On 11/07/12 the government announced the contents of its White Paper on social care. The ideas presented are proposals – nothing is expected to happen until at least 2015. But what does it mean for you?
In the short term, it means very little. And, of course, no matter what these proposals say, remember that social care is still social care (not nursing care).
Social care is assessed and funded differently to health/nursing care. So these new social care proposals do not change the fact that the NHS still has a legal duty to provide care for health needs and nursing care – through free Continuing Healthcare funding.
Back to the White Paper on social care… The proposals include:
- A statutory framework for safeguarding adults – to allow greater intervention and review in cases of neglect and abuse.
- The outsourced of community care assessments and care management to organisations outside the local council.
- New national minimum assessment and eligibility thresholds for social care – across England – so if you move from one local authority area to another, you don’t have to go through the whole assessment process again.
- Ongoing plans to bring in personal budgets by April 2013 for those who want them.
- A new eligibility threshold for support for carers; currently, unpaid carers save the government around £120bn/year.
- A new duty for councils to provide proper information on care and support, including online information services.
- Free social care to people who are dying and on end-of-life registers. This one is interesting… and is surely a contradiction in itself! If you’re on an end-of-life ‘pathway’ you’re likely to have a primary health need, so you shouldn’t be paying for care anyway. By describing ‘end-of-life’ care as ‘social’ care, the government would seem to be further perpetuating the myth that you always have to pay for care. It is proposing an assessment process that is already in place. Elderly people in full-time care and receiving end-of-life care should be assessed for free NHS Continuing Care using the Fast Track Assessment Tool.
- An end to ‘care by the minute’ which is so ineffective in providing any meaningful home care.
- More structured ‘ratings’ for care providers, so it’s easier to see their credentials and how they perform. The Care Quality Commission has failed miserably in assessing care homes effectively, so it will be interesting to see if this new idea actually has any teeth.
- Minimum training standards and an updated code of conduct for adult social care workers. It seems staggering that universal minimum training standards are not in place already.
The gaping hole that most people have identified in the White Paper though is any concrete proposals about how to prevent elderly people losing their homes to pay for care.
Andrew Dilnot in 2010 proposed that a cap could be put on the lifetime costs that anyone has to pay for care – and he suggested somewhere between £25k and £50k. The State would cover the remaining costs of care after this, and a cap of £35k would cost it less than £2bn.
And yet the new White Paper fails to put any concrete proposals forward on this, except that the cap could potentially be set as high as £100k.
Another suggestion is that care costs would only be capped if an individual chose to pay the government an insurance premium upfront.
But what if you don’t have any liquid savings and all your money is in your house? There’s a suggestion that you could avoid selling your home by taking out a loan from the local council to pay for care under a new Universal Deferred Payment Scheme. However, it would all have to be paid back (with interest) when you die – so your estate ends up losing your home anyway.
Interest-free Deferred Payment Schemes already exist – but local authorities are often reluctant to actually use them.
The government talks about £100k of care costs for an individual as “catastrophic”, but £100k covers only 3-4 years in a care home – which is the average length of stay anyway. It certainly is catastrophic for the individual concerned, something successive governments seem to continually brush under the carpet.
Regardless of what the new proposals say, nothing has changed for the moment. And, remember, they are about social care, not nursing care. If you have an elderly relative in care and paying care fees, be sure to get an assessment for free NHS Continuing Healthcare.