By Pete Feldon
The Conservatives’ headline-grabbing manifesto proposal to reform social care and the subsequent ‘clarification’ of it has certainly got many people thinking about how care could or should be paid for.
This could lead to an upsurge in demand for information and advice from local authorities in the short-term, but it also provides an opportunity to engage the public in a wider debate about the impact of these proposals.
The Conservatives have proposed that where a local authority has decided to meet an individual’s care and support needs at home, the individual would have to pay the full cost where the value of their total assets exceeds £100,000. The same threshold would apply for those having their needs met in residential care. Where an individual owned a property this would be taken into account, but it would not have to be sold in their lifetime. In addition it has been ‘clarified’ that there would be a cap (an upper limit) on the total amount that an individual would have to pay towards their care costs.
It’s good news for people with care and support needs that the proposals will include this cap. If the cap were to be implemented in the way set out in the Care Act 2014 and its accompanying statutory guidance, then self-funders would have a financial incentive to seek a needs assessment from the local authority as this would be the gateway to having their care costs capped.
Staffing numbers challenge
However, whilst social workers will be pleased that self-funders would benefit from a professional assessment – because this means that they are more likely to make decisions that prevent, reduce or delay their needs for care – there would be a challenge for local authorities in ensuring that sufficient staff were available to respond to the increase in the volume of assessments.
The proposed changes to the means-testing threshold for people living at home means that a large number of existing council-funded service users would become self-funders. These are people whose current non-housing assets are worth less than £23,250 but whose total assets (including housing) would take them over the £100,000 threshold.
In addition there would be a significant number of people who cease to be self-funders and become eligible for financial support, including:
- those receiving care at home who are living in rented accommodation and have savings between the current upper limit of £23,250 and the new limit of £100,000;
- those in residential care whose home is excluded for charging purposes and have assets between £23,250 and £100,000.
Where they have made their own arrangements for their care and support, they would want to find out if they qualify for financial assistance, and thus would require a needs assessment and all that is subsequently entailed if the local authority agrees to meet their needs.
More assessments required
The planned introduction of the Care Act capping arrangement was deferred to April 2020 from the original implementation date of April 2016. This was ostensibly so that the requirements of those who are self-funding residential care could be properly planned for and resourced. At whatever date were chosen for the introduction of a scheme of this nature, there would be a short-term surge in demand from those people who were already in residential care because expenditure that counts towards the cap commences from this date.
The large number of property owners who would become self-funders under the Tory proposals would not be presenting the same type of short-term challenge, as they would already be in the system and would have received an assessment and a care and support plan. The emphasis would be on financial reassessment and being considered for a deferred payments scheme. However, non-property owners who have made their own arrangements to have their needs met at home and who ceased to be self-funders would want to be assessed.
If these proposals were implemented there would be a period before and after the implementation date when there would need to be a significant short-term increase in the staff available to undertake these tasks. Much of the work could be routinised, but inevitably there would be a proportion of complex cases where it were essential that social workers have a lead role. There would need to be an increase in the number of social workers employed, both to take on the complex cases and be available to advise staff who were working with people whose circumstances are straightforward.
All this is in the future, and conditional on the Conservatives winning the election, but the high profile of this issue may mean that many people will want advice now about how to best manage their finances to pay for their care. Some people may worry about whether they can afford the care that they need, and there are those who will want to maximise the amount of their assets they can pass on to their children. Social workers will be familiar with the local authority duty to tell people how they can access independent financial advice, and should continue to provide this.
Ensuring that there is an incentive for self-funders with care and support needs to receive a professional assessment of their needs is a vital element of capping as set out in the Care Act. Let’s try and make sure that this happens.
Pete Feldon is the author of The Social Worker’s Guide to the Care Act 2014, published by Critical Publishing in May 2017. He is also the author of the A-Z of the Care Act 2014, which defines and explains the key terms used in the act and statutory guidance and is available on Community Care Inform Adults.