Better data on self-funders key to making care reforms work

A Department of Health review is seeking to address limited data on self-funders to help determine how resources for the government's care funding reform will be distributed between local authorities, says Jude Ranasinghe.

Last week, the Department of Health launched a consultation on its proposed reforms to care funding.

These include the introduction, from  April 2016, of a £72,000 cap on reasonable care costs and the provision of help with residential care costs for homeowners with assets of £118,000 or less in 2016-17 prices, up from £23,250 currently. In addition, from 2015-16, people who cannot afford reasonable residential care charges without selling their home will be able to defer the fees.

Overall, these changes are expected to increase the number of people who are now eligible for local authority financial support for adult social care and reduce the number of self-funders. To assess how the funding to pay for these reforms should be distributed between local authorities, the Department of Health has commissioned research from public sector funding specialists LG Futures and the Personal Social Services Research Unit (PSSRU) at the University of Kent/London School of Economics and Political Science.

‘Very limited data on self-funders’

The research requires the team to identify more information about the needs and costs associated with self-funders, given that there is currently only very limited data available on them as many do not have any contact with local authorities. We asked all local authorities nationally to share with us any information that they may have on their self-funder population, and over 30 responded.

As expected, the level of detailed information on self-funders within individual local authorities varies significantly. Most authorities reported that they could provide some information on the care needs of individuals who have been through local authority assessment processes, but were not eligible for local authority funding. However, this was not necessarily an area that authorities investigated or analysed on a routine basis.

A handful of authorities were able to provide detailed analysis on the numbers of self-funders in residential care, which has been obtained through their own local data collection, surveys and market research. Other authorities have shared with us their approaches to understanding more about individuals who transition from self-funding to local authority funding and we will be collecting this information as part of our wider local authority data collection, where available.

Other authorities are making use of nationally available data from sources such as the Care Quality Commission to provide estimates of the numbers of self-funders in their authority for example by subtracting numbers of local authority funded residents from the total number of available beds, making assumptions about out of area placements and occupancy rates. A number of authorities have taken or are taking steps to develop their understanding of self-funders by undertaking local surveys, having recognised a significant gap in local knowledge, particularly in the context of the latest funding reforms.

Information on home care self-funders more difficult to collect

For the most part, data gathering has focused on residential care, although a couple of authorities reported that they are also working with private providers to collect data on home care self-funders.  This is, however, more difficult, due to the multiplicity of providers, with care often being arranged without any input from the local authority.

In terms of the data available, local authorities identified a number of data quality issues that they believe impact on the usability and reliability of survey information on self-funders, including:

  • Timeliness  – survey data may be considerably out of date;
  • Completeness – response rates to surveys have been variable;
  • Missing information – vacancies and out of area placements often need to be estimated.

The information we have gathered from local authorities will complement secondary analysis that the research team will undertake from a range of data sources, such as Census 2011 and existing national surveys.  In addition, the team is also considering specific primary data collection, potentially undertaking a national survey of care homes, to identify numbers of self-funders in residential care.

Data on council-funded clients

We have also asked local authorities to volunteer to provide data on the adult care services that they provided during 2012-13, focusing specifically on admissions to residential care and clients in receipt of non-residential care for both younger adults and older people. We are pleased to report that we have doubled our minimum data requirements of 30 local authorities, with 61 local authorities having now expressed interest in being part of the data collection.

The sample includes a wide range of authorities nationally, across factors such as authority type, region, rurality, deprivation and age profile; and the sample currently accounts for 50% of the population aged 65+ and 85+.

The research team is currently undertaking detailed statistical analysis to ensure that the sample of authorities is representative nationally. The local authorities who are taking part in the data collection will receive further information over the next few weeks, including data templates and guidance, as well as dedicated ongoing support from the research team. Data collection will take place between July and October 2013.

The research team appreciates the significant levels of engagement from local authorities to date for this key piece of research and we are currently reviewing all the information received from local authorities to understand its implications for formulae development.

Jude Ranasinghe is director of LG Futures. To find out more about the research project or to become involved in it, contact him at or on 01908 424387.

This research has been commissioned and funded by the Policy Research Programme in the Department of Health. The views expressed in this article are not necessarily those of the department.

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