Revised Autism Strategy and what this means for Adult Social Care

In this article, Melissa McAuliffe, Asperger's specialist social worker for the NHS, explores the revised Autism Strategy and how this links with the recent Care Act 2014. Melissa discusses these areas in light of the current political climate and suggests ways social care practitioners, managers and commissioners should be focusing their efforts at this time of unprecedented financial strain. 

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Revised Autism Strategy and what this means for Adult Social Care 

In 2009 the Autism Act placed “a duty on the Secretary of State for Health to prepare and publish a strategy for meeting the needs of adults with autism in England by improving the provision of relevant services to such adults by local authorities and NHS bodies”[1]. An update to this strategy, Think Autism, was published in April 2014. The Revised Autism Strategy was produced following a consultation on the Think Autism document.

What does this mean for Adult Social Care?
I was going to write about the key messages in the revised strategy and give an overview. However, the documents are very clear that the vision of the original strategy has not changed, and that the purpose of the revision is to clarify and highlight key elements. I would instead prefer to focus on how this strategy ties into the Care Act 2014, the current political climate, and the areas that I think social care should focus on.
The Care Act 2014 has made the greatest changes to Social Care in 60 years.  It has tried to clean up all of the patchwork of legislation that social care practitioners had to integrate into their work.

The Care Act has a clear ideological bent to it and this is to provide low level, early support in order to avoid people going into crises that result in long-term, high cost support. There is also a clear drive to support Carers and gives them equal entitlement to assessment. This is in order to assist them to continue caring, thereby reducing the likelihood of family breakdown and 'service users' needing costly placements. There is acknowledgement that there will be certain groups where this is unavoidable. 
Prevention is a key aspect of the Care Act, and also in the Revised Strategy. There is a clear and definitive shift in the Care Act that focuses on well-being and making sure that people do not have to hit a crisis before getting services. This preventative focus ties in well with the improved pathways for people to receive a diagnosis of autism. The Revised Strategy places the onus on Care Commissioning Groups (CCGs) to provide a funded diagnostic pathway. However, the more people diagnosed, the more people will seek assessment of their social care needs. A properly resourced clear pathway is essential to early recognition, enabling preventative strategies to be implemented.
Another key area of change to the Care Act - which has been reflected in the Revised Strategy, is an improved legal framework, with clearer outcomes and processes related to Safeguarding. This aims to achieve a process-led system that aligns itself with the person at risk’s wishes, allowing for more positive risk taking. It also looks at better outcomes, rather than a ‘tick-box’ exercise where little is achieved. Carers also have their own rights in relation to being at risk by the person that they care for. 
I believe that these are the two areas that Adult Social Care practitioners, managers and commissioners should be focusing on, particularly as we are likely to be facing 5 years of cuts to services. 
Between 2010/11 and 2015-16 councils have suffered a 37% cut in funding. These reductions have not affected each council equally, with those in the most deprived authorities receiving the greatest reductions.[2]  By the end of this year “local councils face a shortfall of £5bn, £1.9bn of which is in adult social care” according to the Local Government Association.[3]  In these times of severe cuts to an already fragile social care system (and a diminished health system- particularly in Mental Health) we need to focus energies and resources on prevention to make more effective use of limited resources. 
The Revised Strategy makes a call to improve and strengthen local autism partnership arrangements. There is information available on planning and commissioning effectively for people with autism, and this will be supplemented with future guidance. There is a call to consider the needs of specific groups, e.g. older adults with autism and those from BAME communities. The development of local planning and leadership will have a great effect on what care and support services are available in each locality. These arrangements need to look at how to best manage reduced budgets and need to have a focus on the fact that autism is a lifelong condition and ongoing low level support is often the best prevention. This should create better long-term outcomes and improved mental health thereby minimising anxiety and frustration.     
Overall I welcome the fact that autism is remaining on the government’s change agenda and that this is being periodically revised and updated. These suggestions then need to be filtered out to social care staff across teams to ensure that these changes are implemented concurrently with other adult social care policy and legislation.
[1] “The Government response to the consultation on revised statutory guidance to implement the Strategy for Adults with Autism in English”.  Department of Health.  March 2015.  p. 3
[2] “Social care funding in a ‘ridiculous situation says LGA head”. Frances Perraudin.  Guardian newspaper.  28.01.15.
[3] Independent on Sunday.  17.05.15

Author: Melissa McAuliffe

Date added: 22 June 2015