Richard Hawkes, Chair of the CSA, said:
“If this Government wants to ease the pressure on A&E this winter, it needs to invest in local, preventative, social care.
”Many older and disabled people need help with day-to-day tasks, like getting up, preparing meals and doing the shopping but chronic under-funding has seen hundreds of thousands of vulnerable people lose out on council-funded support.
“Without that support experts like the Kings Fund argue that they become isolated, fall into crisis and end up in A&E.
“The Government could have used the Autumn Statement to underpin its important reforms with investment, but with the Care Bill set to be debated in less than a fortnight they have a big opportunity to commit to properly fund the social care system.”
The Kings Fund says: “Social care is feeling the impact of very tight finances and often does not respond at the pace required.” http://www.kingsfund.org.uk/blog/2013/04/can-we-keep-demand-urgent-and-emergency-care
Our joint letter has been published in The Times this morning, see the article here; http://www.thetimes.co.uk/tto/opinion/letters/article3939948.ece
The winter A&E pressures, lonely older people, caring families unable to work, and disabled people struggling to live independently are all urgent, challenging issues for this Government. But behind them is a simple point: the need to fund councils sufficiently to organise enough care for the people who need this help.
The Government acknowledges the scale of the problem and has taken important steps to address it, not least through the Care Bill, which sets out a positive vision for the future of adult social care which the sector is united around. However, the government must provide the means as well as the ends – both now and in the longer-term.
Social care is seriously under-funded and a financially sustainable foundation must be the basis from which to take forward the proposals in the Care Bill, which themselves need to be fully funded
The new Integration Transformation Fund, created to improve NHS and social care joint working, is existing money, albeit better focused. It has the potential to redefine how we allocate resources across the system for the benefit of both the individual and the public purse. But if the Government continues to cut council budgets then the good intentions of the fund will be damaged and it will do no more than slow the growing gap between supply and demand for social care.
So today we call on the Chancellor to use his Autumn Statement to prevent the cracks already evident in our parched adult social care system from becoming still wider. The best way to tackle some of the biggest issues facing the Government is by reshaping local health and care economies and investing more in local, preventative social care and support.
Sir Merrick Cockell, Local Government Association Chairman
Sandie Keene, President of the Association of Directors of Adult Social Services
Richard Hawkes, Chair of the Care and Support Alliance
Here is a full list of the 75 Care and Support Alliance charities: http://careandsupportalliance.wordpress.com/about/
Richard Hawkes, Chair of the CSA, said:
“Up and down the country there are many older and disabled people who need help with day-to-day tasks, like getting up, preparing meals and doing the shopping.
“Without that support they become isolated and risk slipping into crisis.
“But social care system is on its knees. It’s chronically under-funded. Councils say there’s not enough funding for those in the system; meanwhile hundreds of thousands more have slipped out of the system altogether.
“If this Government wants to ease the pressure on A&E this winter, if the Government wants make sure that vulnerable adults are not lonely, if the Government wants disabled people living independently and if the Government wants to realise its ambitious Care Bill plans – it needs to invest in local preventative, community care.”
Richard Hawkes, chair of the Care and Support Alliance, says:
“The social care system is on its knees.
The Government proposals for a care cap are a positive step. But it is becoming clear that a huge number of older and disabled people that need support will not see any of the benefits of the new system – because eligibility will be set too high.
“Eligibility plans to tightly restrict who gets council care could leave more than 340,000 older and disabled people, who need support to do basic tasks, and their families, out of the care system altogether, funding their own support without protection from spiralling costs.
“The real issue is the chronic underfunding of the system; which has forced cash-strapped councils to ration who gets care.
“We want the Government to have the courage to see its bold plans through, and make sure that those who need support to live independently – to get up, get washed, and get dressed, and get out of the house – get council care.”
More than a quarter of a million older and disabled people who need support for day-to-day tasks, and the families who care for them, won’t see the benefits of the Government’s welcome overhaul of social care, because of a plan to tightly ration who gets support.
The figures come from new analysis of London School of Economics (LSE) research by the Care and Support Alliance, which represents 75 leading organisations and charities.
The CSA describes the Care Bill as a ‘real achievement’.
But as Lords debate the bill, the CSA is now urging the Government to be ‘bold’ and ensure its vision of social care becomes a reality for everyone by re-thinking its plans for eligibility and putting in place the funding to make it happen.
The call comes ahead of a week parliamentary events and social media action.
Parliament is debating moves to create a new system that ends the postcode lottery and caps the cost of care at £72,000.
It follows evidence that cash-strapped councils are squeezing the number of people eligible for care and rationing support for those still in the system.
Recently the CSA welcomed a series of positive amendments to the Care Bill, which further improve the system.
But the coalition of charities will now tell MPs and Lords that they now need to make sure as many people as possible see the benefits of the changes.
Outside of these parliamentary debates, the government is planning to restrict the number of people in the system.
Documents reveal that the Department of Health intends to set the national threshold (p6) for who’s in and who’s out of the system at the higher ‘substantial’ level that many councils have recently moved to.
According to new analysis of research conducted by the London School of Economics[i], setting the threshold at this level means approximately 362,000 older and disabled people will not receive any support from their council (see below for details). They will have to pay for their own care without their costs being capped.
There are people – misleadingly described as having ‘moderate needs’ – who are unable to undertake several aspects of personal care, or of work, education or training.
Eligibility is inextricably linked to spending decisions. The CSA argues that a lower threshold also makes economic sense (see below).
As part of a week of action, Paralympians Sophie Christiansen and Hannah Cockcroft are helping Care and Support Alliance members to make the case to MPs.
Sophie has written a blog about the importance of social care to her personally http://polho.me/19P1UXu.
Hannah is attending a Britain Cares parliamentary event on Tuesday 22nd October.
The CSA will also be asking older and disabled people and their families to share on social media how they use social care to do things everyone else takes for granted.
Richard Hawkes, chair of the Care and Support Alliance, says:
“The social care system is on its knees. Older and disabled people are telling us they’re simply not getting the support they need to get up, get washed and dressed, and live independently. Cash-strapped councils are rationing support.
“The Care Bill is the first attempt for generations to radically overhaul the creaking system. The Government has put forward bold proposals to bring social care into the 21 century. It’s a real achievement.
“Now the Government needs to have the courage to see its plans through. It needs to keep going, keep building, and keep listening.
“It’s becoming clear that a huge number of people that need support will not see any of the benefits of the new system.
“Plans to tightly restrict who gets council care mean more than a quarter of a million people may have to find their own support without any protection from spiralling costs.
“Ultimately we want the bill to genuinely promote prevention – rather than crisis care.
“The CSA wants the Government to set the bar for who gets and who doesn’t get council support at a level that includes everyone who needs support live independently.
“Hand-in-hand with this decision has to be a commitment to properly fund the social care system. Councils continue to say that they simply don’t have the resources they need.”
Sophie Christiansen said:
“Social care can often be fairly invisible in society. It’s hardworking, often low-paid carers behind closed doors, supporting those of us who need it to do the basics in life – like getting washed, dressed and out of the house. And if you can’t do those things, what can you do?
“It was so important to me to fulfil my ambitions and win Gold last year. Everyone in Britain has hopes and ambitions for their life – and social care is vital support to enable them to do it. Whether it’s studying, working or taking part in the community, so many things begin with good care and support.
“As a Paralympian, you could look at me and think my life is all sorted, but I still struggle to get the right funding and support. If it’s tough for me as a high-profile figure, what is it like for other people?”
If – like many older and disabled people – you need support to get up, get dressed, get washed and live independently, you can request it from your council – an example could be a support worker who’ll come to your home. That’s social care. Their families rely on it too, to provide extra support so that they can juggle work and care and live healthy lives.
At the moment individual councils can decide the level of need you have to reach before you’re eligible for council-funded support. This has created a postcode lottery, as more and more councils decide to tightly ration who gets care and support.
In May, Government figures (see 2.5 table 8) showed approximately 86% of councils now put the bar for who gets and who doesn’t care at a higher level. Councils point to a chronic lack of funding in the system. Research by LSE suggests the system is under-funded by £2.8bn[iii].
In response, the Care Bill is going to introduce a national level of eligibility.
But the legislative process means the decision about where that level is drawn has to sit outside of the bill, because Parliament can’t make a decision on a threshold until after it’s agreed that there needs to be one in the first place.
Earlier this year Minister Norman Lamb revealed he wanted to set the bar for who gets local care at the higher level that many councils are moving to.
This effectively shuts the door on people who are unable to undertake several aspects of personal care, or of work, education or training.
Under the current system they are described as people with ‘moderate needs’.
But the CSA argues that’s a misleading description which doesn’t capture the significant impact not having support has on a person’s life. Without support they can’t live independently and risk falling into crisis.
According to the research conducted by London School of Economics[iv], the move would see the following people ineligible for council care:
- 69,000 working age disabled people with moderate needs not in the system
- 36,000 working age disabled people with moderate needs currently in the system
- 8,000 disabled people with substantial or critical needs who would also be brought into the system with a moderate threshold
- 170,000 older people (over 65s) with moderate needs not currently in the system
- 65,000 older with moderate needs currently in the system
- 14,000 older people with substantial or critical needs who would also be brought into the system with a moderate threshold
The final decision on where the national threshold will be set will be published for consultation in spring next year and voted on in autumn 2014.
The Care and Support Alliance wants the Government to set the threshold at ‘moderate’.
The decision on eligibility is linked to Government spending commitments.
But there is also an economic case for making the change. Economic modelling on four different service types carried out by Deloitte in 2013 found that for every £1 spent on support for people with ‘moderate’ level needs, an average of £1.30 will be saved in the NHS, local and central government.
The Other Care Crisis is a report published by Scope, Mencap, The National Autistic Society, Sense and Leonard Cheshire Disability – http://www.scope.org.uk/help-and-information/publications/other-care-crisis
It is based on research by the London School of Economics, Personal Social Services Research Unit (2013) Implications of setting eligibility criteria for adult social care at moderate needs level – http://www.pssru.ac.uk/publication-details.php?id=4435
About the Care and Support Alliance:
- Set up in July 2009, the C&SA is a consortium of over 70 organisations that represent and support older and disabled people, including disabled children, those with long-term conditions and their families, and campaigns to keep adult care funding and reform on the political agenda. http://careandsupportalliance.wordpress.com/
[i] The Other Care Crisis, pg 47, http://www.scope.org.uk/help-and-information/publications/other-care-crisis,
[ii] The Other Care Crisis, pg 48, http://www.scope.org.uk/help-and-information/publications/other-care-crisis,
[iii] The Other Care Crisis, pg 48, http://www.scope.org.uk/help-and-information/publications/other-care-crisis,
[iv] The Other Care Crisis, pg 47, http://www.scope.org.uk/help-and-information/publications/other-care-crisis,
From Friday 18th October, the Care and Support Alliance are asking #WhatDoYouDoWithYours? Do you go to the shops, go to work, see your friends? We’re asking you to share on Twitter and Facebook what you can do in your life because of social care – to increase awareness of how important it is in enabling people to live independent lives.
Haven’t heard of social care? It’s the vital support that many disabled people, older people, carers, and those with long term conditions, use every day. Depending on the person’s needs, it can mean help to dress, wash, eat, communicate or get out and about. To find out more about why it’s important, watch Angela, David and Jenny and James’s stories.
The Care Bill, a once-in-a-generation new law, is going through Parliament at the moment, trying to improve social care. But who can get social care? The big problem is, under the Government’s current plans hundreds of thousands of older people, disabled people, carers, and those with long term conditions, could be denied any care at all. Whatever other improvements are made, it won’t help unless the Government makes sure the people who need it are eligible to get care.
The current debate on the Care Bill is wrapping up in the House of Lords within the next two weeks and MPs will likely be discussing it in the House of Commons shortly after. So it’s vital right now that we generate buzz around this issue so social care remains an important topic for MPs.
Please share on Twitter or Facebook your story of what social care enables you to do using the #WhatDoYouDoWithYours hashtag. Or even if you don’t use social care yourself, please share the hashtag and the link to this page to help spread the word. Here are some tweets you can use:
Why is #socialcare so important to you? #WhatDoYouDoWithYours?
How does your #socialcare help you? #WhatDoYouDoWithYours?
Tell Britain why your #socialcare matters to you #WhatDoYouDoWithYours?
I use mine in the shower. #WhatDoYouDoWithYours?
I use mine in the back of a taxi #WhatDoYouDoWithYours?
Some people go to uni with theirs. Some go to the shops. Some pick up the kids. #WhatDoYouDoWithYours?
I get dressed, go dancing and eat dinner with mine. #WhatDoYouDoWithYours?
Let’s get people talking about the importance of social care, drawing on common experiences of what’s important in all our lives.
The Care and Support Alliance has welcomed a Government decision to guarantee that tens of thousands of people each year who would struggle to navigate the social care system alone can turn to an independent advocate.
The announcement comes as the Government prepares to debate its Care Bill plans to reform the social care system in the House of Lords this week. The CSA is calling on the Government to seize the “once in a generation opportunity to improve the lives of many of our most potentially vulnerable citizens”.
The CSA has been campaigning for a right to advocacy since the Bill was introduced to Parliament in draft form last year.
Independent advocates provide intensive support especially to people who find it hardest to express their views and needs, or make decisions about their care. They ensure that people’s voices are heard, that they won’t have to face the often intimidating and complex process of council assessments alone, and that they get the care they need when they need it.
Advocacy charity VoiceAbility argues many struggle to get this support: “Advocacy helps people’s voices to be heard and enables people to stay in control of their lives. But currently the provision of advocacy remains patchy, so whether you are properly involved in your decisions about your life can depend on where you live.”
The Government has now committed to creating a right to advocacy in the Care Bill. When the Bill becomes law, local authorities will need to ensure independent advocates are available for the most vulnerable.
Sue Brown, Vice Chair of CSA, said:
“We’re really pleased to see an amendment, which would guarantee that some of the most vulnerable people can get an advocate.
“Advocates play a critical role in the care system, this duty will ensure that people are properly involved in assessments and care planning, and that they won’t have to face the intimidating and complex process of councils assessments alone.
“Advocates support people to articulate their needs, make informed choices and make the process less intimidating; they support with planning care, reviewing that care and help people speak out if they are unsatisfied with care or when safeguarding issues may arise.
“The amendment is a major step forward and it is pleasing to see that the Government has listened to and acted on our concerns.”
Speaking about the bill, Sue Brown added:
“The Care Bill is a once in a generation opportunity to improve the lives of many of our most potentially vulnerable citizens.
“The social care system is in crisis. Hundreds of thousands of people aren’t getting support to get up, get dressed and get out of the house, because cash-strapped councils are raising the bar for eligibility. While those in the system are struggling to get the support that genuinely gives them a chance to live independently.
“The Bill is back in the Lords on Wednesday. Politicians are starting to realise that getting it right means being bold. The Government has made several amendments to the Bill that we welcome. These include the requirement that assessments must be carried out by people with specialist expertise in certain circumstances, and that councils must take on board the importance of promoting well-being when commissioning services.
“We hope these moves set the tone for the Care Bill, and politicians take the opportunity to build a system that ensures that everyone who needs support to live independently gets it.”
About the Care and Support Alliance:
- Set up in July 2009, the C&SA is a consortium of over 70 organisations that represent and support older and disabled people, including disabled children, those with long-term conditions and their families, and campaigns to keep adult care funding and reform on the political agenda.