The legislative context
Adult social care in Coventry operates within a robust legislative framework which includes several key pieces of legislation. This strategic approach complies with legislative and policy guidance.
The Care Act (2014) imposes a series of duties and responsibilities on local authorities regarding adult care and support, thereby establishing a consistent pathway for care and support entitlement for all adults with support needs. It also provides support for carers. From a commissioning perspective the Care Act (2014) requires local authorities to ensure that people have a range of provision of high-quality services within the local area and that people can access information to make decisions about care.
The Mental Capacity Act (2005) provides a legal framework for acting or making decisions on behalf of adults who lack mental capacity. This Act empowers individuals to make decisions for themselves where possible and safeguards those who lack capacity. It enables individuals to appoint a trusted person to make decisions on their behalf should they lose capacity in the future. The Act includes provisions for Deprivation of Liberty Safeguards (DoLS) and Liberty Protection Safeguards (LPS), and mandates decisions made in a person’s best interest.
The Health and Social Care Act 2008 (updated in 2022) established the Care Quality Commission (CQC) as the regulator of all health and adult social care services under the Care Quality Commission (Registration) Regulations 2009. The CQC represents the modernisation and integration of health and social care, with powers and duties that have evolved over time to ensure health and social care services provide safe, effective, compassionate, high-quality care and encourage care services to improve. In 2022, the CQC launched a new local authority focussed assessment framework that places an individual’s experiences at the heart of social care. There are also reforms to adult social care legislation proposed by the Government that have been delayed but will impact on the level of demand for services experienced by the Council.
The Mental Health Act (2007) refers to a law used in England and Wales which provides a legal framework for both informal and compulsory care and treatment of people diagnosed with having a mental disorder. The Government has recently introduced a Bill looking to reform aspects of mental health legislation which is in a consultative stage. Key changes are expected to include less reliance on detention in specialist hospitals with more treatment in the community which will have implications for commissioning of services.
In January 2025, the Government announced an independent commission into adult social care. This is following the Labour Party Manifesto commitment to the establishment of a National Care Service. The Commission is to publish interim findings in 2026 and a full report in 2028 and it remains to be seen what implications might be for commissioning.
Although not specifically legislative the NHS Ten Year Plan refresh will have impact on adult social care generally and commissioning specifically. Key to the proposed new plan are three core shifts i.e.
Shift 1: Moving more care from hospitals to communities
Shift 2: Analogue to Digital
Shift 3: Treatment to Prevention
Finally, the creation of a National Care System is anticipated over the next few years. Details from Central Government are yet to emerge but it is anticipated that this revised approach will see the Government:
- Address the funding crisis in social care, to ensure that more care is of higher quality and reduce levels of unmet need
- Provide free personal care to older people, with the ambition to extend this to working-age adults
- Build local authority capacity to deliver care, so that more care is delivered in-house.
- Ensure that all providers of care meet our ethical standards for care
- Invest in the social care workforce, so that care staff are valued and supported
- Establish the National Care Service, which will provide person-centred, universal care and minimise the financial uncertainty for people who need care.