The Commission for Social Care Inspection will formally launch its review of adult services eligibility criteria on 1 April (I don't know if that's significant or not!). This was sparked by its third state of social care report, which outlined a two-tier care system with a good level of service for those who received care managed services from councils and a poorer picture for those excluded, either on grounds of means or those of need.

The Association of Directors of Adult Social Services is suggesting the current fair access to care services guidance - under which eligibility thresholds are determined - is not fit for the new world of personalised care. Specifically it only focuses on what councils provide for the minority of disabled and older people receiving care managed services, not the broader range of social inclusion services designed to serve a broader range of people.

Should the FACS guidance be totally scrapped or can it still be reformed to cater for the new world?

I agree that the review of eligibility will only seek to look at care funding and not at the wider social exclusion agenda.  This is distinctly unfortunate and will only lead to a need for a further review at some indeterminate point in the future. This is because one cannot divorce care and other funding - such as supporting people, and because of this often neglected aspect.

If in simple overview the problem with care eligibility is that the four levels of care funding have - by virtue of lack of resources - become that only top two levels of care have been funded then one cannot ignore what has happened to other funding streams for vulnerable people and especially in SP.  Note that both are often administered by the same social services departments in councils.

These departments see the three levls of support funding in SP(call then low medium and high) as a lower form of care funding giving 7 levels of support and care funding.  Critically these are often perceived as a continuum as follows:

Level 1 - low level SP; Level 2 - medium level SP; Level 3 - high level SP; Level 4 = level 1 care - right through to Level 7 being critical level of care.

What has transpired in SP is that move high level SP funding has disappeared (Level 3 in continuum).  In care levels 4,5 and in some case 6 of this continuum has not been funded.

Hence we see vulnerable service users in level 3,4,5 and 6 often now receiving no funding and falling into a great big black hole as only the lowest levels of SP support is funded and only the highest level of care being funded.  What happens to the poor buggers in the middle?  Aside from the morality of this occurring, in financial terms this just defers the support and care needs of vulnerable people for a later date and also- through receiving no care or support - tends to increase the severity of the actual care and support need of vulnerable people.  In the end this is going to cost much more and until we recognise that point will only place even greater pressures on existing care funding resources within councils.

Is it easier for CSCI to claim that this inextricably linked issue is outside of their parameters for review?  Or should they look at this existing problem as part of the outcome of that review?  The latter obviously but I doubt this will happen