The Local Government Association has called for an overhaul in the system of determining eligibility for care ahead of the forthcoming adult social care green paper.
In a discussion paper, the LGA called for the fair access to care services (FACS) guidance on eligibility to be scrapped and current means-testing arrangements to be reformed to bring many more people into the public social care system.
Currently three-quarters of English councils set their eligibility thresholds at the level of ‘critical’ or ‘substantial’ needs, excluding people with ‘low’ or ‘moderate’ needs from direct support and funding for care.
‘Unacceptably high’ number receive no services
Though the LGA pointed out that councils spent money on people with lower-level needs, for instance through grants to charities, it said an “unacceptably high” number of people with support needs received no services.
It called for FACS to be replaced by a two-tier system:-
- A lower tier where people with lower-level needs would receive information, advice and practical support to help maintain their independence. While this would mostly be free, some services, such as meals or gardening, could be charged for.
- An upper tier covering people with needs at or above the upper end of the ‘moderate’ FACS threshold. On top of services provided in the lower tier, they would receive means-tested access to funding for care.
Single portable assessment
It also called for people to have a single assessment of needs and means, which would be portable from area to area, ending the situation in which service users face new assessments whenever they move.
On means-testing, the LGA also called for the upper savings threshold for residential care to be raised from £23,000 to at least £45,000, making many more people with moderate wealth eligible for public funds.
It also called for the current personal £21.90 weekly expenses allowance for publicly-funded care home residents to be raised to ensure they receive a “reasonable income”.
Local variation supported
However, the LGA also said councils should be able spend different amounts of money on care users with similar needs, in accordance with local circumstances and care market costs.
The paper said: “If a person did move, although their needs might be the same, their circumstances would be radically different; input from family and friends would vary, for example, as would the specific conditions between cities, towns and rural areas. One could not expect, therefore, to receive the same service in Cornwall as in Camden.”
The green paper, which will propose options for reforming the funding system in England, is due to be published this month.