Door opened for cheaper social care provision

Social care service users could find their services being cut as councils look for the cheapest way of meeting their needs, experts are warning.

This comes after the appeal court ruled that Kensington and Chelsea Council in west London had acted lawfully and reasonably in withdrawing some services to save money.

The ruling reiterates the longstanding legal position that local authorities are entitled to choose the cheapest way of meeting an assessed and eligible need, which in this case was for assistance to visiting the toilet at night.

Legal expert Ed Mitchell said: “There are hard decisions to be taken by care providers, but these hard decisions are to be taken by the funding public body rather than the court.”

He added: “A local authority’s powers to cut services are the same now as they were before the decision.”

The test case involved Elaine McDonald, 67, who had a stroke and cannot walk unaided and also has bladder problems, meaning she requires the toilet a lot during the night.

The authority initially identified an eligible need for “assistance at night to use the commode” and funded a carer for seven nights a week.

It subsequently reassessed her needs for financial reasons and decided that she in fact had a more general eligible need for support at night in relation to urination.

The authority said it would meet the need by providing continence pads, saving it £250 a week, though is also currently funding a carer for four nights a week.

McDonald challenged the council’s decision, but at appeal it was found to have acted “cautiously and generously” and that it was a “reasonable decision”.

Mitchell said: “Increasingly, local authorities are having to take hard decisions about the provision of community care services. It’s a timely case, given the budgetary pressures that are around at the moment.”

And he added: “The decision may cause authorities to try and define eligible needs in general terms because that gives them more flexibility as to how they meet the needs.”

Andrew Cozens, adult social care group lead at the Local Government Association, said the ruling could open the door for other councils to follow suit.

Age UK policy adviser Stephen Lowe said: “The case doesn’t change the law. It reflects the existing position. The issue is whether a care and support package meets the person’s right to be treated with dignity and with respect for his or her human rights. A decision like this must take these into account as well as an individual’s needs. So it’s not carte blanche for local authorities.”

However Lowe added that the Law Commission’s review of community care law needed to take this issue into account.

He said: “The law needs to enshrine a basic level of dignity which older people in receipt of care and support should be able to expect.

“This would seem to be a basic requirement of a civilised society. It is an issue the Law Commission’s current review of community care law needs to address.”

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