On 4 February 2015, the government launched a consultation on draft regulations implementing the cap on care costs contained in the Care Act 2014. The consultation also sought views on the need for new appeals system in relation to local authorities’ decisions on a person’s care and support. The consultation period closed on 30 March 2015.

The current position

The current rules specify that if an individual has less than £23,250 in assets, they will receive means-tested help and if their assets are below £14,250 they will contribute only what they can afford from their income. 

If individuals want to challenge a local authority’s decision about their care and support, they can only do this through the local authority’s complaints system, and ultimately through the Local Government’s Ombudsman. 

Cap on care costs – what the draft regulations say 

The draft Care and Support (Cap on Care Costs etc) Regulations 2015 provide for a cap of £72,000 in respect of the costs that each individual is obliged to pay to meet their eligible support needs. Costs exceeding the cap will be borne by the local authority. This means that the maximum amount anyone will have to pay for care to meet their eligible care and support needs from April 2016 onwards will be £72,000. 

It was recommended by the Commission on Funding of Care and Support that people should remain responsible for their daily living costs. Local authorities will not be required to calculate the actual daily living cost for each individual in a care home. Instead, the regulations will set a national, notional amount for daily living costs which will apply to anyone who receives care in a care home of £230 per week. People will remain responsible for their daily living costs throughout their care journey, including after they reach the cap. 

Appeals against local authorities’ decisions 

The principles of this proposed appeals system against specific care and support decisions in relation to part 1 of the Care Act 2014 have been set up to promote:

  • Early resolution;
  • Communication;
  • Fairness;
  • Equality;
  • Independence;
  • Accessibility; and
  • Proportionality

A key objective in introducing the appeals system is to save time and money for both the individual and the local authority. The government proposes a three stage process to the appeal system. The first stage would be the early resolution stage with an emphasis on open and constructive dialogue in an effort to resolve the issue promptly. The second stage would be the independent review stage, with an Independent Reviewer appointed to review the original decision and make recommendations. The third and final stage would consist of the local authority’s decision.

Impact of the proposed changes

The cap on care costs is a first step in redressing the balance between the need for care and support and the need to protect individuals against the risk of high care costs. These reforms are significant. Local authorities will have a specific and important role to play, being responsible for delivering change at the local level. They will need to understand, oversee and lead the changes in partnership with central government. Delivering these reforms will involve extensive planning and preparation for local authorities.

The Local Government Association, Association of Directors and Adult Social Services and Department of Health are working in partnership to support local areas in implementation of the care and support reforms through the Care and Support Reform Programme.

The new rules that stipulate how much individuals must pay for their care and the appeal system are expected to come into force in England from April 2016.