Early self-funder assessments vital to avoid ‘unmanageable’ Care Act burden, says DH

Councils must start identifying self-funders in their areas and planning early assessments of their needs in order to ensure they are not overwhelmed when Care Act funding reforms are introduced next year, the government has said.

A letter issued by the Department of Health advises councils on how to prepare for the £72,000 cap on care costs and revised means-testing system that will be introduced under the Act from 1 April 2016. The DH estimates that the changes will require social services to assess around 460,000 people who currently fund their own care. The assessments will register a self-funder’s progress towards the cost cap or consider them for local authority support under the revised means-test.

Managing transition

In order to manage transition to the new arrangements ahead of April 2016, councils have been given £146m to carry out early assessments of around 50% of their self-funders in 2015-16. A failure to plan and carry out the early assessments could lead to unmanageable numbers of people coming forward in April 2016, which would result in significant waits for assessments and present “a real risk to the viability of the new system”, the DH note said.

The early assessments should start from October 2015, when final guidance on the funding changes will be published. The DH recommends early assessments should start with people whose needs are least likely to change, such as care home residents, in order to minimise the risk of people needing to be reassessed prior to the new system’s introduction. The other 50% of assessments should be completed as soon as possible after April 2016, the DH said.

Key dilemmas

The funding changes present two key dilemmas for local authorities – how can they identify and estimate the number of self-funders in their communities and how can they ensure their social care teams can meet the demand for assessments?

To identify self-funders in their areas, the DH recommends that local authorities work with, or survey, care providers to identify the numbers of people they support. The advice note also says numbers can be estimated by carrying out a desktop exercise using guidance issued by the Local Government Association or by using the ‘Lincolnshire Model’ – a model that uses the current picture of spending as a basis for predicting the impact of new demand under the Care Act.

On the issue of assessor capacity, the DH recommends a number of options. Councils can consider whether some assessments might be carried out online or in partnership with providers or third sector organisations, the advice note says. Outsourcing assessments could also be considered, it adds, although local authorities taking up that option should consider what oversight is required of delegated arrangements. Other options floated include: boosting workforce numbers temporarily by taking on agency staff or other outside expertise and ‘streamlining’ assessment processes for people already receiving care and support, such as people already living in a care home.

How the cap will work

The cap, which will initially be set at £72,000 for anyone aged over 25 when they approach their local authority with eligible needs, will be measured according to how much a council would have spent on meeting the person’s eligible needs had it been doing so. Beyond that figure people will receive free care and support, though people in care homes will still have to pay up to £230 a week to meet their daily living costs, on a means-tested basis.

To access the cap, self-funders will need to undergo an assessment to identify their eligible needs and establish an independent personal budget setting out the notional cost to the council of meeting them. They would also have to have their needs reviewed each year, and their accrued costs will be measured through a “care account” until they reach the cap.

The government is consulting on a set of draft regulations and guidance on how the changes will work in practice. You can respond directly on the government’s Care Act consultation website or by emailing careactconsultation@dh.gsi.gov.uk. The consultation closes on 30 March.