The government must set its national minimum threshold for care at the 'moderate' level to prevent hundreds of thousands of people going without the support they need, despite a price tag of over £2bn a year.
That was the message from a group of disability charities today as they released research on the costs of implementing a national threshold at the 'moderate' Fair Access to Care Services (FACS) band and the impact on disabled people's lives of the higher eligibility thresholds in place across most of the country.
The paper, The other care crisis, from Scope, Mencap, Sense, Leonard Cheshire Disability and National Autistic Society, is designed to influence the government's plan to introduce a national minimum eligibility threshold through the Care and Support Bill, which is currently in draft form.
What does the 'moderate' threshold mean?
Councils who set their social care threshold at 'moderate' should provide services to meet people's needs where:
- they are or will be unable to carry out several personal care tasks and/or;
- involvement in several aspects of work or education cannot or will not be sustained and/or;
- several social support systems and relationships cannot or will not be sustained and/or;
- several family and other social roles and responsibilities cannot or will not be undertaken.
Source: Prioritising Need in the context of Putting People First
Substantial threshold likely
The government's costings point to the threshold being introduced at the current 'substantial' FACS threshold, which applies in 80% of local authorities in England. Last week, Association of Directors of Adult Social Services said it was "highly likely" that the threshold would be 'substantial', in evidence to the committee scrutinising the draft Care and Support Bill.
However, the charities warned that a substantial threshold would be a "serious mistake" that would leave many disabled people without the support they needed to live with dignity and contribute to society, drive some into debt and increase pressures on family carers and the NHS.
A survey of 619 disabled people aged 18-64, conducted last summer by Scope, found that 36% were unable to eat, wash dress or get out of the house because of a lack of care and support. Of respondents who had been assessed by their council as having 'moderate' needs, 41% said social care services did not meet their basic needs, compared with 18% of those assessed by councils as having 'substantial' needs.
"It is absolutely appalling that this is the sad reality of life for thousands of Britain's disabled people," said Scope chief executive Richard Hawkes. "We cannot bury our heads in the sand any longer and ignore the desperate situation disabled people find themselves in without help in their day-to-day lives. We need an urgent and long-term solution from the government to lift disabled people out of a life without basic support for the daily tasks that everyone else takes for granted."
A nationwide 'moderate' threshold would have provided state-funded care to an additional 260,000 people at a net cost of £2.8bn a year in 2010-11, found separate research published today by the Personal Social Services Research Unit at the London School of Economics, commissioned by Scope. This includes 76,000 disabled adults aged 18-64, at a cost of £0.8bn a year, and 184,000 older people, at a cost of £1.2bn a year; by 2020 the total additional cost would be £2.8bn a year.
The draft Care and Support Bill is designed to engineer a shift in the social care system from a service that responds only in a crisis to one that supported people with emerging needs to prevent these from deteriorating. However, the charities' report warned that a 'substantial' threshold would maintain a crisis-driven service that intervened too late to support people.
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