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SocIAl cArE lAW: coST cAppINg                                                           SocIAl cArE lAW: coST cAppINg
 Do THESE coUNcIlS’   most people but I do doubt that a   family life and the home, but not a   eligibility regulations. One is not   QUESTIoNS rAISED
 policy of cost capping fits with the
       guarantee that one will always be
                                           eligible for a care home, or homecare
 polIcIES ENSUrE   Care Act framework.  able to be cared for, there, for ever,   any longer: one is eligible, effectively,   by THESE polIcIES
       courtesy of the State. Article 8
                                           for care planning, and two different
 ‘WEllbEINg’?  What is legal under   explicitly includes a reference to the   settings or ways to meet need can be   What would constitute an exception
 the Care Act?
       economic wellbeing of the area as a
                                           compared where both could be offered
 It is legal for councils to take their   legitimate qualification of that whole   by the council.    to a lower/capped rate for care
                                                                                 support?
 two councils are planning to cap   resources into account in relation to   human ‘right’.
 own home care costs at the equivalent   how they meet needs, not whether they   There is nothing wrong in letting   They will inevitably be unequal in   How does the proposal relate to a
 meet them.
                                           many ways: one will cost less and one
 value of those for a care home.      people volunteer to meet the first chunk   will offer more of some things, such   needs-led care planning process
                                                                                 (not service or budget-led), as in
 Does that fit with the Care Act   Councils are also – despite the rhetoric   of their own currently unmet needs, by   as safety and company, and less of   the Act?
 framework and the principle of wellbeing enshrined in it?   about personalisation and user-led   offering informal help through friends,   others; for instance, autonomy, privacy,     Would a council risk judicial review
       relatives, neighbours, or through the
 assessment – the final decision-makers
                                           peace and quiet. Whether one or the
 belinda Schwehr has reservations.   about what is an appropriate way to   use of their own resources – councils   other suits a person’s needs better will   with a policy which does not fully
 meet needs in a particular case.  are only obliged to meet unmet need,   all depend on the perspective through   take into account the effect on a
       just as under the old law.          which they see their home, care homes,   person’s wellbeing?
 But in both cases, this discretion is     and their situation.
 eaders may recall that   because a residential care package   subject to judicial review (legal   There is nothing legally wrong, if there
 R Southampton consulted   for a person with learning disabilities   proceedings challenging the validity   are two alternative adequate settings   Clearly, for some it would be   c. Whether the same approach will be
 about offering people a   may not be cheaper than in an own   of the decision) for unreasonableness,   for meeting the particular needs of a   indefensible that the cheaper of the       taken by CCGs – or CCGs with
 care home instead of home   home setting.   unfairness, illegality, breach of the   person, in a council’s offering to   two was even theoretically adequate.       split package clients – and how
 care, if care in a person’s   person’s article 3 or 8 human rights,   fund the cheaper of the two.   The extent of the impact of one’s       all elements will be taken into
 preferred setting was   Some councils are framing their   or for what’s called ‘fettering of   That well-established principle is set out   assessed eligible needs in one’s own       consideration in the comparison.
 costlier than the council   policies with regard to the gross   discretion’, if what is described   in paragraph 10.27 of the guidance,   home may be less than in a care
 could have paid in a   equivalent cost; others are using net   as a general policy is, in practice,   along with the prohibition on ‘arbitrary’  home, but the environment,   d. The charging implications: why
 managed environment.  costs, offering the value of a residential   going to be implemented as a   ceilings on care costs in particular   including the state of one’s home;       isn’t the amount that a person is
 care home, after the client’s legitimate   concrete rule.  settings. That’s always been the law   for example, whether there is       being asked to spend on their own
 Southampton withdrew its proposals   contribution has been factored in, and   since the Lancashire case, and the   someone else there, will inevitably       home care, always to be treated as
 but Medway has taken up the   expecting people to take that net sum   Review trigger  Care Act doesn’t change that principle.  affect the cost of reducing the impact       disability related expenditure,
 challenge, consulting on a similar   of money and spending it, and their   Bedford’s policy does not go that far:   of what one is not able to achieve,       since it is spending on need that the
 basis. Bedford seems to have finished   own money, on meeting their needs.  it uses the equivalent cost as a review   Unlawfully  in each setting, to a no longer       council has required to be satisfied
 its consultation and has already   trigger and the occasion for a   A person has every right to refuse to   significant level.      has been met.
 implemented a slightly amended policy.  Exceptions  discussion. And it would only be   accept what is offered, or to accept it
 For physical and learning disability   applied where a person could, in the   but then challenge the decision,   And if it would not promote well-being,   Neither of the councils have given
 The plans all have in common the aim   clients, the range in Bedford goes from   opinion of staff, be appropriately cared   via a line manager’s review or judicial   and in fact detract from well-being,   any detail of what exceptional
 of limiting care packages in a client’s   £570-£2,500 a week, because of   for in either setting. Medway is   review proceedings, that the care home  can a council actually drive such a   circumstances would be for not
 home to one or more flat rates, per   variations in need. It seems to be   clearly committed to doing needs   setting would be therapeutically   policy all the way home and risk   applying the policy. Someone having
 week, on the basis that a bed in a care  accepted that if the lower end of that   assessment too.   appropriate. But in so doing, even if   challenge? What would that do for the   both the gumption and the means to
 home will be the same cost.  range was a   the judge agrees that the council has   reputation of the parties involved in the   bring judicial review proceedings is not
 starting point,   However, it’s the   acted unlawfully, the person does not   cross-party design of the Care Act and   a principled reason for deciding when
 Councils say they will ‘assist’ those   people with   relationship of the   get to tell the State what he or she   the reverence for the well-being   the policy should not be applied.
 unable or unwilling to pay for their   needs above   Clearly these   proposal to the staff’s   wants instead. The council decides   principle, that the law is supposed
 own care needs at home, or prevail   this level in   policies raise questions –   approach to the care   and can only be challenged by way   to enshrine?  Nowhere in the consultation
 upon others in their network to meet the  their own   of legality, human rights,   planning process that   of judicial review for indefensibly   documents have Members been told
 cost above and beyond that limit,   home would   care planning discretion,   is unclear. Is it still   unsuitable offers.  Other points of concern   of other options, such as cutting other
 to move into a care home.  be treated as   the relevance of resources,   needs-led, budget-led   a. The legitimacy of the rate within  discretionary budgets, raising the
    exceptions   and the interpretation   or even service-led?   However, the all-important care       the level of care home being    council tax or digging up the reserves
 Exceptions  – but it’s not   of the duty to   The Act and the   planning decision is the one by the       regarded as equivalent in the first  coffers. Nowhere is it acknowledged
 Councils also say that they will not   clear what   meet needs.  preceding law have   staff member as to whether a person’s       place. In areas where top-ups are  that duties and values can trump
 have a ‘blanket’ policy but will make   these people   always been clear:   needs can even be appropriately       running high it is probable that the   budgetary targets.
 exceptions, taking full account of the   would be an   it must be needs-led,   met in a care home setting –       council isn’t paying a justified rate
 duty to be person-centred, and place   exception to. The policy document   and by the needs of the individual in   ie. therapeutically beneficial and       for the cost of standard care home   RIP, legal literacy?
 wishes, feelings and needs, at the   said that for such people alternative   question, not some hypothetical   would not de-skill them. That is the       care at all. This is now beginning to
 centre of the process.  methods of care and support,   average person.  whole basis for not putting young       be the case for people with learning   Belinda Schwehr
 not alternative settings, will be tried,   people with learning disabilities,       disabilities as well.  Care and Health Law
 Some councils see this as applying   an ambiguity that needs to be clarified.  A person does not have a human   terminally ill young parents with
 mainly to elderly people because their   right to live in their own home,   children, and elderly persons who   b. How the nursing element of a
 care home fees tend to be flat-rated for   Clearly these policies raise questions –   or in a non-care home environment,   can still recognise their home       nursing home can be forced   www.SchwehroncArE.co.uk
 ease of commissioning; others see a   of legality, human rights, care planning   if living there with one’s needs   surroundings and partners, and cope,       out of the CCG, since it is clear    for webinars about the legal
 need to apply the same policy to   discretion, the relevance of resources,   being appropriately met would   into care homes.      that the council could not provide   framework, starting at
 people with learning and other   and the interpretation of the duty to   involve relying on the State to fund       for the nursing care in the
 disabilities, presumably to avoid   meet needs. I agree that living at home   that care. Article 8 of the ECHR   The needs to be met will refer back       community within their own    £10 per webinar!
 discrimination, but this is less likely   is a ‘want’ rather than a need for   guarantees respect for private and   to the domains/’outcomes’ in the       statutory functions.

 10      Vol 29 No 4 | Summer 2016     Community Living  www.cl-initiatives.co.uk  www.cl-initiatives.co.uk  Community Living      Vol 29 No 4 | Summer 2016     11
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