Legislation
Adult social care operates within a complex statutory framework including Human rights, Data protection, Equality, Heath & Safety, Mental capacity and Safeguarding. The legislative and regulatory requirements underpin the approach to commissioning, as well as the way in which the services are delivered. One of the key statutory drivers for adult social care is the Care Act 2014 which represents the most significant reform of care and support in more than 60 years, putting people and their carers in control of their care and support. Some of the key changes which will be at the heart of what we do within commissioning, include:
Integration of Health and Social Care
Successful integration is the planning, commissioning and delivery of co-ordinated, joined up and seamless services to support people to live healthy, independent and dignified lives and which improves outcomes for the population as a whole. Everyone should receive the right care, in the right place, at the right time. Integrated care systems (ICS) are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area.
The Health and Care Act 2022 establishes integrated care boards and requires them, with partner local authorities, to form the integrated care partnership.
The core purpose of an Integrated care system is to:
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- Improve outcomes in population health and healthcare
- Tackle inequalities in outcomes, experience, and access
- Enhance productivity and value for money
- Help the NHS support broader social and economic development
The integrated care system is an opportunity to work with a wide range of people, communities and organisations to develop evidence-based system-wide priorities that will improve the public’s health and wellbeing and reduce disparities.
We are part of the Humber and North Yorkshire Health and Care Partnership (our local integrated care system). We have collectively developed strategic aspirations for the integrated care system at all footprint levels, ensuring that adult social care maintains its value and is able to meet its statutory duties. Within the East Riding place, (managed through our health and social care committee), our approach includes:
The Health and Care Act 2022 introduced new legislative measures that aim to make it easier for health and care organisations to deliver joined-up care for people who rely on multiple different services, building on earlier recommendations by NHS England and NHS Improvement.
Human Rights Act
The Human Rights Act (HRA) was developed to assist in promoting dignity in social care.
It enables individuals to enforce 16 of the fundamental rights and freedoms contained in the European Convention on Human Rights in British courts. his makes Parliament and public bodies more accountable to UK citizens through the courts. The fundamental rights include rights that impact directly on service provision in the health and social care sector.
Data Protection
The Data Protection Act (DPA) 2018 sets out the framework for data protection law in the UK. It updates and replaces the Data Protection Act 1998, and came into effect on 25 May 2018. It sits alongside the General Data Protection Regulation (GDPR), and tailors how the GDPR applies in the UK – for example by providing exemptions. It also sets out separate data protection rules for law enforcement authorities, extends data protection to some other areas such as national security and defence, and sets out the Information Commissioner’s functions and powers.
Equality Act
The Equality Act 2010 was developed to assist in promoting dignity in social care.
Equalities legislation replaced anti-discrimination legislation. This area of law is constantly evolving as society recognises new areas of inequality, and over the years a number of laws have been passed in response to changing public perceptions and the development of human rights law.
Anti-discriminatory practice is fundamental to the ethical basis of care provision and critical to the protection of people’s dignity. The Equality Act protects those receiving care and the workers that provide it from being treated unfairly because of any characteristics that are protected under the legislation. The ‘protected characteristics’ are:
- age
- disability
- gender reassignment
- marriage and civil partnership
- pregnancy and maternity
- race – this includes ethnic or national origins, colour or nationality
- religion or belief – this includes lack of belief
- sex
- sexual orientation.
Health & Safety
Safe practice is very important when providing care. There are a number of legislative measures and regulations to support health and safety at work. These are intended to protect people in work, those using services and the wider public. The Health and Safety Executive (HSE), local authority Trading Standards and the Care Quality Commission (CQC) can all bring prosecutions against care providers who breach health and safety standards.
Safeguarding/ The Care Act
Safeguarding adults comes under the Care Act 2014, putting adult safeguarding on a legal footing. Under The Care Act, an adult at risk is someone over 18 years old who:
- has care and support needs
- is experiencing, or is at risk of, abuse or neglect
- as a result of their care and support needs, is unable to protect themselves against the abuse or neglect or the risk of it.
Mental Capacity Act
The Mental Capacity Act (MCA) is designed to protect and empower people who may lack the mental capacity to make their own decisions about their care and treatment. It applies to people aged 16 and over.
It covers decisions about day-to-day things like what to wear or what to buy for the weekly shop, or serious life-changing decisions like whether to move into a care home or have major surgery.
Examples of people who may lack capacity include those with:
- Dementia
- Severe learning disability
- Brain injury
- Mental health condition
- Stroke
- Unconsciousness caused by an anaesthetic or sudden accident
But just because a person has one of these health conditions does not necessarily mean they lack the capacity to make a specific decision.
Someone can lack capacity to make some decisions (for example, to decide on complex financial issues) but still have the capacity to make other decisions (for example, to decide what items to buy at the local shop).
The MCA allows people to express their preferences for care and treatment, and to appoint a trusted person to make a decision on their behalf should they lack capacity in the future.
People should also be provided with an independent advocate, who will support them to make decisions in certain situations, such as serious treatment or where the individual might have significant restrictions placed on their freedom and rights in their best interests.
