New care overhaul leaves 300k older and disabled people struggling to live on their own (23 Oct 2014)

Care & Support Alliance Press Release: New care overhaul leaves 300k older and disabled people struggling to live on their own (23rd October 2014)

Following a crucial Government announcement on its flagship care reforms, a coalition of more than 75 charities is calling on the Government to urgently reconsider plans that risk leaving more than 300,000 older and disabled people without support to things as basic as getting up, getting washed and getting out of the house.

With parties pledging support for the NHS, the Care and Support Alliance joins experts in arguing that an effective, preventative care system is the only way to ease the admissions crisis.

The CSA says that the care system is on its knees, with demand going up but fewer and fewer people getting support.

The Government brought in sweeping reform of the care system in May – ending the postcode lottery, backing carers and capping catastrophic costs.

The Government today publishes a final version of its new national criteria for social care eligibility – in other words, it reveals who will and who will not get care from April 2015.

Chronic underfunding of the care system has seen councils increasingly ration access to care to only those with the highest needs.

But the Government now confirms that it doesn’t plan to reverse the trend.

Research by London School of Economics shows this means 340,000 people – who struggle to live on their own – will be locked out of the new care system.

The Care Minister, Norman Lamb, has previously said his intention is to set the level at the equivalent of ‘substantial’ in the current system. This formally excludes people who are misleadingly described as having moderate needs, but who actually struggle to do basic tasks without support.

The CSA argues that sitting behind this issue is a tale of chronic underfunding.

Councils report that some £3.5bn has come out of the care system in the last five years.

The Alliance is campaigning for a properly funded care system. The call to action follows YouGov polling which shows that the public have lost confidence in the current care system and that care – along with health – is the place they’d most like to see greater investment.

Richard Hawkes, Chair of the Care and Support Alliance, said:
“The Care Act is a ground-breaking piece of legislation – capping catastrophic care costs and ending the postcode lottery.

“But it will only live up to its promise of a genuinely preventative system that promotes wellbeing, if the Government re-thinks its plans to exclude so many older and disabled people from the system.

“Setting a high threshold for the care system is a bit like going to the doctor with a chest infection and being told to come back with pneumonia.

“Every day, our 76 organisations hear horror stories of older and disabled people who struggle to get the support they need to simply get up, get dressed and get out of the house.

“Care – along with the NHS – is now undoubtedly an election issue. Population changes mean more and more people need care. Yet fewer and fewer people get it, as chronic underfunding has seen a year-on-year rationing of support.

“Our survey shows the public has lost confidence in the current system. It shows care, along with health, is where the public want the Government to invest more.

“The only long-term solution to the care crisis is an increase in funding, and – as the Barker Commission experts rightly argue – as a country we can afford it. In fact we can’t afford not to.”

The CSA is on-hand for interviews, case studies and background information.

Contact Warren Kirwan in the Scope press office on 02076197200 or warren.kirwan@scope.org.uk.

The Care and Support Alliance was set up in July 2009. It is a consortium of over 75 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. For more information go to www.careandsupportalliance.com  

Who are the “340,000”…

According to the research conducted by London School of Economics setting a high bar on eligibly (equivalent to substantial) 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
  • 170,000 older people (over 65s) with moderate needs not currently in the system
  • 65,000 older with moderate needs currently in the system

= 340,000

(From Fernández JL et al. (2013) Implications of setting eligibility criteria for adult social care services in England at the moderate needs level. London: PSSRU, LSE, http://www.pssru.ac.uk/archive/pdf/dp2851.pdf)

Care facts and figures

  • The care crisis is well documented. Age UK are reporting that almost 900,000 older people in England and Wales who struggle with such basic tasks as washing and dressing are being left to fend for themselves.
  • Councils report that some £3.5bn has come out of the care system in the last five years. Of the 152 councils in England responsible for care, government figures show nearly 90% now offer care only to those with the highest level of needs. In those areas this means older and disabled people who are unable to undertake several aspects of personal care, or of work, education or training are no longer eligible for council-funded care.
  • When it comes to just older people the figures are even starker. Two thirds of people aged 60+ believe the Government should be doing more on social care. Around seven in 10 are not confident they will receive good care. After the NHS, social care is the biggest priority for voters when it comes to government spending.
  • The most important decision for older and disabled people will be whether they are entitled to care in the new system, due to come in in 2015. The proposals were published for public consultation in the summer 2014 and the Government published its final version on 23rd October 2014. Eligibility will also be used to determine who benefits from the ‘cap on costs’.
  • The Barker Commission recently released its report on how we create a system fit for the 21st Century and proposals for how we can afford it.

CSA members respond to the Government’s new national eligibility criteria for care (23 Oct 2014)

Alzheimer’s Society

Responding to the new national eligibility framework, Jeremy Hughes, Chief Executive at Alzheimer’s Society said:

‘In setting the eligibility criteria for council-funded social care so high thousands of people with dementia will be cut off from the vital support they need and deserve. It is absurd logic that services which help prevent people from reaching crisis point are given such low priority. People with dementia shouldn’t be waiting for an emergency until someone steps in – our care services should be working to prevent that crisis from happening.

‘Without hard cash the black hole in social care finances will suck the potential out of this opportunity for transformative change and we will continue to see people with dementia struggling to live from day-to-day.’

Independent Age

Care Act 2014 (part 1): In response to today’s publication of statutory guidance and response to consultation, Janet Morrison, Chief Executive of Independent Age said:

“We welcome the new rules to support the Care Act, in particular the strengthening of protection for families from having to pay unfair top-up fees for relatives’ care home costs. We also welcome the requirement for councils to improve information and advice services on care issues. However we think the government has missed an opportunity to liberalise the rules on who is eligible for social care, meaning that an estimated 235,000 older people will continue to be outside the system and need to either pay for care themselves, receive it from friends and families – or go without. This is shortsighted because many of those outside the care systems may as a result need to draw on health and other services earlier as a result”

Mind

Paul Farmer, Chief Executive of Mind, the mental health charity, said: “Social care isn’t just for older people or those with physical disabilities. It can play a vital role in keeping people with mental health problems well and able to cope.

“We welcome some of the provisions in the guidance and regulations, in particular the inclusion of support for people to maintain and stay in their home. This will particularly help people with mental health problems and was something we have been campaigning for.

“However, without more funding in the system many people with mental health problems will be denied access to the care and support they need. A very low level of relatively inexpensive support with managing bills, doing the weekly food shop or getting out and socialising with others can make sure someone stays on their feet and manages their mental health problems well. Take that away and people can descend into illness, unable to get out of bed, wash, dress, get to work or maintain relationships. This has serious implications for other parts of the system such the NHS, as people reach crisis point and need much more intensive and expensive hospital or home-based health care.

“As NHS England today highlights, our NHS is straining at the seams. Mental health services in particular are struggling to cope with the numbers of people seeking support and the government would be well-advised to consider the long-term implications of denying thousands of people the basic social care support they need. A little initial investment will not only save money in the long run – it will save lives.”

Sense

Threshold for social care “far too high”

National deafblind charity Sense today (23 October) warned that many disabled and older people will miss out on services they desperately need following the Government’s publication of the regulations that set out who is eligible for social care from 2015 under the new Care Act.

Sue Brown, Head of Campaigns and Public Policy at Sense, said:

“The Care Act is an incredible opportunity for politicians to finally get social care right in the UK. However under the regulations released today the threshold for people to become eligible for social care is set far too high. As a result, many disabled and older people will miss out on the services they desperately need for day-to-day life. It is also vital that the Government releases enough funds for local authorities to provide the right level of support for what is currently a chronically underfunded system. Otherwise the Care Act will be built on sand.

“Inadequate social care has a knock on effect and results in further demands on the NHS. For example, the deafblind people we support can become more susceptible to falls or require hospital treatment because they didn’t get the support they needed from social care. The Government must act and provide the funding that will allow disabled people to receive adequate care.”

CSA response to the Alzheimer’s Society’s report on care costs for people with dementia (10 Sept 2014)

Responding to today’s news about dementia care, Richard Hawkes, Chair of the Care and Support Alliance, said:

“Today’s shock findings from Alzheimer’s Society represent yet more evidence that care is in crisis.

“Care is now undoubtedly an election issue.

“Population changes mean more and more people need care. Yet fewer and fewer people get it, as chronic underfunding has seen a year-on-year rationing of support.
“Our survey shows the public has lost confidence in the current system. It shows care, along with health, is where the public want the Government to invest more.

“The only long-term solution to the care crisis is an increase in funding, and – as the Barker Commission experts rightly argue – as a country we can afford it. In fact we can’t afford not to.”

CSA Response to the Barker Commission’s final report on the future of health and social care (4 September 2014)

The Barker Commission on the Future of Health and Social Care in England published its final report today: http://www.kingsfund.org.uk/publications/new-settlement-health-and-social-care 

Responding to the report, Richard Hawkes, Chair of the Care & Support Alliance, said:

“The Commission is right not to pull its punches. The only long-term solution to the care crisis is an increase in funding, and – yes – as a country we can afford it.

“Care is undoubtedly an election issue. Our survey published this week shows the public has lost confidence in the current system. It shows care, along with health, is where the public want the Government to invest more.

“Population changes mean more and more people need care. Yet fewer and fewer people get it, as chronic underfunding has seen a year-on-year rationing of support.

“The Barker Commission has rightly put the spotlight on how we create a system fit for the 21st Century and come up with realistic proposals for how we can afford it.

“It’s positive that they’re thinking not just about people who get care at the moment, but also the half a million people who would’ve got care in 2009 – and who now find themselves squeezed out of the system.

“The Commission recommends bringing them back into the system in 2025. But 10 years is a long time to wait to get support if you’re struggling to live independently – so we’d like to see the Government progress this faster than that.”

See the results of our YouGov poll which asked more than 4,700 people about their attitudes to social care: http://careandsupportalliance.com/2014/08/31/csa-press-release-the-english-public-has-given-a-vote-of-no-confidence-in-the-care-system-31-august-2014/

CSA members respond to our YouGov findings revealing majority of public concerned about care

THE BRITISH RED CROSS

Mike Adamson, Acting Chief Executive of the British Red Cross said:

“It is clear that care is an issue which the majority of people have real concerns about, young and old alike. People are not confident that our care system would provide them with the support they would need if they were to lose their independence.

“From 2015 the new Care Act will set eligibility for state-funded care at a level which will mean only those with the most serious needs will qualify for support.

“This is despite a wealth of evidence that supporting people with moderate and low-level needs makes economic sense. It enables people to live fulfilling lives in which they can participate in society and can prevent the need for further support from the health and social care system.

“In our experience this is particularly true for frail older people, who are often capable of living independently but could need support at critical times such as following a discharge from hospital.

“Creating a care system which is truly committed to wellbeing, prevention and integration is clearly a priority for everyone, but it will not happen if the Government does not ensure that there is sufficient funding at all levels of the system.”

THE NATIONAL AUTISTIC SOCIETY

Mark Lever, Chief Executive of the National Autistic Society, said:

“The funding and eligibility models for social care do not stack up.

“The care system should give people with autism the support they need to stay safe and healthy, and protect them from abuse, neglect and loneliness. Proper investment is needed to ensure this is the case.

“The voting public are crying out for a proper commitment to rectify the care system. This demand must be heeded before it is allowed to deteriorate any further.”

AGE UK

Caroline Abrahams, Charity Director at Age UK says:

“These polls underline how anxious older people now are as more and more people become aware of just how broken our social care system has become and realise that they really can’t rely on care to be there for them if and when they need it.

‘People of all ages deserve to feel confident that if they need help they will get it. Instead, hundreds of thousands of vulnerable people and their families are being abandoned to sink or swim alone and simply struggle as best they can with those everyday tasks such as dressing, or washing, or going to the toilet or preparing food, that the rest of us take for granted.”

MIND

Paul Farmer, Chief Executive of Mind, the mental health charity, said:
“Social care services are incredibly important in helping some people with mental health problems stay well and live independently in the community but many find it hard to access the support they need. Mental health problems are often hidden or have fluctuating symptoms and, in a cash-strapped system, people with mental health problems lose out because they struggle to demonstrate their need for care and support.

“Investment in social care for people with mental health problems would lead to savings to the wider welfare and healthcare systems, as people stay well and active in the community, are more likely to return to work and are less likely to require costly acute healthcare.​”

ANCHOR

Mario Ambrosi, Anchor’s Head of Corporate Affairs says:

“The Alliance’s report sends a clear message to the government: more needs to be done to support the social care sector through increasing its funding.

“While increasing funding to the sector is key, there are other issues identified in Anchor’s recent Grey Pride manifesto that must be addressed, such as institutional ageism in health, lack of appropriate retirement housing, and the dysfunctional relationship between the NHS and social services.

“We at Anchor believe that to really make changes that will benefit older people today and future generations, someone must take on this responsibility at Cabinet level. This is why we have been calling for a Minister for Older People since 2011. It is imperative the government shows that it is prepared and committed to addressing the needs of Britain’s ageing population.”

SENSE

Sue Brown, Head of Public Policy at Sense, said:
“This survey reveals that three out of four people are deeply concerned about the level of social care they would receive if they needed it. But for the deafblind people we support, this is already the reality and many are not receiving the support they desperately need.

“Without the right support deafblind people risk becoming trapped in their homes without the opportunity to participate in the community. Inadequate social care has a knock on effect and results in further demands on the NHS.

“The results of the survey show that social care is high on the agenda for most people and that there is a need to fix what is currently a broken system. Not just for the people that need care now, but for everyone that will in the future. The Care Act is an incredible opportunity to ensure the future of social care in this country. It is vital that the Government releases enough funds for local authorities to provide the right level of support for what is currently a chronically underfunded system.”

MIDLAND HEART

Commenting on the Care & Support Alliance YouGov poll into the level of funding for care needs, Ruth Cooke CEO Midland Heart said:

“Appropriate Government funding to deliver the right care system is absolutely critical. Every single local authority we work with is faced with massive financial pressures. We are told we will lose 50% funding in some adult social care areas by the end of the year, with local authorities having to make incredibly difficult choices about what they fund and what they cut.

“Providers also need to make changes to the services we deliver -often we work with the same customers as our health colleagues and we also want the right reform to give the best outcomes for our customers.  Too much is at stake if our health and care services don’t deliver – for our most vulnerable customers  it’s their dignity, their health, quality and enjoyment of life.”

ACTION ON HEARING LOSS

Responding to the CSA YouGov poll, Paul Breckell, Chief Executive of charity Action on Hearing Loss (formerly RNID), said:

“As the UK’s largest hearing loss charity and a member of the Care and Support Alliance, we support the call for increased investment into the extremely underfunded social care sector. One in six of us has some form of hearing loss and with a growing ageing population this figures is set to increase dramatically. Many of those already affected by hearing loss are denied access to the support and equipment they need to stay healthy, safe and independent and the 250,000 care home residents with hearing loss are often left isolated in a world of silence due to a lack of support and deaf awareness. Effective management of hearing loss can have a huge impact on people’s health, wellbeing and safety and improves the management of any other health conditions that they have, reducing the need for more intensive care and saving the NHS millions of pounds in the long run.”

MENCAP

Mencap spokeswoman, Loraine Bellamy, who has a learning disability, expressed her pleasure at hearing the public’s backing for greater funding in social care. However, the survey revealed a huge lack of confidence in the care system, with just 3% of people saying they were very confident that they or a close family member would get a sufficient level of care provided to have a good quality of life. While 24% say there were fairly confident and 13% said they did not know.

Mencap spokeswoman Loraine Bellamy, who has a learning disability, said:

“I am delighted to hear that the public want to see more money spent on social care. For myself, and many other vulnerable people, social care means we are able to go out and be part of our communities. Without help with things such as managing money, washing or medication many vulnerable people would be stuck indoors and isolated. I am lucky enough to have a full-time job, but this is possible because I receive the support I need. Without the support of social care I fear of going back into my shell and being isolated.

“I am glad the government can now see how the general public thinks social care is one of the most important issues for the entire country. I hope they listen to this message and do not ignore the country’s wishes for more funding in the care system”

UNITED RESPONSE

Shan Nicholas, United Response Interim CEO said, “The clear “vote of no confidence” issued in the Care & Support Alliance survey displays that the public are waking up to the reality of the social care crisis.  Local Authority budgets are being squeezed down to providing a level of care that is at best just “sufficient”.  However, United Response firmly believes that meaningful social care should be far more than just the bare minimum – it is about respecting dignity and providing choice. Ultimately, the care we provide to the most vulnerable sends a clear message about our priorities as a society. We need to get those priorities right.”

CSA Press Release: The English public has given a ‘vote of no confidence’ in the care system (31 August 2014)

See coverage by Sky News and The Sunday Telegraph: 

http://news.sky.com/story/1327512/warning-over-dramatic-rationing-of-care  

http://www.telegraph.co.uk/health/elderhealth/11063984/Only-one-in-four-have-faith-in-system-to-care-for-them-in-old-age.html

75 leading charities: one of the largest ever independent surveys of social care in England shows people back funding increase

- Six in 10 people are not confident they will receive sufficient care; that goes up to seven in 10 for over 60s

- Two thirds of those aged 60 and over in England believe government should be doing more in this area and less in others

- Along with health services, support for elderly and disabled people is the biggest priority for where the electorate would want to see the Government increase expenditure

– One in three in England rely on, or have a close family member that relies on, the care system

The public has sent a loud, powerful and unambiguous message that they are concerned about getting care if they or their loved ones can’t live on their own.

Released today, one of the largest ever surveys of public attitudes to social care, reveals the sheer number of people who rely on – or have a close family member that relies on – care to do tasks as basic as washing or eating.

But the YouGov survey of more than 4,500 people in England, commissioned by the Care & Support Alliance (CSA), shows around a quarter believe that if they need it, they will receive enough care that would allow them a good quality of life.

The majority of people are demanding the Government acts.

Along with services such as hospitals and GP surgeries, support for older and disabled people is the biggest priority for where the electorate would want to see the Government increase expenditure.

When it comes to just older people the figures are even starker.

Two thirds of people aged 60+ believe the Government should be doing more.  Around seven in 10 are not confident they will receive good care.

The independent poll was commissioned by 75 of the country’s leading charities who are campaigning, alongside the millions of older and disabled people and their carers, for a properly funded care system.

The CSA argues that the system is on its knees, with demand going up at the same time as chronic under-funding, leading to a tightening of eligibility, which has seen fewer and fewer people getting support.

Councils report that some £3.5bn has come out of the care system.

LSE research shows that 500,000 people who would have got care in 2009 are no longer entitled to it.

Age UK are reporting that almost 900,000 older people in England and Wales who struggle with such basic tasks as washing and dressing are being left to fend for themselves.

In June the Government confirmed that it’s not planning to reverse the trend that has seen the majority of councils restrict care to only those with the highest needs when it sets its national level for eligibility, due to come into effect in April 2015.

The findings come as the Government prepares to roll out major reforms to care – including ending the postcode lottery, capping care costs and rolling out the Better Care Fund, and as the debate about integrating care and health intensifies ahead of the publication of the findings of the Barker Commission.

Richard Hawkes, chair of the Care and Support Alliance, said:

“Care is well and truly an election issue.

“The message from the public is loud and unambiguous. It’s a real vote of no confidence.

“They are worried about who will care for them or their loved ones, if they can no longer do basic things for themselves.

“Above all they want the Government to invest more money in the system.

“Every day, our 75 organisations hear horror stories of older and disabled people who struggle to get the support they need to simply get up, get dressed and get out of the house.

“This is also putting unbearable pressure on family carers.

“Chronic underfunding has led to a dramatic rationing of care. We need a long-term funding commitment for social care by the Government.”

“The new Care Act, and the Better Care Fund, are bold and ambitious bids to address the crisis, and move us closer to a preventive, more integrated, system that keeps people out of crisis and living independently.

“But unless care is properly funded it will be the next Government’s first crisis.”

For more information please contact Daniel Mazliah at the Scope press office on 02076197203 / 07970813630 / Daniel.mazliah@scope.org.uk

The Care and Support Alliance
Set up in July 2009, the C&SA is a consortium of over 75 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/

The polling

All figures, unless otherwise stated, are from YouGov Plc.  Total sample size was 4,685 English adults. Fieldwork was undertaken between 6th – 9th July 2014.  The survey was carried out online. The figures have been weighted and are representative of all English adults (aged 18+). www.yougov.co.uk

Social care
This is taken from the NHS explanation of social care:

“Some people need practical or emotional care or support to lead an active life and do the everyday things that most of us take for granted. The social care system provides this support for those who need it to help them keep their independence and dignity…

“…The adult social care department, part of your local authority’s social services, is responsible for assessing people’s need for ‘community care’ or ‘social care’ services. It arranges or provides these services, and might give financial support to meet certain needs.

“…Services provided can include: help in your home with things like cleaning and shopping; disability equipment and adaptations to your home; day centres to give you or the person who cares for you a break; day care for your child if either you or they are disabled; care homes; support for carers; financial support.”

Here’s the Government’s info on social care.

Care Act
The Care Act received Royal Assent on 14 May. The CSA has called the Act ‘a real achievement’ and praised a series of positive amendments during its passage, including the right to an independent advocate for some of the most vulnerable people.

CSA responds to Age UK estimates of almost 900,000 older people with unmet care needs

Richard Hawkes, chair of the Care and Support Alliance, said:

“Every day, our 75 organisations hear horror stories of older and disabled people who struggle to get the support they need to simply get up, get dressed and get out of the house.

“This is also putting unbearable pressure on family carers.

“The new Care Act, and the Better Care Fund, are bold and ambitious bids to address the crisis, and move us closer to a preventive, more integrated, system that keeps people out of crisis and living independently.

But as today’s figures show chronic underfunding has led to a dramatic rationing of care. We need a long term funding commitment for social care by the Government.”