Ministers should allow service users to carry out online checks of their eligibility for care to reduce the burden on social workers of a massive hike in the number of assessments.
That was the message from a report published today by the Association of Directors of Adult Social Services’ information management group on the implications for council IT systems of the government’s reforms to care funding under the Care Bill.
This includes the introduction, from April 2016, of a £72,000 cap on the ‘reasonable’ social care costs that an older person with eligible needs can incur before receiving full state funding for these costs. To qualify for the cap, self-funders will have to receive an assessment from their council to calculate what it would spend on meeting their needs, which will form an “independent personal budget”. They will then have their needs regularly reviewed and the sum of their independent personal budgets, adjusted for inflation, will accumulate in a “care account” until they reach the cap.
The change means councils will have to assess an additional 500,000 people with eligible needs in 2016-17 and many others without such needs – largely self-funders who have not been in contact with social services before. The Adass report, which was based on discussions with major suppliers of council case management and financial systems for social care, said this would be implemented at a time when “care management resources are already under severe strain”.
The Department of Health has suggested the burden could be managed by more outsourcing of assessments and greater use of online self-assessments by service users. The Adass report, by social care systems consultant Richard Pantlin, said there was a “strong business case” for using online self-assessments if they could be used by at least 5% of people who approach councils.
It also said that increasing use of the internet among older people and the influx of more affluent people into the system would increase the numbers of potential service users who could complete an online self-assessment. It also said they could be completed by people’s family.
However, the report added that while many of the major IT suppliers had developed online self-assessment options as part of their care management software,”very few” councils had implemented them. This was because of uncertainty about the legality of online self-assessment – which has been subject to legal challenge – and “nervousness about security of access, authentication, data quality and ease of understanding” by service users.
The report said the DH needed to make clear through regulations under the Care Bill that online self-assessments were legally permissible, encourage councils to use them and also provide guidance on their design to reduce development costs.
It said online self-assessments should definitely be available as a screening device to establish whether people are below the eligibility threshold and to provide those people with signposting information. However, it suggested full needs assessments should always be carried out by a qualified practitioner, and stressed that “online self-assessments will never be appropriate for the more complex cases or for some individuals”.
It also said there may be the case for a fast-track process for existing self-funding care users to set up an independent personal budget and care account, to reduce the assessment burden. This could be appropriate for people who are already in a residential or nursing home for whom the council need only apply their standard or enhanced rate for care to the user’s independent personal budget, minus the accommodation costs. However, it said councils would need to have discussions with IT suppliers so that they could set up a process for fast-track assessments.
The Adass report also said the Care Bill reforms should encourage the development of systems to enable councils to electronically exchange information about clients between themselves. This would enable the care accounts of people who move areas to be maintained. It said this would require a unique identifier for each client, most probably the person’s NHS number, requiring councils to put systems in place to obtain people’s NHS number.