CSCI: Councils improve but eligibility criteria keep on rising

Council performance in adult social care in England improved in several areas in 2006-7, but the most comprehensive analysis of eligibility criteria to date showed today that thresholds have risen sharply and will rise further.

The Commission for Social Care Inspection released results from self-assessments by the 150 councils with social services responsibilities for their performance against a range of performance indicators, which will form the basis of their star rating this year.

CSCI said the proportion of adults receiving direct payments rose by 33% from 2005-6 to 2006-7 – compared with a council target of 27% – with 54,000 people receiving payments for care as of March this year, up from 7,900 in 2002. Other positives included a rise of 10% in younger adults with mental health problems helped to live at home.

Councils also appear to have responded to CSCI criticisms about the lack of support for carers identified in last year’s star ratings, with a slight rise in carers receiving a service as a proportion of the number of service users receiving care.

However, CSCI reported that the proportion of councils with a “substantial” or “critical” threshold for care rose from 53% to 62% in 2006-7, with councils predicting that this would increase to 73% by the end of the current financial year.

The news follows an exclusive survey by Community Care which found adult social workers were coming under increasing pressure from managers to ration services while more than one-third would be prepared to exaggerate clients’ needs to get them a service.

Association of Directors of Adult Social Services president Anne Williams said it was “of deep and abiding concern to directors” that more councils were prepared to raise eligibility criteria.

She said the debate on the future funding of long-term care, which will inform a green paper next year, “cannot come soon enough for the increasing numbers of older people who are being excluded from our services and support”.

Apparently reflecting this shift, the average unit cost of intensive social care for adults and older people increased by 3.4% in 2006-7 to £543 per person, in contrast to councils’ ambitions for a small reduction.

CSCI also found the proportion of older people helped to live at home fell by 1%, despite a target for this to rise by 1%.
It also said performance in supporting people with learning disabilities into work or volunteering was highly variable. On average, 2.1 people with learning disabilities per 10,000 aged 18-64 received help into paid work, but 20 councils achieved more than twice this rate and 62 councils less than half.

CSCI found that the median number of referrals among councils of adult abuse cases rose by 32% from 2005-6 to 2006-7 from 160 to 211, while the median number of completed cases rose by 37% from 94 to 129. It said this was “not necessarily a reflection of levels of actual abuse”.

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