Coronavirus update – changes to the adult social care system in England
Published on 03 June 2020
The Government’s new Coronavirus Act contains emergency powers, which could lead to changes in how the social care system works for adults in England. If councils ‘turn on’ these emergency powers during the coronavirus outbreak, their existing duties to provide social care under the Care Act would be temporarily relaxed. Under these circumstances, autistic adults’ access to social care could change.
The Government has set out more information about how councils can ‘turn on’ these powers, under which circumstances and what their duties will be to provide support to people who need care in the guidance for local authorities. We have summarised this and set out the impact that this could have on autistic people and their families during the outbreak.
Why would access to care change?
Councils can ‘turn on’ their new emergency powers if they struggle during the coronavirus outbreak because lots more people need urgent support, or because there aren’t enough care workers to provide care. Many councils have already said they are getting requests for urgent support and at the same time have fewer staff because of the pandemic.
The potential changes are sometimes described as ‘easements’, because they allow councils to temporarily not fulfil their usual legal duties to assess people’s needs, plan their care, review their care, and carry out financial assessments. The powers would also allow councils to prioritise who they provide care to.
What could change?
Unless councils ‘turn on’ their new powers, the care and support people receive should not change.
If councils do decide they need to use their emergency powers, this could lead to temporary changes in autistic adults and their families’ access to support:
- Councils will be allowed to make decisions to prioritise care for those who they think need it most. This could mean that some autistic people see their care reduced, or stopped.
- Councils will not have to carry out detailed assessments of people’s care and support needs. But they will still be expected to respond “as rapidly as possible to requests for care and support”, and to consider people’s needs and wishes. This could mean the content and process for care assessments could change during this time. For example, assessments could be shorter and carried out virtually. This could be different across councils.
- Councils will not have to carry out financial assessments of what people can afford to pay towards their care and support. But they will have the power to charge people later on, after care has been provided. They should still provide information and advice to people affected by this about the kinds of costs people might face.
- Councils will not have to prepare or review people’s care and support plans. But they will still be expected to carry out “proportionate, person-centred care planning”. This could mean that a review you had scheduled will be delayed. This could look different in each council.
The guidance is clear that these powers are temporary and can only be used if absolutely essential. Even if councils use these powers, they will still need to make sure they don’t breach people’s human rights under the European Convention on Human Rights. Councils will also still have to meet their duties under the Equality Act, including duties to make reasonable adjustments (e.g to the ways they communicate with people).
Your rights to advocacy
It’s important to remember that duties around advocacy haven’t changed – if you need an advocate you should still get one. Find out more on VoiceAbility’s website.
Guidance for people receiving direct payments (Updated 1 May 2020)
On 21 April, the Government published guidance for people who are getting direct payments – either through personal budgets or personal health budgets. If you’re not sure what a direct payment is, it’s when someone who needs social care gets money directly to choose their own support, instead of the council or the Clinical Commissionning Group (CCG) doing it for you.
Steps you should take if you employ personal assistants (PAs) to support you
If you get direct payments and employ one or more PAs, you should take the following steps during the coronavirus outbreak:
- Put in place arrangements in case your PA/PAs can’t come to work, for example if they need to self-isolate.
- Consider alternative options for support if you’re worried about what could happen if your PA can’t support you as they usually would. For example, you could look into local mutual aid groups to help with shopping.
- If your PA/PAs can’t be there to support you, consider whether you could potentially get other paid support, such as other temporary PAs or temporary support from care agencies.
- Make sure that if you do have new staff come in to support you, you’ve been able to let them know about your preferences and what you need.
- If you can’t find any alternatives yourself, contact the council or the CCG that gives you your direct payment, and they should make sure you can find other support quickly.
What you should do if your PA is concerned that they have COVID-19
- They should follow the guidance on home care provision – if they are advised by the NHS to self-isolate, they should not visit and care for you until it’s safe to do so.
- If your PA/PAs cannot give you the care you need, you may need to put contingency plans into action – eg if you have family around, you might have to ask them to temporarily step in if that’s possible.
- The Government’s guidance says councils and CCGs should be flexible about how you use your direct payment, so you should be able to pay the money you usually pay to your PA to a family member who’s supporting you, for example.
- In cases of emergency and where time-critical, you can put a suitable package of care and support in place for a short period, as long as you can justify and evidence this retrospectively.
What you should do if you, as the person who needs support, has symptoms of COVID-19
- If you’ve got symptoms of Covid-19, your PA/PAs should use Personal Protective Equipment (PPE) if they’re coming into close contact with you. The Government’s guidance recommends that the person/people who support you wear; plastic aprons, fluid resistant surgical masks, eye protection and gloves.
- As the person who employs the PA/PAs, you are usually responsible for getting any necessary PPE and continue to buy this from your usual supplier. If you’re having problems getting supplies, report this to your council or CCG.
What does the National Autistic Society think about these changes?
We’re really concerned that the Coronavirus Act could end up with lots of people losing out on the care they need. We have outlined our concerns and what we’ve been saying to Government about this in a news story.
We also think it’s wrong that autistic people who get direct payments should be responsible for getting their own PPE during such a difficult time, and have raised this with the Government.
We will keep speaking up and showing the Government the impact of the Coronavirus Act on autistic people and their families during this time. Please share your experiences, and any worries or concerns you have, with us by emailing stories@nas.org.uk.