Tag Archives: Care Bill

Rationing for social care hardwired into the Care Act

This week the Queen’s Speech set out the Coalition’s plans for their final year in Government. Today we learnt the details about one of the most critical reforms of the last year – who will be eligible for social care under the new Care Act.

Last month’s passage of the Care Act represents a huge achievement for the Coalition Government.  For the first time, we have a single modern law that governs social care.  It is a truly aspirational piece of legislation – placing the well-being of those using social care at the heart of the Bill.

For Scope – and other members of the Care and Support Alliance – the final question remained – who will be eligible for social care support?  The Care Act represents a huge opportunity to make sure that every disabled and older person who needs social care support can get it, with the introduction of a new ‘national eligibility threshold’.

Today the Government has released details about who will be eligible for social care – and has confirmed that those older and disabled people who are shut out of the social care system will continue to receive little to no social care support.

For Scope, we believe there is a real risk that continuing to ration social care support will fatally undermine the Government’s focus on improving preventative social care.

We know that as local authority budgets are squeezed, the support that disabled people receive to get up, get washed and get out of the house is also being squeezed.

Take the example of Julie-Ann from Crawley in Sussex. Julie-Ann lost her sight three years ago and is deaf. She used to receive four hours of social care support a week that supported her to wash, cook and get out of her house.

She has been deemed no longer eligible for care, and now struggles with tasks around the house and suffers from loneliness.

Specifically, today’s publication confirms that many people unable to get out and about could fall through the net – this could include people who are on the autistic spectrum or who have dementia, a learning disability or a mental health condition.

With the Care Act comes the opportunity to make sure such people are eligible for social care. However, on the basis of the Government’s plans today, we have instead seen existing rationing for social care hardwired into the Act.

We know that sitting behind this rationing is the chronic underfunding of social care. For the Care Act to be truly transformational – ensuring the wellbeing of everyone who uses social care – it must be matched by bold investment.

With increasing numbers of older people and disabled adults needing care, there must be a new consensus on adequately funding social care services. What’s more, there is increasing consensus that doing so could generate real savings across Government.

The Department of Health is holding a final public consultation on the regulations. Scope will be responding to make sure that the details are improved as far as possible to allow disabled people who need social care support are able to receive it.

We encourage you to get involved, making it clear just how important social care support is in allowing disabled people to live their lives.

The Care Act is welcome, but there’s plenty of unfinished business

Post from Caroline Hawkings, Public Policy Advisor at Scope.

This week, we’ve reached a significant milestone for adult social care in England.  After many months of debate, the Care Bill has become the Care Act through Royal Assent, meaning that the primary legislation is complete.

In the words of the Minister Norman Lamb, the Act’ represents the most significant reform of care and support in more than 60 years and at least on paper, there are many things to welcome about the new Act.

  • For the first time adult social care law has been brought into a single Act, replacing disparate and sometimes outdated laws
  •  Local authorities have a duty to promote a person’s well-being, which is comprehensively described in a ‘well-being principle’ covering different aspects of life
  • The Act introduces a national minimum threshold for getting care and support, which all local authorities must adhere to, aiming to end the post-code lottery of the current system where local authorities decide their own level. Currently, eligibility for support is assessed against a framework called Prioritising Need, also referred to as the Fair Access to Care Services criteria (FACS). There are four levels ‘critical, substantial, moderate and low’, the majority being at substantial or above.

Other positive features include: an emphasis on providing personalised services, prevention, personal budgets, improvements to care planning and access to advocacy in certain circumstances

But, the key question for disabled people remains whether they will be able to get the care and support they need to as live independently as possible?  Social care is vital to promoting a person’s dignity, well-being and independence and one in three people using social care are working age disabled people. Increasing access to social care is a key part of improving disabled people’s living standards.

There are two crucial inter-linked decisions which have yet to be finalised, which will determine the success of the Government’s landmark piece of legislation.

Firstly, although the Act establishes a national minimum threshold for social care, the level at which it is set will be determined by eligibility criteria contained in regulations (secondary legislation). These criteria will decide whether a person is in or out of the formal system.  The criteria have yet to be finalised and are due for public consultation at the end of May.

The Government has stated that their intention is to maintain eligibility at ‘substantial’ under the current Fair Access to Care (FACS) criteria.  So, the worrying prospect is one of a more uniform threshold which is consistently too high, where care continues to be restricted. This means that thousands of disabled people are likely to be shut out of the benefits which the new Care Act brings.

Secondly, the Act sets out the legislative framework, but the funding allocated to actually implement and apply what it says, is largely dictated by the Treasury. The tight rationing of care is largely due to historic underfunding and budget cuts.  Due to funding pressures, research from the Care and Support Alliance shows that 97,000 fewer disabled people who would have received social care five years ago, now receive no support.

The most frustrating thing is that it needn’t be like this. A lower eligibility threshold is good for disabled and older people and has benefits for the economy. Modelling by Deloitte, in the Ending the Care Crisis report, has shown that a £1.2 billion investment in establishing a lower national eligibility threshold would lead to £700 million saving to Central Government and £570 million saving to the NHS and local government.

Scope, working with other members of the Care and Support Alliance have been consistently urging the Government to introduce a lower eligibility threshold, backed up by sufficient funding to so that local authorities can afford to implement it properly.

If the Government is to realise the bold and welcome ambition of the Care Act, it’s essential that disabled people up and down the country get the support they need to live independently and live well.

Budget 2014: How the Chancellor can put disabled people at the heart of the recovery

At the start of the year the Chancellor was clear that the economy is not out of the woods yet – ‘it’s far too soon to say: job done’. The Budget gives him the opportunity to put some meat on these bones and deliver one of the most important speeches in the long election campaign.

As he reveals what this ‘year of hard truths’ will entail, the focus will be on his ‘strategy for growth’.

There is a huge opportunity for disabled people to be part of this strategy. Scope has called on the Chancellor to put disabled people at the heart of the economic recovery to meet his own aspiration of making a ‘strong and fair economy’.

We will be looking for his red box to contain some of the following to make this a reality:

A Commitment to covering the extra costs of being a disabled person

Disabled people’s ability to pay their way and be financially secure is hampered by various extra costs. The Personal Independence Payment (PIP) is designed to help meet some of these costs.

  1. We want to see the Chancellor protect the value of PIP by taking it out of the new cap on Annually Managed Expenditure.
  2. The Chancellor can tackle these extra costs head on by announcing an innovation fund that looks to drive down the extra cost.

Action to get disabled people into work

By 2020, there will be an increase in the number of disabled people looking for work. Following reassessment of Incapacity Benefits claimants, between March 2011 and March 2013, there are at least 650,000 more disabled people are seeking work.

To help them find jobs, the Chancellor needs to:

  1. Make regional growth strategies work for disabled people.
  2. Give disabled people personal budgets to spend on back to work support.

Social Care

The Care Bill has completed its passage through Parliament – but one crucial issue still remains: funding. The Care System remains chronically underfunded, and for the Bill to be the legacy legislation that the Government intended, it needs to be matched with the right investment.

  1. The Government introduced the ‘Better Care Fund’ in June last year. The Chancellor needs to commit to extend this Investment every year.
  2. Piloting a community budget approach to care integration for disabled people – bringing together care, health and employment support.

The Minister for Disabled People, Mike Penning, will be in Manchester on Wednesday as part of the Government’s Disability Confident Campaign – and I hope the Chancellor’s Budget gives him every opportunity to say just how the Government will make sure that disabled people are at the heart of the economic recovery.

George Osborne has to support vital care in next week’s budget

Do you get annoyed at how long it can take to get things done sometimes? Simple things like trying to reach someone at a helpline or waiting in busy traffic can be pretty frustrating – never mind something as important as trying to make sure everyone who needs care gets it.

Ema - a young woman using a wheelchair, holding a dogOn Monday MPs had just that chance during the latest stage of the Care Bill. The Care Bill is an important new law looking to improve social care for people like Ema, to make sure she can live her life the way she wants to.

It’s been a long road to get to this point. There’s still a lot to be done to make sure everyone who needs care gets it, but thanks to the great support for our campaigns – MPs know now more than ever just how important this vital support is.

From the 25,000 people who contacted their MP by sending them a postcard in one of our shops, to the people who sent in photographs that we hand delivered to Parliament, it showed MPs just how important social care is. We even asked people to Speak Out for Care and send their own message to their MP on giant speech bubbles, and to go one step further and record a message for one of our speaking cards just a few weeks ago.

But there’s still more we need to do.

The decisions about the specifics of who will be able to get care have still to be made. A consultation is going to run over the next few months ahead of another vote by MPs in the autumn.

In the meantime we want to make sure that the proper funding is in place to pay for this vital support for disabled people. So when MPs go to Parliament for the Budget next week, we want to send them a clear message that they need to invest in care.

Do you want to add your voice? Join with people from across the country and send the Government a message on Facebook or Twitter to fund social care.

The Care Bill: the final chapter

Guest post by Megan Cleaver, Parliamentary Officer at Scope.

Today’s debate in Parliament on the Care Bill marks the final opportunity for MPs to make changes to reforms the Government claims will transform social care for older and disabled people and make the system fit for the 21st century.

We are looking out for a debate in Parliament on an amendment from Paul Burstow to ensure there is sufficient funding of the social care system. This has support from a broad coalition including the Care and Support Alliance, the Local Government Association, the Association of Directors of Adult Social Services, and Society of Local Authority Chief Executives.

This is an important statement as local authorities and charities can often appear at loggerheads over social care.

Because while the Care Bill has been broadly welcomed by both charities, care providers and local government who have applauded the Government for setting out their vision to create a preventative care system where older and disabled people will not just be supported to survive, but to live full and active lives in their communities, there are grave concerns about whether this bold vision can actually become a reality on the ground.

Cuts to local authority budgets of more than 20% since 2010 have had a devastating impact on social care provision. Indeed, just last week Age UK reported that over 800,000 older people were going without vital help due to the squeeze on social care funding.

To reverse this damaging trend, Paul Burstow’s amendment would require the Care and Support Reform Programme Board (which brings together senior figures from both local and central government responsible for commissioning and providing care services) to report annually to the Department of Health on whether they are satisfied that sufficient funding is in place to ensure that the reforms in the Bill i.e. creating a preventative care system with the well-being of care users at its heart- can be implemented.

In addition, the Programme Board would also review where the new “national eligibility threshold” for care has been set. This is hugely important as last June the Government stated its intention to set, and thereby fund, the threshold at a level where only those older and disabled people with ‘substantial’ needs will be able to get care. This will mean that hundreds of thousands of older and disabled people with ‘moderate’ needs will be denied the care they need to get washed, get dressed and get out of the house- the very essence of an individual’s well-being.

Without this reporting from the front line of social care, shortfalls in funding will likely continue leaving too many older and disabled people unable to benefit from the preventative care system they had been long promised.

Indeed, recognising that Labour’s vision for “whole person care” will not be achieved without the necessary investment, Shadow Care Minister Liz Kendall has also put her name to this amendment- making it a truly cross-party appeal to the Government to ensure “the most valuable legacy in health and care reform for a generation” can truly be achieved.

Because while the Government has claimed that the key to putting social care on sustainable footing is to ‘use the resources we currently have more efficiently’, there is significant evidence that it is  through properly investing in social care that is in fact the most efficient use of local authority budgets.

Join us on Twitter this afternoon for live Tweets from the report stage.

It’s time to speak out for care…literally

When I worked for a Member of Parliament one of the first tasks every morning was to struggle through the bulging post bag. That was before I even considered opening up the email inbox to see the hundreds of new emails that had flooded in since the day before. As well as the letters and emails from constituents, we would hear from organisations, all trying to get the attention of the MP on different issues or causes.

To get their attention you’ve got to try something a bit different

We’ve tried some innovative actions as part of our Britain Cares campaign. Last year we sent MPs over 1,000 individual photos of constituents showing how much they cared about social care. We followed it up by asking people to speak out for care and delivered over 400 speech bubbles to Parliament.

Social care is so important to so many disabled people across the UK. It’s the vital support that helps them live their lives in the way they want to. It’s help with getting up and dressed in the morning, preparing and cooking a meal or getting out of the house.

With the final debate in Parliament on the future of social care only weeks away we knew it was more important than ever to grab MPs attention.

This time we went one step further – we asked people to literally speak out for care. We took their messages, in their own voices, to their MPs.

The messages

Here’s some examples of the great messages we sent to MPs:

It was simple too. We recorded short messages on to small audio modules that we stuck into big cards and sent them on to Parliament. The video below shows how we did it:

When MPs opened up the mail the morning after we dropped off our audio cards, they received something a bit different, something that stands out from other letters. They heard from one of their own constituents. They heard why social care is so important and the opportunity that Care Bill is to make sure that everyone who needs care gets it.

With the 2014 Budget due next week, the CSA is uniting to put pressure on the Chancellor to invest in social care. To take part, sign up for the CSA thunderclap, asking George Osborne to take action and invest in care.

Speaking out for Care – The second reading

Guest post by Ben Parker, Parliamentary Assistant at Scope.

Monday marked a significant day as the Care Bill entered the House of Commons to be debated by MPs for the first time. With the Government choosing to have the Second Reading in the last week of Parliamentary business before the Christmas Recess, and falling the day after Nelson Mandela’s funeral, there were understandable concerns that the Bill wouldn’t receive the political attention it deserved.

For disabled people the Bill has huge importance. It marks the first move towards building a preventative and sustainable social care system after years of political neglect and chronic underfunding.

The opening exchanges between Secretary of State for Health Jeremy Hunt and Shadow Secretary Andy Burnham were fiery; a reminder of the political tensions between the two parties before the last election and fuelled by strong feelings on either side of the Chamber around the Care Bill. Speaker John Bercow was forced to interject at length in an attempt to maintain order as Hunt and opposition backbenchers traded verbal blows.

It was disappointing that the Secretary of State’s opening remarks failed to recognise disabled people’s role in the debate. Instead he focused on the NHS, the bolstering of the role of the Care Quality Commission in safeguarding health services and in particular, the administration of enforced service changes at Lewisham Hospital.

But there was also encouragement – Scope’s Britain Cares campaign has focused on addressing the eligibility threshold for social care and ensuring that all disabled people who need access to the care system to live independently can do so. Without this, the Government’s welcome ambitions for the Care Bill risk not being realised. The media also picked up on the story, with Sky News yesterday highlighting eligibility with the powerful real-terms implications for disabled people going without care.

This campaigning has had evident impact. Several backbenchers including David Ward (Lib Dem – Bradford East) and Anne McGuire (Labour – Stirling) chose to focus on this issue, McGuire arguing that if “social care is to mean anything to the lives of the disabled, it should be underpinned by a real recognition of the importance of an independent life.”

John McDonnell (Labour – Hayes and Harlington), Emma Lewell-Buck (Labour – South Shields) and Bill Esterson (Labour – Sefton Central) took the opportunity to highlight the statistics published by the Personal Social Services Unit at the London School of Economics, emphasising that the Government spending on social care has not kept pace with demographic change. McDonnell summarised: “those with moderate needs, which are still significant and should be within the system, are being ignored completely. We need to address this matter with some seriousness now and try to reach some all-party agreement on the way forward.”

The former Communities and Local Government Minister Hazel Blears outlined that failing to address eligibility had implications for the ambition of a preventative care system. “If we are talking about the well-being duty and the duty to prevent, reduce and delay somebody’s need for care, how can we say that we are going to support only people with substantial and critical needs?”

The backbench Conservative MP for Swindon South, Robert Buckland, made a measured and eloquent case in agreement, calling on the Government to ensure that “local authorities’ understanding of prevention is wide ranging and includes the very types of low-level support that can make this prevention aspiration a reality.”

In response, the Minister of State for Care Norman Lamb was at pains to point out that Local Authorities could still choose to set their thresholds at lower levels, although as Burnham countered, legislating for only critical and substantial needs sends a clear political message. This freedom of choice would also seem to run contrary to the Minister’s desire for a simplified ‘in-or-out’ care system designed to eradicate the current post-code lottery of care provision.

The Government’s decision to bring the £3.8bn health and social care integration funding under the banner of the ‘Better Care Fund’ also appears to be an acknowledgement of the increasing political pressure around the importance of lower-level care.

We will continue to watch closely for the amendments at the Committee Stage of the Care Bill. With your help as part of the Britain Cares campaign, we will continue to fight to make the legislative reforms as strong as possible and to ensure that all disabled people who need care can access it and live independent lives.

Around the country people #SpeakOut4Care – will MPs today?

Guest post from Graeme Hay, National Campaigns Officer at Scope. 

Social care takes so many different forms and can help people with loads of different tasks and activities in their everyday lives. Whether it’s helping people get up and ready in the morning, preparing and eating food, or getting out and about – this crucial support helps many disabled people live independent lives.

The Care Bill, Government legislation which will decide the future of social care, is being debated by MPs for the first time today. But at the moment it risks shutting more than 100,000 disabled people out of social care completely.

So we wanted MPs to hear from their constituents about why social care is so important to them, asking them to send in a message that we promised to deliver to their MP. We got a huge response from people all over the country – people who use social care, relatives and people who just believe everyone should be able to live their lives the way they want to.

Graeme Hay holding up Speak out for care bubble

Powerful stories

All the messages were printed out on to big speech bubbles and delivered to almost 400 MPs in Parliament last week. There were some incredibly powerful stories, here are just a few examples to share with you: 

“I want everyone who needs care to get it because… everyone deserves an equal chance to live to their full potential with the support they require in order to achieve this.”

“I want everyone who needs care to get it because… I am a 67 year old man who has been disabled from birth. I need help with everything, getting dressed, taking medication, and as I am also registered as severely sight impaired. I would be jailed in my own house and unable to get out or talk and meet new friends without help.”

“I want everyone who needs care to get it because… my wheelchair using friend has so much to offer the world but is housebound because of lack of care – lack of care makes people more dependent, not less.”

“I want everyone who needs care to get it because that is the way it should be.”

As well as all the usual briefings filling up MPs post bags, we hope they’ll pay special attention to these unique stories from their constituents, speaking out for care, and use the Care Bill debate to make sure that everyone who needs social care gets it.

Growing number of voices

And the voices speaking out for care are growing even bigger.

Alana and her brother James from Oxfordshire, who relies on social care to live independently, started a change.org petition calling on party leaders to commit to making sure everyone who needs care can get it.

At the time of writing nearly 40,000 people have already signed the petition showing just how big an issue social care is for so many people around Britain.

Will MPs respond and speak out at the debate today, to make sure everyone who needs care gets it?  Follow the debate on Twitter and check back here tomorrow for our rundown and what happened in Parliament.

Autumn Statement – what’s in it for social care?

Guest post from Megan Cleaver, Parliamentary Officer at Scope.

Today’s Autumn Statement was the last big political announcement of 2013. But what was left out of the Chancellor’s speech this morning was just as revealing as what was included.

The A&E crisis has dominated the headlines over the past few months, with investment in social care seen as one way to ease the pressure on hospitals. But despite rumours overstretched social care budgets would be given a boost today, on this the Chancellor was silent.

Such a commitment to extra funding would have been especially welcome given the second reading of the Care Bill in the House of Commons was also announced today. The Care Bill contains the biggest ever reforms to the social care system, and its debate on 16 December will be the first opportunity for MPs to debate changes to social care which will affect over half a million disabled people.

And providing good quality social care can bring huge economic benefits. George Osborne spoke at length in the Autumn Statement about the need to get the benefits bill down and get people working. For disabled people, social care is the cornerstone of their independence- the support they need to both seek and stay in employment.

Indeed, recent research by Deloitte has shown that investing in social care for disabled people with ‘moderate’ care needs – who the Government have stated they intend to shut out of the social care system by tightening up eligibility for care – creates considerable savings for the public purse. Deloitte found that for every £1 that is spent on moderate social care needs, £1.30 is saved through increased tax revenue to the Treasury and a reduction in welfare spending as a result of disabled people and informal carers entering the workplace, not to mention the significant savings to local authorities and the NHS from ensuring disabled people’s needs do not escalate to crisis point and therefore require more expensive medical treatment at a later date.

And when George Osborne states that the job of getting rid of the deficit ‘is not yet done’, these are financial savings that cannot be ignored.

Disability History Month 2013

Post from Alice Maynard, Chair of Scope

Disability History Month begins this week. Recently a fantastic and timely BBC documentary charted some of the big milestones in the struggle for independent living.

It’s clear society’s attitudes to disability have come a long, long way.

But it wouldn’t have happened had disabled people, like Paul Hunt, who led a care home revolt and became one of the Movement’s founding fathers, not looked around and said “this isn’t good enough”.

It’s got me wondering if this month could go down in disability history.

Hear me out…

Columnist Frances Ryan recently did a great job of summing up what life is like if you’re disabled in 2013. For too many people it’s a real struggle to live independently.

But could November 2013 go down as the month when we once again made our voices
heard?

At the beginning of the month five disabled activists waited nervously outside the court of appeal for the outcome of their challenge to the way the Government has gone about closing the Independent Living Fund. They won.

Following on from Labour’s promise to scrap the bedroom tax and news that the Government have had to slow down the roll-out of personal independence payment, have we hit a point when it’s dawning on the public that with living costs spiralling and incomes dropping that the answer to disabled people’s living standards crisis isn’t to take away financial support?

Also this month MPs are preparing to debate the Care Bill. There are positive moves in the bill – the role of advocates is now enshrined – but plans to restrict council-funded support to only those with the highest need, will force too many disabled people to have to pay for their own support to live independently. At a time when disabled people are struggling to make ends meet, that is support they simply can’t afford.

Disabled people have for too long sat outside a debate that focused on making sure middle England baby boomers didn’t have to sell their homes to pay for their parents’ care. But again it feels like disabled people are starting to make their voices heard. With disability now a mainstay in the social care debate, could the Government be forced to re-think its plans and genuinely make history by guaranteeing council-funded independent living support for everyone that needs it?

Making sure disabled people can get support is one side of the coin. The other is what that support looks like. Does it genuinely promote independent living?

This is the month that we at Scope tackled this question head on. Again disabled people’s voices have played a big part. For a long time activists have been urging Scope to transform its more old-fashioned residential homes. Not long ago they protested outside our offices.

This month we begin work on proposals to close or significantly change 11 care homes. It’s the right thing to do. But we also need to do it the right way, which means making sure disabled people who live in these homes have choice and control over where they live in the future. I don’t think we’ve done anything radical. But hopefully we’ve given the sector a bit of a jolt.

The message for Disability History Month 2013 is ‘Celebrating our struggle for independent living: no return to institutions or isolation’. Let’s remember some big milestones. Let’s not forget that we have a long way to go. But let’s be optimistic – disabled people continue to speak out and continue to make society think differently.

UK Disability History Month runs from 22 November to 22 December.
Visit the UK Disability History Month website