{"id":854,"date":"2021-09-14T18:12:23","date_gmt":"2021-09-14T18:12:23","guid":{"rendered":"http:\/\/www.jointpublicissues.org.uk\/?p=10983"},"modified":"2021-09-14T18:12:23","modified_gmt":"2021-09-14T18:12:23","slug":"explainer-social-care%ef%bb%bf","status":"publish","type":"post","link":"https:\/\/standrewsurcrustington.org.uk\/?p=854","title":{"rendered":"Explainer: Social Care\ufeff"},"content":{"rendered":"
<\/div>\n

Following the government\u2019s announced social care reforms<\/a> in September 2021, JPIT\u2019s Paul Morrison provides a guide to some of the issues involved.<\/em><\/p>\n

What is social care?<\/strong><\/p>\n

Social care covers a wide umbrella of services to people of working
\nage as well as the elderly. It varies from light touch support to help people
\nstay active and engaged in their communities, to regular personal care visits
\nto help with washing or dressing all the way through to long term nursing home
\ncare. For some, the care is simply essential for life, and for many more social
\ncare offers the opportunity to maintain a dignified and connected life. <\/p>\n

Good social care can transform lives, but bad or absent
\nsocial care can ever so quietly close people off and strip them of their
\ndignity. Both good and bad care often go unnoticed by all but very close
\nfriends and family.<\/p>\n

Who gets social care?<\/strong><\/p>\n

Adult social care is used by adults of any age whose needs[1]<\/a>
\nare assessed to be significant enough to warrant support. The service is
\nparticularly needed by people of pension age who account for two-thirds of the
\n800,000 individuals receiving long term care, and just under over half of all social
\ncare spending. This does however mean that support for working age people with
\ndisabilities or impairments forms a sizable and often overlooked component of
\nsocial care.<\/p>\n

Why does social care need reform?<\/strong><\/p>\n

The case for change falls into three broad areas of concern[2]<\/a>:<\/p>\n

1. There are not enough social care services available to meet the need<\/strong>: Local authorities in England receive around 2 million new requests for help each year, and for a variety of reasons reject around 42% of them. The number of requests is steadily rising, levels of reported disability are rising, but the numbers receiving long term care are steadily falling. Other surveys indicate that 1.5 million over 65s who need and are entitled to care do not receive it. Increasingly stretched local authorities have had to spread their resources more thinly. <\/p>\n

You only need to talk to families who have
\ndealt with the care system to know that the effect of this is to make it much
\nharder to ensure loved ones are cared for with dignity. The system can appear
\nto be a confusing, guilt inducing maze. Unfortunately to ensure good care families
\nare often required to have sufficient money to top-up the basic care packages
\non offer, and\/or the ability to put their case to the local authority
\npersistently and well. <\/p>\n

2. Care staff have persistently
\nbeen undervalued: <\/strong>There are around 1.5 million people working in the care
\nsector. In Scandinavia, care work is viewed as a profession with progression,
\ntraining programmes, and wages at around three quarters that of a nurse\u2019s. In
\nthe UK care work is viewed as a low paid, low skill occupation with a limited career
\npathway. By 2019 average pay had slipped back relative to other low paid jobs,
\nand for example is now below that of retail assistants.<\/p>\n

The job can be difficult and demanding and given the low pay
\nand status we cannot be surprised that each year almost 1 in 3 carers leave the
\nprofession (for home care workers it is nearer 1 in 2), and that recruitment is
\na persistent problem. <\/p>\n

Even if not financially rewarding, care-giving can be a
\nhugely rewarding job. However, when surveyed, three quarters of domiciliary
\ncarers said that cost pressures meant they did not have time to provide
\ndignified care. <\/p>\n

3. For some people care is very expensive, even to the
\npoint of needing to sell their home to pay for it: <\/strong>Unlike the NHS, social
\ncare is not free when you need it. Essentially if you have assets of over
\n\u00a323,250 then you must foot the full cost of care, and may need to pay a
\nproportion of costs if you have assets below this threshold. The \u2018housing
\ndisregard\u2019 means that if you need to continue living in your own home, the
\nvalue of your property is not counted in your assets, but if you move into
\nresidential care it does then count. <\/p>\n

Fees
\nfor care can quickly become substantial, and the government estimates that 1 in
\n10 adults over will face costs of over \u00a3100,000. <\/p>\n

What
\nreforms are being proposed?<\/strong><\/p>\n

The Command Paper contains 3 sections. The first about the
\nNHS, the second about social care and the last about a 1.5% rise in National
\nInsurance contributions to be branded \u201cthe Health and Social Care Levy\u201d. The
\nincreased tax will raise an additional \u00a311 billion[3]<\/a>
\nbut to be divided between the NHS and the social care sector.<\/p>\n

Changes to means tests<\/strong>: There is a fairly detailed
\nanswer to the issue of families needing to pay high fees for care. It sets a
\ncap where once a person has paid \u00a386,000 they will not be asked to pay any more
\nfor their care.<\/p>\n

The means test is also restructured, so that if you have assets
\nof less than \u00a320,000, no care fees are payable; between \u00a320,000 and \u00a3100,000 a
\ncontribution of disposable income and up to \u00a320,000 per year may be charged;
\nand over \u00a3100,000 the person must pay full costs. <\/p>\n

The annual cost of this will be around \u00a31.6 billion, but this
\nis not additional money to the sector to improve services \u2013 local authorities will
\nlose some fees from people with assets, but they are replaced by money from National
\nInsurance contributions.<\/p>\n

Few specific commitments to social care:<\/strong> Ironically
\nfor an announcement billed as \u2018fixing social care\u2019, beyond the funding reforms,
\nthere are very few commitments to change or even provide additional funding to
\nsocial care. The paper says encouraging if familiar things about the system and
\npromises that a White Paper will be forthcoming, however the only money it specifically
\noffers the sector is \u00a3160 million per year to provide a helpline and other
\nsupport for care staff.<\/p>\n

For context, the care system costs \u00a323 billion a year, and
\nthe Health Fund estimates that an additional \u00a31.9 billion is needed to simply keep
\npace with current demand. \u00a3160 million will not go far \u2013 nor does the paper
\nsuggest it will. It is currently unclear how much of that \u00a311 billion will go
\nto the NHS and how much to social care.<\/p>\n

\n

[1]<\/a>
\nThe criteria of sufficient need is set at what I found to be a surprisingly
\nhigh level and defined in the Care Act 2014<\/p>\n

[2]<\/a> Experts
\nwill rightly accuse me of oversimplifying the issues. If you are interested in
\nmore detail go to the excellent and readable Kings Fund Social Care 360 website
\nhttps:\/\/www.kingsfund.org.uk\/publications\/social-care-360<\/a>\n<\/p>\n

[3]<\/a>
\nafter taking into account increased benefit payments and costs to public sector
\nemployers<\/p>\n

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Following the government\u2019s announced social care reforms in September 2021, JPIT\u2019s Paul Morrison provides a guide to some of the issues involved. What is social care? Social care covers a wide umbrella of services to people of working age as … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[3],"tags":[],"class_list":["post-854","post","type-post","status-publish","format-standard","hentry","category-urc-news"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t