CJO - Social Policy Digest

Social Policy Digest

Subject:	Social services and care
Topic:	Social care policy
Year:	2014 \| 2013 \| 2012 \| 2011 \| 2010 \| 2009 \| 2008 \| 2007 \| 2006 \| 2005 \| 2004 \| 2003 \| 2002

Call to stop 'pushing' elderly and disabled people into nursing homes

A discussion paper said that the social care system would collapse if elderly and disabled people continued to be 'pushed' into nursing homes and day centres. A change of approach was needed, under which local councils – building on relationships with health professionals and community groups – provided care services for older people and those with physical and learning disabilities in their own homes and communities.

Source: Discussion Paper – The Future of Adult Social Care, Local Government Association

Links: Discussion paper | LGA press release

Date: 2010-Nov

Social services in Wales – Pearson review

The report was published of an independent government-commissioned review (chaired by Geoffrey Pearson) on the future of social services in Wales. It recommended that Wales should create national eligibility criteria for adult care services to end the 'postcode lottery' for service users, along with the introduction of standardized contracts between service providers and local authorities.

Source: Independent Commission on Social Services in Wales, From Vision to Action, Welsh Assembly Government

Date: 2010-Nov

Government vision for adult social care

The government published a statement of its vision for adult social care in England. It challenged local councils to provide a personal budget by April 2013, preferably as a direct payment, for everyone who was eligible. As councils devolved commissioning responsibility to individuals, the government would expect them to work with providers to broaden the market of care services, particularly small social enterprises, so that individuals could exercise real choice. A consequence of personalization was that people would increasingly take their own decisions about how to balance their new freedoms with a 'sensible approach to risk'. The statement called for an increase in preventive activity in local communities, to keep people independent for longer and to contribute to building the 'Big Society'. The government simultaneously began consultation on a new strategic approach to quality and outcomes in adult social care: councils would in future assess one other on care provision and determine their own standards, while providers would no longer receive quality ratings.

Source: A Vision for Adult Social Care: Capable communities and active citizens, Department of Health | Transparency in Outcomes: A framework for adult social care – A consultation on proposals, Department of Health

Date: 2010-Nov

Munro review – initial findings

The initial findings were published of an official review of the child protection system in England. Previous reforms had led to social workers spending less time with vulnerable children and families. Although the reforms had been well-intentioned, they had not delivered positive, long-lasting improvements at the front line. Changes made in reaction to high-profile cases over the previous four decades had focused on parts of the system, rather than considering it as a whole.

Source: Eileen Munro, The Munro Review of Child Protection Part One: A Systems Analysis, Department for Education

Date: 2010-Oct

Permanent settlement for funding social care?

A paper said that the conjunction of the government's Spending Review (October 2010), the report of the Commission on Funding of Care and Support (due in December 2010), and Law Commission recommendations on a new social care statute (due in April 2011) created the possibility of a permanent settlement for funding the social care system. The big question was whether the proposed funding settlement and statute would be aligned with each other and with a vision for social care that was designed around people's lives, rather than around services.

Source: Emma Stone and Claudia Wood, A Funding Settlement that Works for People, Not Services, Joseph Rowntree Foundation

Links: Paper

Date: 2010-Oct

Social policy for social work in Scotland – new textbook

A new textbook examined social policy and its central relevance to social work, social care, and related practice in Scotland.

Source: Steve Hothersall and Janine Bolger (eds.), Social Policy for Social Work, Social Care and the Caring Professions: Scottish Perspectives, Ashgate Publications

Links: Summary

Date: 2010-Oct

Review of law on adult social care – government response

The government responded to the Law Commission's consultation on the legislative framework for social care. It said that it agreed with the Commission that the framework was outdated and needed modernizing.

Source: The Government Response to Law Commission Consultation Paper 192: Review of the Law on Adult Social Care, Department of Health

Links: Response | Consultation document

Date: 2010-Sep

Financing of long-term care in England

An article said that the long-term care system in England could be characterized as a 'residual' system where care was free only to those who could not afford to pay for themselves, with access heavily targeted to those with the highest levels of needs and with no informal care, and with substantial local variation in access and means-testing for home care.

Source: Adelina Comas-Herrera, Raphael Wittenberg and Linda Pickard, 'The long road to universalism? Recent developments in the financing of long-term care in England', Social Policy and Administration, Volume 44 Number 4

Links: Abstract

Date: 2010-Aug

Long-term care – call for social insurance approach

An article said that there were potentially large welfare gains if people could buy insurance that covered the costs of long-term care. However, technical problems on both the supply and demand sides of the market suggested that the actuarial mechanism was not well suited to addressing risks associated with long-term care. A system based on social insurance was a better solution.

Source: Nicholas Barr, 'Long-term care: a suitable case for social insurance', Social Policy and Administration, Volume 44 Number 4

Links: Abstract

Date: 2010-Aug

Social care – government responds to MPs

The new coalition government responded to a report by a committee of MPs (published before the general election) on social care. It reiterated its plan to establish an independent commission to make recommendations on how to achieve an affordable and sustainable funding system for care and support.

Source: Government Response to the Health Select Committee Report on Social Care, Cm 7884, Department of Health/TSO Links: Response | MPs report | Hansard

Date: 2010-Jul

Long-term care 'should not be funded through taxes'

A think-tank report said that the official commission on the funding of long-term care should not consider paying for care solely through general taxation – because of the annual cost of up to £106 billion. Three specific funding models should be considered instead: a partnership model; a social insurance model; and a hybrid model whereby the state guaranteed some level of care, but people were required to make top-up payments through insurance- or annuity-backed products.

Source: Henry Featherstone and Lilly Whitham, Careless: Funding long-term care for the elderly, Policy Exchange

Links: Report | Guardian report | Community Care report

Date: 2010-Jul

Commission on the Funding of Care and Support – terms of reference

The new coalition government announced the terms of reference for the Commission on the Funding of Care and Support. The Commission would consider a range of funding ideas, including both voluntary insurance and partnership schemes.

Source: Written Ministerial Statement 20 July 2010, columns 10-11WS, House of Commons Hansard/TSO

Date: 2010-Jul

Department of Health – structural reform plan

The new coalition government published a draft 'structural reform plan' for the Department of Health. The plan set out how the department would implement the coalition government's key policy aims, in particular taking power away from Whitehall and putting it into the hands of people and communities.

Source: Department of Health: Draft Structural Reform Plan, Department of Health

Links: Plan

Date: 2010-Jul

Framework for reform of health and social care

A think-tank report set out a framework for the reform of health and social care services. It said there was a need for: an extension of integrated preventative care; a refocusing of local commissioning on improved health and social outcomes; and a radical reconfiguration of services in support of more home-based care.

Source: Health Working Group, Improving Health Outcomes: A guide for action, 2020 Public Services Trust

Links: Report

Date: 2010-Jul

NHS structure – White Paper

The new coalition government published a White Paper on the structure of the National Health Service. Groups of family doctors would be given freedom and responsibility for commissioning care for their local communities. Strategic health authorities and primary care trusts would be abolished. Patients would be able to choose which family doctor practice they registered with, regardless of where they lived, and choose between consultant-led teams.

Date: 2010-Jul

Future of adult social care – Dartington review

A report presented an evidence-based assessment of the development of adult social care up to 2020, identifying prospects and opportunities for change.

Source: Richard Humphries, Dartington Review on the Future of Adult Social Care, Research in Practice for Adults

Links: Report

Date: 2010-Jun

Adult social care – key policy issues

A briefing paper set out the key policy issues facing the adult social care sector. It said that adult social care had an important role in economic regeneration.

Source: Fit for the Future: Policy, Purpose and progress in adult social care, Association of Directors of Adult Social Services

Links: Paper | ADASS press release

Date: 2010-Jun

Coalition government publishes policy programme

The new Conservative-Liberal Democrat coalition government (formed following the general election in May 2010) published its policy programme for a five-year term of office. The programme included:

• A 'significantly accelerated' reduction in the structural public deficit, with the main burden of deficit reduction borne by reduced spending rather than increased taxes, and arrangements that would protect those on low incomes from the effect of public sector pay constraint and other spending constraints.

• Cuts of £6 billion to non-front line services in 2010-11, 'subject to advice from the Treasury and the Bank of England on their feasibility and advisability'. Spending would be cut on the child trust fund and tax credits for higher earners.

A full public spending review, reporting in autumn 2010.

• An independent commission to review the long-term affordability of public sector pensions, while protecting accrued rights. The earnings link for uprating the basic state pension would be restored from April 2011.

• The personal allowance for income tax to be increased in order to help lower- and middle-income earners. There would be a substantial increase in the allowance from April 2011, with a longer-term objective of increasing it to £10,000 per year: this would take priority over other tax cuts, including cuts to inheritance tax. Liberal Democrat MPs would be allowed to abstain on budget resolutions to introduce transferable tax allowances for married couples.

• Funding for the National Health Service would increase in real terms in each year of the parliament. Overall management responsibility for the NHS would be transferred to a new independent board.

• A commission would examine the future of long-term care, reporting within a year. Legislation giving free personal care to the most needy, enacted at the end of the previous Labour government, would be scrapped.

• An annual limit on the number of non-European Union economic migrants admitted into the United Kingdom to live and work. Detention of children for immigration purposes would be ended.

• The establishment of fixed-term (five years) parliaments. There would be a referendum on the introduction of the alternative vote system of voting in general elections. A committee would be established to bring forward proposals for a wholly or mainly elected upper chamber on the basis of proportional representation.

• A referendum on further Welsh devolution.

• A commission would investigate the creation of a British Bill of Rights that incorporated all existing obligations under the European Convention on Human Rights. The identity card scheme would be scrapped.

• 'Radical' devolution of power and greater financial autonomy to local government and community groups. There would be a 'full review' of local government finance.

• Phasing out of the default retirement age. There would be a review to set the date at which the state pension age started to rise to 66, although it would not be sooner than 2016 for men and 2020 for women. Rules requiring compulsory annuitization of pension savings at 75 would be scrapped.

• Replacement of all existing welfare-to-work programmes with a single programme. Jobseeker's allowance claimants facing the most significant barriers to work would be referred to the new programme immediately, rather than after 12 months. Jobseeker's allowance claimants aged under 25 would be referred to the programme after a maximum of six months.

•Reform of schools in order to ensure that new providers could enter the state school system in response to parental demand. All schools would have greater freedom over the curriculum. A 'significant' premium would be introduced for disadvantaged pupils, funded by cuts from outside the schools budget.

Measures to make the police service more accountable through oversight by directly elected police commissioners. There would be a 'full review' of sentencing policy. Anonymity in rape cases would be extended to defendants.

• Extension of the right to request flexible working to all employees. A 'fair pay review' in the public sector would consider how to implement a proposed '20 times' multiple limit between the highest and lowest pay rates.

Source: The Coalition: Our Programme for Government, Cabinet Office

Date: 2010-May

Abuse and protection issues across the lifespan – literature review

An article said that there was a paucity of work in the field of abuse and protection across the lifespan.

Source: Fiona Johnson, James Hogg and Brigid Daniel, 'Abuse and protection issues across the lifespan: reviewing the literature', Social Policy and Society, Volume 9 Issue 2

Links: Abstract

Date: 2010-Apr

Personal Care at Home Act – Royal assent

The Personal Care at Home Act 2010 was given Royal assent. The Act gave around 280,000 of the neediest people in England free personal care in their own homes, with effect from April 2011 – subject to endorsement by Parliament after the general election. Care provided would cover basic living tasks such as getting up, dressing, washing, and using the toilet.

Source: Personal Care at Home Act 2010, Department of Health/TSO

Links: Text of Act | Explanatory notes | Community Care report

Date: 2010-Apr

Reform of social care system – report by MPs

A report by a committee of MPs called for fundamental reform of the social care system in England, based on cross-party consensus. The existing system was chronically underfunded, severely rationed, locally variable, too often of poor quality, and discriminatory towards older people. The government's Free Personal Care at Home Bill 'smacked of policy-making on the hoof', and risked creating perverse incentives and being substantially underfunded.

Source: Social Care, Third Report (Session 2009-10), HC 22, House of Commons Health Select Committee/TSO

Date: 2010-Mar

Call for cross-party agreement on reform of social care

A paper called for cross-party agreement as the way to achieve the reform of social care for elderly people. It set out a statement of shared principles on which agreement could be based.

Source: Stephen Dorrell MP, David Lipsey, Julia Neuberger, Derek Wanless and Norman Warner, Long Term Care of the Elderly: Shaping the Future, Social Market Foundation

Links: Paper | SMF press release | BUPA press release | Community Care report

Date: 2010-Mar

Funding care for an ageing population – views of public

A report (based on 'deliberative workshops') said that the public did not have a clear idea of how the care system worked. Most people had no idea how they would foot the bill when they, or their loved ones, needed care and did not want to face the issue of payment or care needs until they had to. People wanted payment decisions to be completely separate from decisions on the levels and forms of care: people should get the care and support they needed, and this should be provided by society as a whole.

Source: When I'm 94: How to fund care for an ageing population, Institute for Public Policy Research/PricewaterhouseCoopers LLP

Links: Report | IPPR press release

Date: 2010-Mar

Options for social care reform – King's Fund report

A think-tank report said that a revised version of the 'partnership model' proposed by the Wanless review in 2006 was the fairest way of funding social care in the future. This would see the state guaranteeing to pay 50 per cent of everyone's care costs and 'matched funding' for individual contributions to encourage people to save for their old age.

Source: Richard Humphries, Julien Forder and Jose-Luis Fernandez, Securing Good Care for More People: Options for reform, King's Fund

Date: 2010-Mar

Social care – White Paper

The government published (following consultation) a White Paper on the future of social care. It set out proposals to build a comprehensive 'National Care Service' for all adults in England with an eligible care need, free when they needed it. The National Care Service would be underpinned by six founding principles. The service would:

• Be universal – supporting all adults with an eligible care need within a framework of national entitlements.

• Be free when people needed it – based on need, rather than the ability to pay.

• Work in partnership – with all the different organizations and people who supported individuals with care and support needs.

• Ensure choice and control – valuing all, treating everyone with dignity, respecting an individual's human rights, personal to every individual's needs, and putting people in charge of their own lives.

• Support family, carers, and community life – recognizing the vital contribution that these made in enabling people to realize their potential.

• Be accessible – easy to understand, helping people make the right choices.

At the start of the next Parliament the government would establish a commission to help to reach consensus on the fairest and most sustainable way that people should contribute to this system. It would make recommendations to Ministers that, if accepted, would be implemented alongside the introduction of the comprehensive National Care Service in the Parliament after next. Under the National Care Service, the government expected that people would continue to pay for their accommodation costs in residential care if they were able to do so: but it would introduce a universal deferred payment system, so that no one had to sell their home in their lifetime in order to pay for residential care.

Source: Building the National Care Service, Cm 7854, Department of Health/TSO

Date: 2010-Mar

Future funding of social care – views of users

A report summarized the views of a group of adult social care service users on proposals for the future funding of social care. Service users felt that a false divide between social care and healthcare was perpetuated by conflicting funding arrangements. Almost all service users thought that general taxation was the best way to fund social care. They opposed any withdrawal of existing universal disability benefits to fund means- and needs-tested social care.

Source: Peter Beresford, Funding Social Care: What Service Users Say, Joseph Rowntree Foundation

Links: Report

Date: 2010-Mar

Funding social care – 'care levy' proposal

A report examined the various options put forward for funding the social care system, including those in the government's Green Paper. It suggested an alternative approach under which each generation took responsibility for its own care, through a 'care levy'. An initial charge on inheritance would gradually be replaced by funds built up through extra national insurance paid by younger age cohorts.

Source: Donald Hirsch and Philip Spiers, Funding Care: How can each generation pay its fair share?, Joseph Rowntree Foundation

Links: Report | JRF press release

Date: 2010-Mar

Adult social care law – advisory body consultation

An official advisory body began consultation on adult social care law in England. It said that the existing structure for determining eligibility was complex and, at times, impenetrable.

Source: Adult Social Care, Consultation Paper 192, Law Commission

Date: 2010-Feb

Wider economic and social benefits of social care reform

A government-commissioned report said that without a radical rethink of existing priorities the real cost of providing social care would double in the next twenty years. It said that spending on adult social care should be seen as a form of social and economic investment that had the potential to deliver a better service for the people who used social care services, while also generating significant savings in other parts of the welfare state. An improved social care system could generate significant savings by reducing the number of hospital admissions and the pressure on emergency hospital beds. Helping social care users into paid employment could reduce social security spending while also providing a significant boost to the economy.

Source: Jon Glasby, Chris Ham, Rosemary Littlechild and Steve McKay, The Case for Social Care Reform: The wider economic and social benefits, Health Services Management Centre/University of Birmingham

Links: Report | Summary | Birmingham University press release | Community Care report

Date: 2010-Feb

Call for 'new social contract' on social care

A report called for a 'new social contract' on social care provision, involving government, employers, public services, communities, and families. It recommended: a nationally determined entitlement to care and support that recognized the contributions of families and carers; a funding system for care that was fair and transparent; flexibility and support from employers to provide workplaces that met both business needs and the needs of families and individuals to juggle work and care; and a tax and benefits system that prevented financial hardship, recognized families' contribution to care, and gave carers the flexibility and security to juggle care and working lives.

Source: Tipping Point for Care: Time for a new social contract, Carers UK

Links: Report | Carers UK press release | Community Care report

Date: 2010-Feb

Complexities and contradictions of policy for adult social care reform

An article examined the complexities and contradictions that characterized much policy directed towards the reform of adult social care. Of these, the inadequacy of the resource base of adult social care was the most significant. Problems in other areas included: the rhetoric that accompanied policy change and the evidence base for that change; the lack of connexion between issues of independence and protection; the partial understandings of partnership; and the inadequate conceptualizations of both the nature of those people who required social care support and the character of that support.

Source: Mark Lymbery, 'A new vision for adult social care? Continuities and change in the care of older people', Critical Social Policy, Volume 30 Issue 1

Links: Abstract

Date: 2010-Feb

Personal Care at Home Bill – third reading

The Personal Care at Home Bill was given a third reading. The Bill was designed to give around 280,000 of the neediest people in England free personal care in their own homes, with effect from October 2010. Care provided would cover basic living tasks such as getting up, dressing, washing, and using the toilet.

Source: Personal Care at Home Bill, Department of Health/TSO | Debate 12 January 2010, columns 563-657, House of Commons Hansard/TSO

Links: Text of Bill | Explanatory notes | Hansard | Community Care report | Local Government Chronicle report

Date: 2010-Jan