CASCAIDr Year In Review 2022

CASCAIDr’s annual review for 2022

2022 was ‘make’ or ‘break’ time for CASCAIDr after 2 years of coping with the impact of Covid on donations, our workforce, and social care law itself.

Several care provider businesses in the sector were sufficiently engaged with our aims, and generous to finance our employing an operations manager, each for a single month. We hit upon converting someone who’d worked long and hard as a self-employed IT contractor for us, INTO that operations manager: someone who already ‘got’ what we do, and what we need to do! We committed to a 2 year contract for him, on the footing that proper management would mean we could re-open to chargeable work again. In turn, this would mean that we could build our finances back up after Covid, instead of surviving on thin air – just doing Triage for people, through nothing more than our CEO’s legal acumen and mostly unpaid time.

In the Spring, the first green shoots poked through in the shape of the NHS Improvement arm trusting our Trading Company with a large contract for ‘Advocacy Plus’. This was for input to Care and Treatment Reviews for people detained under the Mental Health Act, a form of guided professional decision-making process, where grasp of the legal framework for aftercare, housing, public law and the Care Act can make an enormous difference to the patient’s and family’s future services. It wasn’t easy to find people for that contract at the right time, given how the NHS works and how psychiatric hospitals function, but it meant that we were assured of sufficient margin to honour the second year of the commitment to the Operations Manager.  And we were able to take on a well-paid review of a council’s direct payment policy and processes, again through the Trading Company. These activities meant we even had to apply for VAT exemption for the Trading Company – the outcome of which we are still waiting to be told, somewhat unbelievably, 6 months later!

That safety net gave us the courage to start looking for other financial support and for people with the skills to do what needs to be done. That’s always been a challenge – we think because lawyers who are good at community care law not unreasonably want long term job security and partnership prospects – or a premium locum fee, or an advisory only job that finishes at 5.30pm – those features only being available in legal aid law firms and local councils’ legal departments, respectively. It is our CEO’s firm view that the area of expertise has withered away to virtually nothing, simply because there aren’t wide enough career prospects arising from it these days, to make it worth learning about. And that’s why it’s been a founding principle of this Charity that we have to be able to PAY people a decent salary or fee, in return for their professional skill.

How can there be insufficient career prospects, you may well ask, given that legal rights to care are honoured by councils more in the breach than in the observance, these days, and complaints to the ombudsman are running at an all-time high, without even the Care Act easements for hiding behind? It is a fascinating example of economic truth, come home to roost, to our CEO’s mind: if it doesn’t MAKE PROFIT, law firms won’t do it, and they’re not obliged to, even if they have a community care legal aid contract, and therefore won’t resource this area of work if nobody on the other side is making them. It’s such grindingly difficult work, and it requires proper supervision, which costs the firm too much. Who’d want to work on emotionally draining subject-matter, in those conditions?

RE-OPENING AND EXPANDING ONCE AGAIN

So in the Summer, we did what we’d planned, and turned some of last year’s Legal Framework Course graduates into Triage team members, caseworkers, advocates and writers-up of our ombudsman report analyses. And that’s gone well and meant that we could commit to our CEO running another year’s worth of courses – one for professionals and one for the public, mainly family carers, all over again. We added two short courses too – one on ‘Getting Your Direct Payment UP’, and another on ‘Challenging Your Financial Assessment’.  This brought in more income and will hopefully spawn more people with the acumen and appetite to use law to help others to enforce their legal rights.

We invited one of these fantastic people to manage the production of a fortnightly Round-Up, which we’ve made a little income from too, at his own suggestion – it is only £50 per YEAR, but it has found its niche between more broadly local government legal round-ups and more specialist mental capacity ones – which is perfect for our aims and output. It covers all things related to the Care Act, to remind people that the Act still exists, and must be complied with! It’s written for ordinary people and those who work in the sector – whether that be within the NHS, councils, care and support provision or regulation.

In the Autumn, our CEO gave evidence to the House of Lords’ Adult Social Care Committee, on the invisibility of adult social care. The report came out with a different focus – ‘A Gloriously Ordinary Life’ – taken from one of the other witnesses’ telling evidence to the effect that delivering that ambition for disabled people should be the whole purpose of the Care Act. Our CEO also gave evidence to the ECHR’s research team on the drawbacks of current routes to challenge social care decisions by councils, and we’re sure that CASCAIDr will build on the conclusions of that project in its own work.

FINANCES

The charity has finally begun to attract grants, too, after 5 years of trying and failing, for reasons we could only put down to being too young or too ‘edgy’. If one offers advocacy, it’s easy to get grant funding, it seems; whereas if one offers legal advice to enforce people’s rights, one is setting one’s stall out with a very different ‘tone’ to it – and that hadn’t attracted funding, to date, and there was never any feedback from funders.

But this year we received a Lottery grant for an advocacy outreach project, focused on people excluded from services in London, and a massive grant for simple survival purposes, from the Ministry of Justice – just in time to avoid being part of the implosion and collapse of the wider welfare advice sector.

We’ve used the MoJ money to advertise ‘proper’ jobs at competitive salaries, thinking that that would be enough to seduce at least one more person with real legal skills and knowledge to join our senior team and manage our output, to deliver on our charitable objectives AND expand our chargeable work once again. Not a single lawyer applied, but we did secure interest from two brilliant people whose lengthy and practical experience in the sector is perfect for the organisation, and we found more contractors to take on for casework, with experience of helping particular client groups, such as elderly people or young people with learning disability and autism.

And we’ve welcomed at least 3-5 law students to the fold, from University College, London University, for volunteering, to expand our writing team’s output, and thus ensure that that important Care Act Round-Up comes out on time, every fortnight.

IMPACT

Readers with an eye on reform – the care charges cap, etc, will have spotted that the government has put that off again, to a date well after the next election. We spent an inordinate amount of time discussing with the Trailblazers, the DHSC and other stakeholders, innovative means of helping councils get through the additional assessments and workload that that radical reform would have engendered. But it all came to nought, after the government regrouped, in the wake of the mini-budget, and deferred the proposals to 2025.

To top it all off, in the last few days of December, we were awarded a licence enabling us to go directly to barristers on what is called Direct Professional Access. This means that we have the right to go members of the Bar, without engaging a solicitor, so we do not need to use law firms for instructing barristers to write important and wide-ranging opinions.

We can use those opinions either for publication so that the whole country can grasp which are the social care legal points that are already CLEAR, and which are the points that are NOT, in terms of public law. Individuals can also use those opinions to crowd-fund for legal help from a law firm, or if they qualify for the means-tested funding needed for judicial review, they could take the opinions to legal aid law firms to get over the hurdle of the law firms’ seemingly firmly shut front doors.

We are determined to take the fight TO local authorities through use of this licence – so if you know a barrister with big brains and a social conscience, please send them our way. We are going to be ‘reverse auctioning’ the topics to find out who’d like to work with us to put social care law back into central government’s consciousness, as well as that of the public!

Has it been a good year for CASCAIDr coups for the clients of all this effort, regarding shifting councils’ positions from their starting points?

We find it hard to tell. Of course we have had successes for individual people, and generally great feedback from people who cannot quite believe that they can GET actual expert help for free, or a low-cost charge. But there is no doubt in our minds that people working in the sector are less and less minded to abide by the Care Act, given that their organisational workforce issues are still unresolved and everyone AT work is doing 2-3 serious jobs. Then there is the high profile shortage of people interested in working in frontline care itself – which does rather raise the question what good is a legal right to care, if there’s nobody willing to do it? And no money to raise the fees that might attract people back into it, or more businesses back into thinking that the competition for local authority work is even worth the candle? We do not think that it is a mere coincidence that 2022 was the year when health and social care was supposed to start functioning in a genuinely integrated way through the conversion of CCGs into ICBs, and the whole health and care economy into integrated care systems. The only ‘right’ to services from the NHS is a right to what a Health body is minded to afford or can otherwise manage to deliver on the day – and our CEO’s view is that that will also become the fate of that precious, absolute and individually enforceable right to have one’s eligible unmet needs, met by the State.

CONCLUSIONS

The dawning of 2023 therefore sees CASCAIDr in a good financial position, but in a time of rapid re-expansion on the personnel front, whilst we have got the money, in order to generate income, before the grants run out, and at a critical point for the survival and the evolution of social care law itself.

This means we are still relying on part timers and self-employed contractors; still needing to spend a lot of time supervising and quality-controlling the output, still needing to fundraise – and still needing to explain to people that there’s hardly any firms taking social services cases (even the strong ones) – any further forward.

Any charity which gives and sells advice to people – people who almost by definition, will not have the money to pay for what it really costs, is under constant pressure to be all things to all people. It must be decisive as to what it really can or cannot achieve, in our view. Our model has always combined chargeable work and services with our charitable public benefit work. We have developed a combination of plans for increasing public awareness and managing the consequential increasing throughput of people needing advice, categorising their needs as either for basic information, or something more sophisticated. This will enable us to continue our output, whilst still not having clear or certain income streams to offer real job security for any more highly qualified staff. We think that this is the best way to hit three elements of our business plan: to get more grant-funding, to work more efficiently, whilst skilling up anyone willing to work for, or with us, and building our charging model back up again, so as to remain independent of grant funding in the longer term.

At the end of this critical year for CASCAIDr, the whole team and our CEO’s efforts were acknowledged by the award of ‘Change Agent’ for Belinda Schwehr, in the Women Achieving Greatness in Social Care Awards – the nomination for which our CEO was touched and delighted, and felt hugely honoured to win.

OUR FUTURE PLANS

So in what will be our CEO’s final year of running CASCAIDr, now she has done what she said she would do, these are our ambitions for 2023.

The unifying theme behind all of this is our intention to focus on accountability for anyone who is paid public money for making decisions about people’s care and support. That is a concept which is almost entirely absent from the public sector cultures in which we do our work, in our experience.

• We’re going to start podcasting about the most common issues which CASCAIDr’s referrals process has brought in, over the last year, and what we think about them. These podcasts will be free to all, to raise the profile of the body of principles which exists to protect disabled and elderly people from an unacceptable quality of life, in this country.
• We’re re-working our website, in part, to make a 20 year old database of case law and commentary into a central and free part of our site’s architecture and offering – the purpose being to increase the chances of keeping adult social care law and legal principle alive and kicking, and accessible to all who care to look…
• We will provide a referenced commentary on the Care Act Guidance, in order to make it unavoidably clear that it is worded less than helpfully, in places, somehow obscuring the fact that the Guidance is subject to decided case law – and of legal significance, in and of itself. Alongside this will be an FAQ page, where people can post brief questions instead of making referrals. As that library builds up, it will be a freely accessible way in to the deeper database – we get that one cannot navigate a database, unless one knows what to look for in the first place!
• We’re creating conditional logic forms to help people identify whether they themselves NEED to and CAN push for a reconsideration of an assessment, care plan or revision decision in draft, from their council or ICB – maybe with the help of a self-directed set of templates – or go find some other sort of organisation entirely, or make a proper and now likely better organised referral to CASCAIDr’s Triage team or a CASCAIDr caseworker. This is going to help US function more efficiently, and hopefully kickstart the better flow of basic level advice and information from the sector out to the public.
• We’ll be offering specific issue-related mental capacity assessments for anyone who wants one through an independent team of qualified assessors, without the need to charge for VAT, on top, given our charitable status and the welfare exemption. This will make such processes available for £250 rather than the usual £350 or more.
• We’re hoping to provide consultancy and materials to organisations like Research in Practice and Independent Age – as we become a better known centre of in-depth expertise, to support stronger and more effective practice.
• We’re going to offer practising barristers the opportunity to create a library of legal opinion about those common issues, taking the most controversial or moot points that have never gone to court – so as to widen the quality of debate amongst senior management in councils, their own local authority lawyers, and young lawyers working in legal aid law firms, some struggling without sufficient supervision ever to get those points litigated, productively.
• We’re going to crowd-fund for money in our own name, which will attract Gift Aid and another 25% from the government, so as to match the money we spend from our reserves on getting those opinions from barristers, and advertise for test cases.
• We’ll be offering private legal framework advocacy for supporting people at online meetings, so that the chances of wool being pulled over their eyes is reduced – that work must be charged for, but it will only be £50 per hour.
• We’ll offer more proactive outreach to service user and peer support / family carers’ groups by way of training and networking now that we can provide recordings on all community care legal topics at a very low cost.
• We’re planning on running another series of 4-session evening courses for members of the public over two 6 week periods – the topics being What’s Wrong with Your Care and Support Plan?, and one on Transition (from children’s services, education and NHS continuing care) to Adults’ Services and Supported Living.
• We’ll be finishing off the NHS contract by expanding our role into the situations faced by people with autism and learning disability or mental health issues BEFORE they’ve been detained, rather than for aftercare purposes.
• We’re putting a lot of effort into offering an evolved form of training courses for councils and ICBs and NHS England, about social care law, now we can use Vitrium for the presentation and safe-keeping of our intensively knowledge-based materials, which are like small books, on any given topic. By ‘evolved’, we mean we’re going to focus on selling Q&A sessions AFTER staff have listened to a recorded lecture with a powerpoint. These sessions will remind councils of classic Care Act Principles, but allow exploration as to how they apply, which we believe to be timely, given this is the year when the CQC has been handed the challenging task of ‘assuring’ local authorities’ performance. If Covid has done nothing else of value, it has turned Legal Framework training into a topic for online delivery, which makes it more affordable AND less of a strain on the few remaining trainers operating in the field.
• We hope to work with BASW, to train independent assessors and refresh the Care Act credentials of social workers, if the DHSC ADASS and the LGA decide to get behind a generic Care Act qualification, for coping with the demographic upswing that’s likely to last for another 10 years.
• We hope to provide consultancy through the Trading Company for the shaping of an e-learning course about human rights, public law, and mental health aftercare planning law, through work for HEE and NHSE.
• We intend to approach JUCSWEC about creating a review tool for course materials and a content list, along with updates of new learning to include each semester for institutions offering social work degrees.
• We hope to outsource administrative and ‘charging and DRE challenges’ work to staff in South Africa, because of the savings that would make for us, without it actually counting as modern slavery. It would keep willing and well-qualified graduates in a good and well-paid job, by their own country’s standards. We hope to do this in partnership with this country’s largest provider of professional appointeeship services.
• We’re going to seek MORE grant funding, if we conceivably CAN, to offer proper long term jobs to people with legal knowledge and experience of applying Care Act law.
• We will try to work in partnership with the Law Centres Foundation, to offer secondment opportunities to Law Centres who can see the benefit of some intense exposure for young lawyers or advice workers to our daily diet of referrals.

So now we have said it, we’ve just got to get on with doing all of that, in 2023! 😊