People at the Heart of Care white paper

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People at the Heart of Care: adult social care reform

The People at the Heart of Care white paper | GOV.UK is a comprehensive policy paper that sets out the government’s 10-year vision for transforming adult social care in England.

This summary highlights some of the content likely to be of most interest to people working in adult social care. 

In April 2023 the government published the Next steps to put People at the Heart of Care | GOV.UK, providing further details on the plans and funding for this work in 2023/2024 and 2024/2025.

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Objectives and vision

The 10-year vision for how to transform support and care in England, revolves around three objectives:

1. People have choice, control, and support to live independent lives 
2. People can access outstanding quality and tailored care and support
3. People find adult social care fair and accessible

Person-centred care is a key theme running through this vision. Genuine choice and control about personalised care and support can enhance quality of life and promote independence in a way that matters to individuals.

Below is a summary of the vision for each of these objectives. More details about the vision and how each objective relates to different stakeholder groups, are explained in the Our 10-year vision for adult social care | GOV.UK white paper.

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People have choice, control, and support to live independent lives

People who draw on care and support can:

• feel connected
• maintain their wellbeing
• make valued contributions
• live in their own homes
• have housing and support options available
• have control of their support
• have information they need to help them plan for the future

Families and unpaid carers can:

• provide care that accounts for their wellbeing and personal circumstances
• have a life outside caring
• know that their needs are recognised and fulfilled
• make informed choices
• access support and breaks

Local authorities and the system will:

• ensure homes and technology enable independence
• ensure a range of personalised support is available
• support people to use direct payments flexibly
• achieve outcomes that matter to people
• co-design care and support with clients and unpaid carers
• champion early health and wellbeing interventions

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People can access outstanding quality and tailored care and support

People who draw on care and support can:

• receive support that is safe and responsive
• receive personalised and inclusive support based on their strengths
• access a person-centred and appropriately trained workforce whose professional development and wellbeing are prioritised
• experience joined-up health and care services
• choose direct payments to meet their outcomes
• optimise their last stage of life

People who work in adult social care can:

• feel valued and progress their career
• feel recognised for their role and develop new skills
• work in a culture that supports their health and wellbeing
• have confidence in using technology to support people
• work effectively with other organisations

Local authorities and the system will:

• enforce safeguarding and standards
• strengthen assurance and address improvements
• make quality and timely data available
• use technology to enable preventative care
• ensure social care is valued by the public (on par with the NHS)
• ensure provision by a qualified and valued workforce
• ensure that professionals can access digitised information
• join up health and care services
• help unpaid cares to provide seamless care experiences

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Opportunities for improvement

This white paper identifies eight key challenges facing adult social care that need to be addressed: 

• Rising to the challenge of increased demand
• Shaping healthy and diverse social care markets
• Addressing variation in quality and safety of care
• Supporting our adult social care workforce
• Navigating the system and finding the right care and support
• Accelerating adoption of technology
• Expanding the choice of housing options
• Driving integration of health and care services

For further details about these challenges and how each one will be addressed by the government's priorities and policies, see  'Opportunities for improvement' under Strong foundations to build on | GOV.UK in the white paper.

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People find adult social care fair and accessible

People who draw on care and support can:

• receive affordable care
• access care homes at local authority rates
• access user-friendly and empowering information and advice
• know their rights on care and housing options
• receive accessible care and support without delay

Unpaid carers can:

• navigate the social care and health system with ease
• understand what local support is available to maintain their wellbeing
• access tailored information and advice to make informed decisions about caring and support those they care for

Local authorities and the system will:

• reform charging to cap personal care and expand means-tested support
• move towards paying a fair cost of care and ensure self-funders can access care homes at local authority rates
• ensure care fees are transparent
• make information and advice more accessible
• provide accurate and up-to-date information and advice tailored to individuals

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Priorities and policies

The white paper identifies four priorities to address the key challenges facing the sector.

• Providing the right care in the right place at the right time
• Empowering those who draw on care, unpaid carers, and families
• A strategy for the social care workforce
• Supporting local authorities to deliver social care reform and our vision

Below is a summary of the key proposals for each of these priorities. The white paper includes a separate vision and policy overview for each of these priorities. These proposals should be seen in the context of the reforms previously set out in the Build Back Better policy paper | GOV.UK which includes more details about funding and charging reform.

Providing the right care in the right place at the right time

This priority, covers proposals relating to providing the right care | GOV.UK :

• housing,
• use of technology,
• developing and scaling new types of care support
• prevention and health promotion

Overview of proposals and policies

£300 million over three years to connect housing with health and care, and new supported housing, that includes:

• boosting supply of specialist housing and funding improved services
• Integrated Care Partnerships to drive integration of housing within health and care

£30 million for the Innovative Models of Care Programme to build the culture and capability for innovation, that includes:

• trailing and embedding new services to support prevention, reablement, unpaid carers, local community capacity, or outcomes-based commissioning
• supporting local authorities and partners to develop new models of care for people living in non-residential settings
• risk-sharing funding to local authorities to mitigate system change costs and to support providers to build capacity

New services to make minor repairs and changes in homes, alongside increase in upper limit of the Disabled Facilities Grant (DFG), that includes:

• increasing the amount the grant can pay for an individual adaptation
• reviewing allocation of DFG to local authorities
• considering how to align the DFG means test with the charging reforms

£210 million for the Care and Supported Specialised Housing Fund (CASSH) for 2022-23 to 2025-26, that includes:

• ensuring the CASSH is well targeted and easy to access and navigate
• funding local areas to modernise existing housing units

£150 million over three years to drive digitation and unlock care-tech across the sector.

Empowering those who draw on care, unpaid carers, and families

This priority covers proposals related to information and advice | GOV.UK, building on the Carers Action Plan, supporting economic participation of unpaid carers, and supporting employment for people with a learning disability or autism.  

Overview of proposals and policies

1. £5 million to test new ways to help people navigate adult social care systems through personalised advice.
2. National website explaining adult social care information and reforms.
3. £25 million to kick-start changes in services supporting unpaid carers. This includes testing a range of new and existing interventions for unpaid carers and exploring different models of respite and barriers to accessing these.
4. Obligation for Integrated Care Boards and NHS England to involve carers when commissioning care for the people they care for.
5. Department of Work and Pensions (DWP) to launch Local Supported Employment to identify how local authorities can support autistic people and people with a learning disability into employment.
6. Introduce a carer’s leave entitlement of 5 days unpaid leave per year for eligible employees.

Supporting local authorities to deliver social care reform and our vision

This priority covers how local authorities will commission and shape care markets | GOV.UK, engage in the development of a new assurance framework, adopt improvement approaches, engage in statutory interventions, and adopt new approaches to data collection and sharing. 

Overview of proposals and policies

From 2022 to 2025, £3.6 billion to reform social care charging and move towards paying providers a fair rate for care and prepare markets for implementing reform.

From 2022-23 to 2024-25, £70 million to ensure local authorities can deliver reforms, and improve market shaping and commissioning capabilities, that includes:

• a new ambition/vision for market shaping
• ways to strengthen market shaping capability

Introduce Care Quality Commission (CQC) assessment of local authority delivery of adult social care duties (under Part 1 of Care Act 2014), supported by an improvement offer that provides resources and bespoke support to local authorities.

Legal powers for Secretary of State to intervene to secure improvement where failings in discharge of adult social care functions (under Part 1 of Care Act 2014).

By Spring 2022, establish an adult social care data framework to improve quality and availability of data nationally and locally, that includes:

• updating the Adult Social Care Outcomes Framework
• transitioning from aggregate to (anonymised) client-level data
• agreeing a core provider data set

A strategy for the social care workforce

This priority covers proposals related to workforce development | GOV.UK and wellbeing. 

Overview of proposals and policies

The strategy is based on a £250 million (reduced from £500 million) investment over three years that includes:

• a Knowledge and Skills framework, career pathways, and supporting progression for care workers and registered managers
• funding for Care Certificates and a care standard to improve the portability of Care Certificates
• continuous professional development budgets for registered nurses, nursing associates, occupational therapists, and other allied health professionals
• investment in social worker training routes
• wellbeing and mental health support to improve access to occupational health
• a digital hub for the workforce to access support, information and advice, and a portable record of learning and development
• policies to identify local best recruitment practices
• new national and local policies to ensure consistent implementation of this strategy and higher standards of employment 

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Further information

You can read the full version of the white paper | GOV.UK or contact ASC Personalisation with any queries you may have.

Read more about the proposals and responses to them from relevant national bodies:

• Local Government Association
• ADASS
• The King's Fund

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