scheme, which will result in many more people being assessed and entitled to a personal budget, is likely to lead to an increase in disputes and legal challenges.

“We are not confident that ministers have yet fully thought through the implications for local authorities of these changes.”

The committee said there should be an urgent review of the proposed system for complaints, adding that the government should consider giving a care and support tribunal the responsibility for resolving disputes over decisions about care.

It also questioned whether funding for adult care and support can deliver the transformation of services set out in the report.

Former care minister Paul Burstow, chair of the joint committee on the bill, said: “We need care and support to be more focused on prevention and more joined up with health and housing. There is much in the government’s draft bill to welcome – it cuts through a complex web of arcane legislation that people struggle with. But there is room for improvement.

“The government must take stock of its funding for adult care and support and think seriously about whether the transformation we all want to see can truly be delivered without greater resources.

“There is a growing imperative to join up services so they fit around people’s lives and make the best use of resources. The whole system must shift its emphasis away from crises and towards prevention and early intervention. The draft bill helps, but we believe it could do more.”

The joint committee also called for an end to “contracting by the minute”, where care workers sometimes spend just 15 minutes with the person being cared for.

It also called for stronger measures on safeguarding vulnerable people in care, including explicit responsibilities for local authorities to prevent abuse and neglect.
Carer from Catholic Welfare Society, Manchester The government has been warned to ‘take stock of its funding for adult care and support’. Photograph: Don Mcphee for the Guardian

The committee warned that without greater integration with health and social housing services, the care and support system is unsustainable.

A separate report by the health select committee suggests that social care funding should be ringfenced alongside NHS cash to ensure a truly integrated care service.

The health committee said the government should pledge to protect the current level of real-terms funding available to social care.

The committee chair, Stephen Dorrell, said the only way to sustain current levels of service would be to develop “a much more joined-up approach” to commissioning health and social care services.

He added: “It’s unlikely that public expenditure on health and social care services will increase significantly in the foreseeable future. This means that the only way to sustain or improve present service levels in the NHS will be to focus on a transformation of care through genuine and sustained service integration.”

Services should be designed to treat people rather than conditions, he said. “They need to respond to individuals rather than expecting individuals to find their way round a bewildering range of specialist departments,” Dorrell added. “To make this ambition a reality, we need to develop a much more joined up approach to commissioning health and care services; we propose that responsibility for this process in a given area should be vested in the health and wellbeing board.

“Joined-up commissioning would ensure that resources are no longer treated as ‘belonging’ to a particular part of the system, but become shared resources to use more efficiently to develop and deliver a more flexible and responsive local health and care services.

“Moving to this approach must not however result in less overall funding for care services. We therefore propose that the government’s commitment to protect real-terms funding for health care should be extended to cover local authority social care services and that these funds should be ringfenced at current levels in real-terms.”

The health select committee recommended that health and wellbeing boards – new local bodies that include council members, adult and children’s services and health representatives – should take charge of delivering local health, social care and social housing services.