Service restrictions leave older people stranded

Social care leaders are predicting a crisis in the provision of adult social care after exclusive research by Community Care  revealed increasing numbers of councils are being forced to restrict access to services.

Our survey of 75 local authorities, half of those providing social services in England, found 18% have raised their criteria in the last 18 months, due to increased budgetary pressures driven by mounting demand. A further 12% are reviewing their eligibility criteria for services and may raise them.

Overall, 72% of councils operate a “substantial” threshold – the second highest after “critical” – for services, according to the Fair Access to Care Services (FACS) system, excluding people with low or moderate needs.

Moderate needs are defined as an inability to carry out several personal care tasks, continue with aspects of work or education, or sustain several family or other social roles. Only 24% of councils operate “moderate” or “low” thresholds.

Essex Council leader Lord Hanningfield said: “The figures speak volumes and reflect what we are facing as a country: local authorities’ care budgets are significantly overstretched.

“We do not want to increase eligibility criteria; however, we have some incredibly difficult choices. With ever-growing numbers of elderly people with increasingly complex needs, combined with the government grant that has failed to match that spent on other key services, services for the elderly are now teetering on the brink.”

He warned that unless the government gave an adequate settlement for adult care in this autumn’s comprehensive spending review, which will set public expenditure limits from 2008-11, “we may soon reach crisis point”.

Andrew Cozens, strategic adviser at the Improvement and Development Agency, added: “The raising of the criteria sends a signal politically, to other agencies and to service users and carers, about hard times ahead.”

However, he added that raising criteria saved little money, as withdrawing or reducing services often exacerbated need, making more people eligible at higher thresholds.

Barbara McIntosh, co-director of the Foundation for People with Learning Disabilities, said she was “very concerned” about the trend and its impact on more able people with learning disabilities. She added: “This group may only need a small amount of support but without this they can be at risk.”

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Are councils to blame for increased eligibility criteria, or does it reflect a lack of government grant? Have your say on our Discussion Forum