Care Act cultural change in health and social careElaine CassSocial Care Institute for Excellence

The Care Act 2014

• A single law for adult care and support that replaces outdated and complex legislation

• It aims to transform the social care system to focus on prevention and the needs and goals of people requiring care

Principles

• Promote individual wellbeing• Prevent, reduce and delay needs• Integration, cooperation and partnership• Embed and extend personalisation –

individual’s choice and control• Consistency, fairness and transparency

Wellbeing: the central principle

WellbeingIndividual contribution to society

Social and

economic wellbeing

Work, education, training & recreation

Personal dignity

Personal control Domestic,

family & personal

relationships

Protection from abuse & neglect

Suitability of living arrangements

Physical, mental & emotional health

Rights for individuals / wider duties and responsibilities for local authorities • Information and advice• Advocacy• Prevention• Carers• Self-funders

Strength based assessment

• Draws on what the person can do, what they’d like to achieve

• Utilises the person’s skills and community networks

New culture √ Old culture X

Outcomes focussed Process driven

Person centred Service led

Individual choice and control Paternalistic / professionals know best

Partnership, cooperation and information sharing

Silo working

National eligibility criteria Local eligibility criteria

Making safeguarding personal Safeguarding as a local authority process

Social work values and professional judgement

Care management – conveyor belt approach

Prevention, continuity of care, transition Crisis intervention

How do we change culture and practice?• Co-production• Training to address ingrained attitudes and practice• Systems change• Change in organisational approach, policy and procedures• Resources• Leadership, management and supervision• Learning organisations – evaluating and improving