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The article discusses a court case involving the Care Act 2014 and the treatment of disability-related expenditure (DRE). The court considered whether the costs of activities undertaken by a disabled person should be considered DRE and exempt from charges under the Act. The court emphasized the importance of the wellbeing duty and the role of the UN Convention on the Rights of Persons with Disabilities in interpreting the Act. The judgment highlights the progressive potential of the Care Act 2014 in promoting wellbeing, autonomy, and rights for individuals receiving care and support. [Extracted from the article]

This document explores the challenges faced by older autistic adults with intellectual impairments and their family carers. It discusses issues such as a lack of tailored support services, difficulties in accessing diagnostic assessments, problems with transportation, and limited access to digital resources. The document emphasizes the importance of increased awareness and understanding of autism, as well as the need for planning for the future care of autistic adults. Recommendations include improved training for public service personnel, accessible information, and a coordinated approach to addressing the needs of autistic adults. The text also highlights the experiences of autistic adults and their families in accessing support for mental health difficulties, self-injury, and suicidality, and calls for a comprehensive and inclusive approach to support. [Extracted from the article]

SUMMARY: Clinicians should be aware of the inherent jurisdiction of the High Court in providing a 'safety net' to protect 'vulnerable' adults who are not within the scope of the Mental Capacity Act 2005 (MCA) or the Mental Health Act (MHA) 1983. Many situations in which the inherent jurisdiction has been deployed have been to safeguard vulnerable adults where there is abuse, coercion or undue influence, but the person does not lack decision-making capacity under the MCA. We explain the nature of the inherent jurisdiction, including descriptions of concepts surrounding 'vulnerability'; as an intervention of last resort, we consider what statutory alternatives may exist, including safeguarding law under the Care Act 2014; we discuss decision-making capacity in relation to contact with others and, using real cases, the types of order that may be made under the court's inherent jurisdiction. It is important to be mindful that although there may be a legal remedy to safeguard this 'vulnerable but capacitous' group, there is a delicate and challenging balance between protecting those at risk and respecting their autonomy. [ABSTRACT FROM AUTHOR]

The editorial discusses the results of the recent General Election in Britain, which saw the Labour Party, led by Sir Keir Starmer, win a majority of seats in the House of Commons. The Labour Party's manifesto focused on "change" and included several relevant passages for social welfare and family lawyers. These include commitments to strengthen the rights and protections for women in cohabiting couples, reduce violence against women and girls, and address issues such as maternity and menopause discrimination and the gender pay gap. The manifesto also outlines proposals to review Universal Credit, improve building safety, and make changes to the private rental sector. The editorial also provides an overview of the contents of the current issue of the Journal of Social Welfare & Family Law, including articles on topics such as homelessness, local welfare assistance schemes, and protective legislation in the welfare state. [Extracted from the article]

The purpose of this study is to examine year-by-year effects of the 2014 Affordable Care Act Medicaid expansion on infant mortality by race and ethnicity over the first 6 years. Publicly available 2011–2019 Multiple Cause of Death data were extracted in October and analyzed by November 2021. A difference-in-differences event-study design compared infant mortality changes in states that expanded in 2014 to nonexpansion states. In the main model, the 2014 Medicaid expansions were associated with a statistically significant decline in Black infants' mortality in 2018 and 2019 by 1.19 (95% CI= –2.27, –0.12) and 1.35 (95% CI= –2.45, –0.26) deaths per 1,000 live births, respectively. There was also a decline in mortality for Hispanic infants in 2015–2019, including by 0.8 (95% CI= –1.25, –0.36) and 1.28 (95% CI= –1.88, –0.68) deaths per 1,000 live births in 2015 and 2019, respectively. Overall, infant mortality declined by 0.37 (95% CI= –0.70, –0.05) deaths per 1,000 live births in 2019. The study adds evidence on the association of the Affordable Care Act Medicaid expansions with a decline in mortality of Black and Hispanic infants. The findings shed light on the importance of examining year-by-year effects over multiple years. [ABSTRACT FROM AUTHOR]

The registration and inspection of private and voluntary social care began under the National Assistance Act 1948 and regulation of this very small sector remained limited until the late 1980s and 1990s when private health care, private home care providers and community care emerged. 1. The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. CQC's purpose as a regulator is to make sure health and social care services provide people with safe, effective, compassionate, high-quality care. Historically, given that most care was provided by the state, charities or the church and care standards were monitored by those bodies, the need for regulation in health and social care was perceived to be minimal. [Extracted from the article]

From 2011, Suffolk County Council ("SCC") provided direct payments of between £108-150 per week to both BG and KG. Eligible needs, Care Act 2014, carers, care and support, judicial review, wellbeing principle BG and KG sought a judicial review of the Council's decisions to cease the payments. [Extracted from the article]

This article presents an analysis of policies on young carers in England, considering both the design but also the lived experience of policy subjects. Drawing on affect theory we can increase understanding of the reach of these policies into family life and the nature of English policy‐making focussed on this group. This analytic framework presents the opportunity to draw on the use of affect theory developed in other disciplines but less so in the discipline of social policy. The article argues, firstly, that normative messages through policy design are conveyed to families through affects. Secondly, it argues that hierarchies of subject positions established within policy design are reaching and impacting on young carers and their families through affective pressures. This article demonstrates that affect theory contributes to the analysis of social policies on young carers and also illuminates the impacts of policies in the context of limited formal implementation. [ABSTRACT FROM AUTHOR]

Personal budgets have been heavily promoted in government policy in England as a means of increasing the personalisation of public services, particularly in the field of adult social care. The Care Act 2014 for the first time creates a statutory requirement for personal budgets to be allocated to all individuals using state funded social care. This article examines how a particular rhetoric has developed in social care policy around personal budgets, which draws freely on the language of the disabled people's movement and suggests that grassroots ideas are the central purpose for the introduction of personal budgets into policy. It considers whether the promises made in policy are embedded in the 2014 Act and finds that there is a mismatch between claims in social care policy on the one hand and the model of personal budgets created by the 2014 Act on the other. It concludes that the policy rhetoric around personal budgets directly appropriates the language and ideas of the disabled people's movement while promoting a wholly distinct agenda of public sector marketisation. [ABSTRACT FROM AUTHOR]

Cluley et al. ([3]) recognized that, while co-designing a public service may be the gold standard, individual perspectives of public service value will differ, with some individuals experiencing dis/value. If that individual is exposed to further risks, at a societal level, public service dis/value is likely to emerge, since safeguarding agencies would not have fulfilled their responsibility of keeping the individual safe. [Extracted from the article]

This article discusses potential opportunities for best practice in the United Kingdom that may be brought about by the Care Act (2014). Carers in the United Kingdom were given new rights within this legislation with a focus on needs led assessment. The underpinning philosophy of the Care Act is to streamline the previous legislation and offers a framework for carers and people in receipt of care, to enable a more personalized approach to care and support. Offering a discussion of likely opportunities brought about by provisions of the Care Act, this article draws on a small study involving older parent/carers of sons or daughters with intellectual disabilities. Exploring the extent to which such parents of adults with intellectual disabilities were aware of the details of this legislation and the potential impact it may have on their lives highlighted other significant areas, some of which are discussed below. Semi-structured interviews were conducted with five parents over the age of 60 of sons or daughters with intellectual disabilities in North West England. The study adds to the body of knowledge and understanding about parents of adults with intellectual disabilities and explores and provides a deeper understanding of parents' experiences of the implementation of this specific piece of legislation and their perception of the relevance of it to themselves. Findings include some awareness of the legislation and some feelings of optimism about its likely implications, although participants appeared less clear about the specificities and the impact of these upon them and/or their sons or daughters. Findings from the semi-structured interviews also showed parent's articulation of the extent of reciprocal care manifest between them and their son or daughter with an intellectual disability, as well as an awareness of the fragility of their own emotional well-being. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present a case study describing the progress that is being made in one city in England to increase access to Care Act 2014 assessments and personal budgets among people with experiences of homelessness and multiple exclusion.Design/methodology/approach A case study employing a “study group” to describe and reflect on local development work.Findings The authors focus on the “systems change” activity that was undertaken by one voluntary sector partnership project to address issues of referral and access to adult social care. This included the development of a “Multiple Needs Toolkit” designed to support voluntary sector workers to communicate more effectively with adult social care around the application of the new Care Act 2014 eligibility thresholds. The authors discuss the role of “persistent advocacy” in increasing access to assessments and also the limitations of this as regard the potential for poorer joint working.Originality/value Throughout, the authors draw on the “ambiguity-conflict” model of policy implementation to assess if the learning from this single case study might be applied elsewhere. [ABSTRACT FROM AUTHOR]

The Affordable Care Act's (ACA) Medicaid expansion (ME) has expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($17,774 for an individual in 2021) and provided states with an enhanced federal matching rate for their expansion populations. To date, 38 states have adopted the Medicaid expansion. We sought to evaluate lung waitlist and transplantation outcomes in states that have adopted ME. The United Network for Organ Sharing (UNOS) registry was used to identify all isolated adult lung waitlist and transplant patients between January 2010 and June 2022. Patients in states that have adopted ME were divided into pre-ME and post-ME groups based on each state's ME adoption date. Patients in states that have not adopted ME were excluded. Primary outcomes were center waitlisting and transplantation volumes, patient waitlist time and 1-year post-transplantation mortality. Kaplan-Meier and multivariable Cox proportional hazards models were used for unadjusted and risk-adjusted analyses, respectively. A total of 18,473 lung transplant patients were waitlisted and 18,704 were transplanted in states that have adopted ME within the study period [Waitlist: (patients pre-ME: 5,470 patients vs. post-ME: 13,003 patients), Transplantation: (pre-ME: 6,010 patients vs. post-ME: 12,694)]. There was an increase in annual center volumes of both waitlisting (pre-ME: 53.65±35.19 patients vs. post-ME: 58.46±33.92, p<0.001) and transplantation (pre-ME: 52.64±33.83 patients vs. post-ME: 59.97±34.93, p<0.001) [Figure 1]. Patient waitlist time was significantly decreased post-ME (pre-ME: 56 days [17, 153] vs. post-ME 48 days [14, 151], p=0.004). In an unadjusted analysis, patients transplanted post-ME had a higher 1-year survival rate (pre-ME: 87.1 % vs. post-ME 88.6 %, log-rank p = 0.002). In a risk-adjusted analysis, the Hazard Ratio (HR) of 1-year post-transplantation mortality in post-ME patients was 0.79 (0.70-0.88, p<0.001). States that have adopted the 2014 Affordable Care Act's Medicaid expansion demonstrated an increase in lung waitlisting and transplantation volumes. Patients waitlist time and mortality outcomes have significantly improved. Results suggest that states that have not adopted Medicaid expansion yet may need to consider it. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to look at the impacts on adult safeguarding partnerships and practice over 18 months following the implementation of the Care Act (2014) from the perspectives of an independent Chair of two Safeguarding Adults Boards (SABs) and a senior manager in adult social care in a local authority. They look at the areas of: wellbeing and safety, safeguarding activity and process, changing criteria and definitions, Making Safeguarding Personal, SABs, safeguarding adult reviews and advocacy. Design/methodology/approach: The authors draw together information from published sources, experience and networks. Findings: The paper argues that the impact on adult safeguarding and SABs has been greater than originally envisaged in a range of areas. This appears to be as a result of adult safeguarding having been made statutory, a new framework having been put in place, and added impetus given to a cultural change in adult safeguarding practice. Originality/value: The authors have been engaged in delivering the adult safeguarding elements of the Care Act (2014) and so provide unique insight into the experience of making the changes required to meet the new statutory requirements and achieve the objective of protecting peoples' rights to live in safety, free from abuse or neglect. [ABSTRACT FROM AUTHOR]

Aims The Care Act 2014 gives carers the right to an assessment of their needs and provides a structure for a more personalised approach to care and support. This study aimed to explore the perspectives of carers of adults with learning disabilities of the act, and examine the potential opportunities for, and concerns and misunderstandings about, its implementation. Methods A qualitative methodology was used, with face-to-face semi-structured interviews conducted with nine carers of adults with a learning disability. A coding framework identified elementary thematic patterns and formations, which were developed into more manageable sets of themes. These were refined and arranged to yield meaningful and potentially useful themes. The article focuses on one theme -- knowledge and implementation of the Care Act 2014. Findings All participants had heard of the act but none had received information about it from a learning disability healthcare professional, and believed it was difficult to find information about it. They recognised the significance of the legislation but their main concern was if, when and how its application would meaningfully affect their lives. Conclusion The enhancement of carers' status under the Care Act 2014 is an opportunity for learning disability professionals to practise more holistically and work collaboratively with carers, supported by legislation. Evaluation of the training of learning disability practitioners in how to engage with the act, and its effectiveness, should be undertaken to enable policymakers to enhance the potential for making, and sustaining, real differences to the lives of carers. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report on findings from an evaluative research study which looked at a timed intervention model of practice comprising of up to 24 weeks of intensive meetings with adult service users set up by one local authority in England, to prevent and delay the need for care and support. A particular focus of this paper is on adults who hoard.Design/methodology/approach The study employed a mixed-methods design, consisting of interviews with service users (n=13), social workers (n=3), social work managers (n=2) and stakeholders from external services and agencies (n=6). It included a costing analysis of staff time and an analysis of goals of service users and “satisfaction with life” self-report questionnaires (n=20), completed at pre- and post-intervention stages.Findings There was evidence that social workers used strengths, relationship-based and outcome-based focused approaches in their work. The techniques used by social workers to engage, achieve change and assess effectiveness with service users varied. These techniques included the use of photographs to enable the service user to map and assess their own progress over time, encouraging hoarders to declutter and reclaim their living space. The service users valued the time the social workers spent with them and the way that they were treated with sensitivity and respect.Research limitations/implications The study focused on one local authority in England; there was no comparison group. This, and the small sample size, means that statistical generalisations cannot be made and only limited conclusions can be drawn from the quantitative data.Originality/value The paper provides insights into the work undertaken by social workers with adults who hoard. It contributes to the body of knowledge on effective social work interventions with adults who hoard. [ABSTRACT FROM AUTHOR]

The article discusses the terms and provisions contained in the Care Act 2014 of Great Britain with focus on the definition of individual's contribution to society (ICS). Topics include the reference to reviews of existing care and support plans (CSP), needs assessment clause under the Care Act as well as eligibility criteria stated in the Community Care Act 1990. Also mentioned are welfare checklist under the Children Act 1989, Mental Capacity Act 2005 and the ICS statutory phrase.

Purpose – The purpose of this paper is to describe and discuss the pilot Making Safeguarding Personal (MSP) project that ran in three London boroughs in England in 2014-2015. The project aimed to help local authority social work practitioners better engage with adults at risk at the beginning, middle and end of safeguarding work and to develop a more outcomes focused approach to safeguarding. Design/methodology/approach – Three adult social care teams volunteered to take part in the MSP pilot for four months, November 2014-February 2015. They were closely supported through telephone conferencing, bespoke training and individual mentoring. Evaluative data were collected from the participating teams about their work and the MSP change processes to assist in further implementation. Findings – The findings suggested that staff felt that the open discussions with adults at risk that were encouraged by the MSP initiative enabled safeguarding to be more effective and provided a better basis of support for adults at risk. The support from the project team was appreciated. Staff reported their own increased confidence as a result of involving adults at risk in decisions about their situations and risks of harm. They also reported their increased awareness of cross-cutting subjects related to adult safeguarding, such as domestic abuse and working with coercive and controlling behaviours. Permission to exercise greater professional discretion to make responses more considered, rather than the need to adhere to time-limited imperatives, was received positively. Staff felt that this enhanced discussions about resolution and recovery with adults at risk although it required greater expertise, more extensive managerial support, and more time. These were available in the pilot. Research limitations/implications – The MSP pilot was confined to three teams and took place over four months. The numerical data reported in this paper are provided for illustrative purposes and are not statistically significant. As with other evaluations of implementation, the data provided need to be set in the local contexts of population profiles, care settings and the reporting source. The pilot also took place during the early implementation of the Care Act 2014 which affected the context of practice and training. The views of adults at risk were not collected. There is a risk of bias in that participants may have wished to convey positive views of MSP to their colleagues. Practical implications – The paper indicates a need for the roll out of MSP philosophy and MSP approaches to be communicated with other agencies supporting adults at risk and for project support of some form to continue. It will be important to see if the overall enthusiasm, support and motivation reported by the pilot teams when taking a MSP approach in practice extend beyond a pilot period during which the staff received substantial support from a dedicated Professional Standards Safeguarding Team. Many of those staff participating in the pilot perceived the MSP approach as a return to core social work principles and welcomed putting these into practice. Originality/value – The paper provides details of one pilot in which the feasibility of the MSP approach was tested by supporting three frontline teams working in different contexts. The pilot suggests that the level and type of support offered to the pilot teams were effective in a variety of practice settings. It draws attention to the need for the MSP concept and approach to be shared with other agencies and for implementation support to continue beyond initial pilot period. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to discuss how the signs of safety and wellbeing practice framework offers a practical and logical reinforcement for the Making Safeguarding Personal programme within the practice context of the Care Act. The new practice framework orientates safeguarding practice to be person led and person centred while reinforcing an outcomes focus. Design/methodology/approach – The principal social worker co-led the design and pilot programme where the new practice framework was developed and trialled. Findings – A practice framework that houses the policy and practice updates needed to deliver the Care Act and Making Safeguarding Personal agenda is logical and necessary for the practitioners. An outcomes focus is encouraged because safeguarding practice is goal orientated and outcome focused. Practical implications – A debate about how practice frameworks can help achieve the Making Safeguarding Personal approach and deliver on the Care Act principles is offered. This is a new and important debate for adult social care; a debate well-established across children’s services. Originality/value – A debate about how practice frameworks can help achieve the Making Safeguarding Personal approach and deliver on the Care Act principles is offered. This is a new and important debate for adult social care; a debate well-established across children’s services. [ABSTRACT FROM AUTHOR]

Homecare is a major source of women's low-wage employment in the UK. Practices of unpaid working time are widespread and many workers are not paid in accordance with their existing national minimum wage entitlements. On 1 April 2015, a new duty of well-being in social care came into force and local authorities are required to promote the control of care by service-users. As a consequence, homecare workers will increasingly be engaged in complex multi-lateral work relations and subject to multi-party control. This article examines how the national minimum wage entitlements of homecare workers have been legally interpreted and questions if their entitlements might be adversely affected under provisions of the Care Act 2014. There is a legacy of judicial decision-making in which care-giving is not recognised as 'work' for the purposes of the national minimum wage. Yet recent decisions have produced a more satisfactory entitlement framework by establishing that employer control over working time determines 'work' . However, it seems this framework is put at risk by the statutory promotion of service-user control. As work relations are re-cast, contractual relationships in which care-giving falls outside the protection of national minimum wage law will appear increasingly attractive because they may both enhance service-user control and facilitate very low cost labour. Without innovation in legal treatments of multi-party control and sustained attention to the worth of care-giving as employment, the rights of homecare workers are at risk under the Care Act 2014. [ABSTRACT FROM AUTHOR]

This article assesses the extent to which it is 'fair' for the government to require owner-occupiers to draw on the equity accumulated in their home to fund their social care costs. The question is stimulated by the report of the Commission on Funding of Care and Support, Fairer Care Funding (the Dilnot Commission) and the subsequent Care Act 2014. The enquiry is located within the framework of social citizenship and the new social contract. It argues that the individualistic, contractarian approach, exemplified by the Dilnot Commission and reflected in the Act, raises questions when considered from the perspective of intergenerational fairness. We argue that our concerns with the Act could be addressed by inculcating an expectation of drawing on housing wealth to fund older age: a policy of asset-based welfare. [ABSTRACT FROM AUTHOR]

The article examines how the Care Act 2014 is changing social care provision in Great Britain. Topics discussed are the concept of a person's well-being, the safeguarding duties of local authorities under the law, the physical, mental and emotional well-being needs of carers, the national eligibility criteria for social care services, the changes to the way care social services are paid for, and the transition arrangements from the old to the revised law.

Purpose The purpose of this paper is to look at family carers’ views and experiences of self-funded care for older people with an emphasis on attitudes to public intervention.Design/methodology/approach Semi-structured interviews were conducted with family carers in a densely populated city in Northern England. Study participants were recruited according to a purposive sampling strategy; data analysis was based on a qualitative content analysis approach.Findings The paper concludes that it may not be straightforward for local authorities to engage with family carers as appropriate under the Care Act 2014. An issue is that family carers do not envisage an intervention of the local authority in circumstances involving the use of privately paid social services.Research limitations/implications Qualitative information gathered within a broad study of family carers’ views, attitudes and practices of care of dependent older people have been interpreted in the light of the provisions of the Care Act 2014 concerning self-funders. The qualitative approach and the limited number of study participants are issues with the generalisation of findings.Originality/value Only a handful of studies have attempted to look into family carers’ experiences of self-funded care and the paper aims to contribute to such limited literature. It also provides an evidence-based assessment of the challenges associated with the implementation of the Care Act 2014. [ABSTRACT FROM AUTHOR]