The Care Industry is disappointed in the Government’s recent white paper entitled “Caring for our future: reforming care and support” as it fails to offer a long term care funding solution. The industry had hoped that the White Paper might propose a government financed cap on the costs of care which all but the poorest elderly people have to meet out of their own resources.The central thrust of the Dilnot Commission’s report (which the government had itself commissioned) was that a universal cap of £35,000 on care costs would cost the Exchequer only £1.7 Billion in a full year and would remove the fear and risk of huge liabilities for the individual and their family should they need expensive care for a long time. The Dilnot report argued that this would result in benefits to both the community and the individual: it would be perceived as a more just system; it would encourage saving not discourage it; it would broaden the market for insurance products to help people fund their care. But the proposal has been deferred to an indefinite future. So after that hope is dashed what is left?The scope of the White paper is more modest; some tweaking here, some tinkering there, some new low cost initiatives for training and to encourage Local Authorities to improve their online information services; some proposals to develop a voluntary central register of Quality measures (mediated by the DoH) to try and fill the gap left by the withdrawal of the Regulator’s star rating service. The main topics addressed in the White paper are summarised below and this is followed by a precis of each of the chapters. It is instructive to read not least because it gives insight into the limits to the power of Central Government to institute major Health and Social care reforms; Government is dependent upon and has to work with a whole host of Local NHS bodies, Local Authorities, Quangoettes and voluntary bodies committed to local consultation, participation, information gathering and sign-posting to achieve its strategy.The main topics which the White paper addresses are;
Promoting initiatives that foster voluntary and self help groups and activities
Promoting the development of specialised housing for older and disabled people
Developing a national online website to provide clear and reliable information on care and support (£32.5 million for better on line services)
Work with various organisations to develop comparison websites to promote feedback and facilitate comparison of service
Introduce national minimum eligibility threshold for access to care and support
extend the right to an assessment to more carers;
Ensure that no one’s care is interrupted if they move.
Outlaw “contracting by the minute” for dom care.; consult on what to do better when a major provider goes out of business
Improve the quality of training of care workers; raise the status of the job
Legislate to entitle people to have personal budget
Improve access to independent advice to help people who are eligible for financial support from their local authority to develop their care and support plan
Investing £300 million over three years to improve joint funding between the NHS and social care to improve social care.Chapter 2The white paper is addressed to the care customer and in this chapter states that care services will be refocused
To promote well being and independence rather than waiting for a crisis to occur
To put customers in control of their care and support (rather than being passive recipients of what is given to them)
To inform them of their entitlements and responsibilities
To ensure that customers are happy with the care and support they receive
To ensure that care and support is given with dignity and respectChapter 3This chapter focuses on what should or will be done to promote mutual support of people for another both to family members and to the lonely and isolated. Specifically;
create shared measures of well being across the 2013/14 editions of both Public Health and Adult Social Care Frameworks
Involve local Healthwatch and health and well being boards
Support My Home Life and national provider organisations to work to develop “open care homes ” that build links with their local community.
Develop in a number of trailblazer areas new ways of investing in supporting people to stay active and independent such as Social Impact Bonds.
Work with Home improvement Agencies to extend their service to more people who fund their own adaptations.
Legislate to require Local Authorities to provide ad commission preventative services.Chapter 4Three sections to this;
Better information and advice. LA’s will be given £32.5 million over next two years to upgrade their internet information systems. NHS III urgent care. A telephone service will signpost callers with social care needs to their local authority. The DoH’s proposal to setup an information service, provider search and provider evaluation service in 2013. Legislation will ensure people get information on how the care and support system works locally regardless of whether they are entitled to any state-funded support towards the cost of their care.
Legislation will be introduced to eliminate postcode lotteries in access to state funding for care; the process of assessment will be reviewed to facilitate self assessment. Also to recognise who is to be responsible for assessing the care needs of those in prison.
Greater support for carers; first clinical commissioning groups will be responsible for working with local partners to identify and support carers. This includes more statutory support for carers.Chapter 5This section describes ways the DoH will empower people to make decisions about their own care and support by being given better information not only on what is available but on the quality of the services which are available.
Good quality care will be more fully defined.
Age discrimination in health and care support will be banned for Oct 2012.
The DoH is working to develop comparison websites that facilitate getting information on the location, quality and content of care services.
Put action to protect people from abuse and neglect on a statutory footing with clear duties on local authorities, the NHS and the Police to work together to keep people safe.Chapter 6Various measures intended to raise the number care apprenticeships, to raise the quality of care training, to raise the status of caring and strengthen the status of registered managers as critical leaders and advocates for quality care.Chapter 7Empowering individuals to have control over their own care and support through giving people an entitlement to a personal budget and “we will strengthen our ambitions on direct payments” “People will not have to fight against the system: health, housing and care services will join up around them”
Legislate to give people an entitlement to a personal budget as part of their care and support plan.
Improve access to independent advice and support to people who are eligible for support from their local authority to develop their care and support plan
Invest £300 million over three years in schemes to promote better integration between health and social care.
Develop plans to ensure that everyone with a care plan has a key worker.Chapter 8To take this forward the government will
Launch a new Care and Support Transformation Group
– Create a Care and Support Implementation Board. This will work closely with other key sector -led organisations such as the Think Local,Act Personal partnership and the Towards Excellence in Adult Social Care programme
– Finance; ” The White paper is not intended to set out a funding settlement for care and support in future years. Future decisions on the overall funding in the system will be taken alongside other funding decisions at Spending Reviews.”