How will the care bill affect social care

The new legislation will bring huge changes, so it is important to be prepared for the forthcoming reforms to practice

‘Legislation changes of this magnitude do not happen often, so it is important that we take the time to engage with the reforms.’ Photograph: Christopher Thomond

The legislative framework for social care services in England has remained unchanged for the past 40 years. Back in 2003, Andrew Cozens, then president of the Association of Directors of Social Services, spoke of “the long shadow of the Poor Law that has remained over social care to its detriment – that long shadow brings with it the armoury of measures we are still familiar with: rationing, eligibility criteria and means testing to sort out the deserving from the undeserving.” The language enshrined in current acts describes disability in terms that are uncomfortable in today’s world.

However, welcome reform is on its way. Much of the legislation that has underpinned social care in England, including the Chronically Sick and Disabled Persons Act, will be repealed when the care bill goes onto the statute book in 2015. It will consolidate more than a dozen different laws into a single modern framework for care and support. Legislation changes of this magnitude do not happen often, so it is important that we take the time to engage with the reforms.

So what will this mean to service users and professionals working in social care, and what changes will practitioners need to make to their understanding of care and support provision? The social care workforce will need to adapt and work differently with healthcare, housing and other sectors. Practitioners will also need to recognise which legislation will remain intact throughout the reform, and exist alongside the new act.

Occupational therapists are a key part of the social care workforce, and the only allied health profession working in significant numbers in the social care sector. This is recognised in the bill, many parts of which have occupational therapy at its heart. One key change will be the new statutory principle of wellbeing; placing the wishes and goals of people at the centre of social care provision.

This marks a move towards more personalised care, where services are designed around the individual’s needs. Occupational therapists have unique skills in enabling and facilitating the activities, roles, routines that greatly improve a person’s quality of life. Whether it’s a leisure activity such as swimming, going shopping, walking the dog, returning to work or meeting friends – these are the things that matter to people and must be considered in effective care and support services.

The new legislation will also give people more choice and more control over their life with the extension of personal budgets. Increasingly, people will have the tools and information to make their own decisions, make the most of their strengths and abilities and feel part of the process, not separate from it. Helping people to focus on what they can do, instead of what they can’t is key to occupational therapists’ daily practice and must be integral to the assessment of need. There will also be statutory recognition for carers, who not only make a valuable contribution but have their own needs which must be considered.

At the College of Occupational Therapists, we also welcome the stronger focus on prevention; reducing the need for further support so that people can live independently for as long as possible. It is vital we think about preventative care, before it becomes crisis care. Preventing and enabling is a key part of the occupational therapist’s toolkit through which they facilitate rehabilitation, encourage self-management and work with community services. People with low and moderate needs can benefit from the right equipment, and they need to be able to access this quickly and easily.


The care bill is an opportunity for people in all sectors of social care to work together in a more collaborative way. It requires professionals to take some time to ensure that we are fully equipped, knowledgeable about the new legislation and prepared for changes in what to take account when assessing under the new act. Then we can take advantage of a new and improved framework of care and support – one that is fit for the 21st century.