‘Councils should start tackling discrimination against self-funders before the Care Act forces them to’

The Care Act will require councils to improve their support to self-funders, who currently substantially subsiside state-funded care, says Ray Hart

Picture posed by model (Credit: Bill Truslow/Rex Features)

By Ray Hart, managing director, Valuing Care

The Care Act 2014 places new responsibilities on local authorities to act on behalf of people who are expected to self-fund their own care – a group historically neglected by councils.

From April 2015, councils will come under a duty to provide information and advice to people in their areas to enable them to plan for their care and support, including in relation to how they can benefit from independent financial advice.

A year later, the cap on care costs will come into force, enabling self-funders to receive state-funded care and support after accruing a certain level of cost, as measured by what the local authority would have spent on meeting their needs, calculated through regular assessments.

At the same time, in April 2016, councils will come under a duty to arrange residential care for people who are not eligible for any financial support from their authority but ask the council to make arrangements for them. This duty comes into force a year earlier – in April 2015 – for non-residential care, though its biggest impact will be in the residential sector.

It seems the most relevant information a local authority could provide to its citizens, under the information and advice duty, are the rates at which the council can procure services for them – which is often substantially less than what a self-funder would have to pay. This information will become available to anyone assessed for the cap in any case from April 2016. And the duty on the council to arrange care, regardless of a person’s financial status,will give self-funders the power to have care arranged at council-procured prices, in return for an administration fee. This could potentially save people hundreds of pounds a week in care home fees.

The cost survey and negotiations service undertaken by Valuing Care for councils has highlighted self-funders who arrange and pay for care themselves, with no or little state support, pay a far higher price for a service than their local authority pays for the same service.

This may be a known fact in the market but the evidence from these cases is that this goes way above the expected 10% additional costs attributed to dealing with a number of single individuals compared to one council. Price discrimination between rates offered to councils and those offered to private citizens sometimes rises to 50% more for the same care.

For example, Valuing Care recently heard of an example of a person funded by a council in a care home at £650 per week. When the older person’s home was sold and they had sufficient means to pay for their own care, they became a self-funder charged £1,050 per week for exactly the same bed and facilities.

The local government funding squeeze has exacerbated the problem as councils choosing not to inflate their fees has encouraged providers to apply above-inflation increases to their self-funding residents who are signed up to the providers contract, under which they have limited or no protection.

The reforms coming into force in April 2016 – the care cap and the duty to arrange care for self-funders – create a ticking time bomb for authorities that would be better defused now. For councils that are prepared to grasp the nettle there are options to deal with the market issues. These include:

  • Conducting their own validations of Older People’s residential costs to get to the bottom of the problem and increase transparency.
  • Providing information and advice lines that provide much more than general signposting and support services.
  • Market managing current vacancy rates and mapping supply to the needs of individuals.
  • Providing direct advice and support on how to get the best price for their care, not just how to best fund it.
  • Providing simple contract support for self-funders through standard contracts.
  • Providing readily available and competitively priced alternative support packages in the community through proactive contract management.
  • Brokering preferred supply deals for self-funders with willing providers.

Acting in the financial interest of self-funders requires a significant change of thinking within councils who have historically overlooked their financial interests, whilst at the same time benefitting from the cross subsidisation of council funded residents. Councils embracing the new act should be recognising the enormous financial benefit they may be to their self-funding residents, and putting in place the necessary systems and processes to act on their behalf. It will be interesting to see which councils are ready and willing!

Ray Hart is managing director of Valuing Care, a company that analyses and negotiates care home fees on behalf of councils and self-funders.

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4 Responses to ‘Councils should start tackling discrimination against self-funders before the Care Act forces them to’

  1. Yvonne Bon if as December 10, 2014 at 5:38 pm #

    Vested interests here?

  2. Mark Highfield December 11, 2014 at 12:51 pm #

    And central government should stop cutting Local Authority budgets, but they don’t!!

    • valma james December 12, 2014 at 9:09 am #

      Self funders have been at a disadvantage only because they have the ability to pay, however what has been missing in their journey is the necessary support information.Regarding- how to access residential and community support or having the opportunity to discuss with someone independent of the social worker ideas on options for providing care in the community. This discussion and support should be during hospital admission – nursing staff need to integrate the carer’s needs in the hospital discharge plan and process, which can identify any circumstances in which will impact on hospital discharge,such as the carers health, whether the carer is employed or has additional caring responsibilities such as parental responsibilities or caring for another dependent. Equally identifying what local community support services are available, such as day centres, social clubs, or residential homes that can provide reqular respite or flexible day support. ( Example : Fremantle Trust, that provides flexible day support and respite.
      GP practices have an essential role in developing information in their practice about community care support services, even to the extent of employing a support worker/advice worker or social worker. Residential homes should be recognised as a community support resource that can offer respite, day support services , rehab and outreach support services
      Whilst working in the capacity as a Hospital Discharge Co-ordinator, I developed an integrated approach for improving the quality of support for carers/care recipient through contributing to reducing hospital delay and re-admission, through identifying and reducing anxieties for carers, associated with the transition of the care recipient into the community. ” What they do not know they cannot act on -some need more help then others”

      Valma James

  3. Neil Clarke December 15, 2014 at 9:49 am #

    A number of local authorities do seek to assist self funders in the market. There is a self interest in doing so as fewer people will run out of funds and seek L.A. funding. Homes – especially in my experience when part of large concerns – are often unhelpful. Vulnerable families are frequently asked to divulge financial information before a placement will be offered. Top up payments are then manipulated and increased – notably when a property has been sold. Local authorities need tighter contracts and monitoring to avoid this manipulation.