Abstract

Objectives: To explore how care managers in selected local authorities in England view and understand draft national eligibility regulations, how they perceive the likely impact of new regulations on social care and support eligibility for adults and carers, to examine care managers’ views about the potential consequences of new regulations on the existing level of access to care and support, the likely costs of reforms and implications of new regulations for assessment processes.

Background: Since 2003 eligibility for adult social care and support in England has been determined according to Fair Access to Care Services (FACS) guidance and local authorities (LAs) assess the needs as critical, substantial, moderate or low. LAs retain autonomy to determine the minimum level of needs at which individuals are eligible to receive state-funded support, and majority of LAs have adopted minimum eligibility threshold as substantial. As part of social care reforms set out in the 2014 Care Act, the FACS framework will be replaced by national minimum eligibility criteria from April 2015 with an aim to improve the transparency around entitlement to support, to establish a common minimum level of eligible needs across all local authorities simultaneously allowing LAs to maintain their existing levels of access to care and support.

Data & methods: This paper presents reflections from a qualitative part of a study testing draft national eligibility regulations in adult social care in England. The first part of the study involved a survey in 25 LAs in England where care managers familiar with assessments for different user groups (i.e. older people, adults with physical disabilities, adults with learning disabilities, adults with mental health problems and carers) were asked to assess two variants of draft eligibility criteria and apply them to the last ten to fifteen assessments of service users they have undertaken. Subsequently, six focus groups were carried out in a sub-sample of participating LAs with between three to nine care managers taking part in each. Focus groups lasted between one to two hours and participants were asked to provide feedback on the content of the draft eligibility regulations relative to FACS, to discuss the potential implications of new regulations on the eligibility for adult and social care support for users and carers, for the assessment processes and the likely impact of implementing new regulations for LAs. Discussions were audio-recorded, transcribed verbatim and material was entered into qualitative data management software: NVivo 10. Thematic analysis was employed in analyzing the content of discussions to systematically organize data by focusing on identification and reporting of patterns and themes across the whole dataset and collating passages relevant to each theme.

Policy implications: The findings reflect on a number of important policy questions liked to the aims of the reforms of eligibility criteria. The results elucidate on care managers’ views about the new regulations relative to FACS, the likely impact of new regulations on the number of individuals 29 eligible for services and the anticipated implications of new regulations for assessment processes and for LAs’ budgets.

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