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

Care Bill – second reading

The Care Bill was given a second reading. The Bill was designed to:

• Introduce a cap on the cost of social care in England, and give carers the legal right to support from their local council.

• Provide protection to people whose care provider went out of business.

• Set out provision for local authorities to assess the care and support needs of children, and young carers, who may need support after they reach the age of 18, to facilitate the transition to adult social care.

• Set out entitlements to personal care budgets and provisions for deferred payments for care.

• Introduce a rating system for hospitals and care homes, and give new powers of intervention to the chief inspector of hospitals.

• Create two new public bodies, Health Education England and the Health Research Authority, designed to provide additional training and support for health professionals.

Source: Care Bill, Department of Health, TSO | Debate 16 December 2013, columns 487-580, House of Commons Hansard, TSO

Date: 2013-Dec

Whole person care

A think-tank report examined the case for a system of 'whole person care' in England, and how to move towards this approach. It said there were two core elements: connecting physical health, mental health and social care needs; and supporting people in their wish to remain in their own homes. Recommendations included: a single point of contact for all care needs; peer support; joint health and care plans; and longer term funding plans.

Source: Sarah Bickerstaffe, Towards Whole Person Care, Institute for Public Policy Research

Links: Report | BMJ article

Date: 2013-Dec

'Adults at risk' in Scotland

An article examined the construction of 'adults at risk' in Scottish policy on adult support and protection. The policy remained underpinned by unhelpful assumptions about disabled people, older people, and people with mental or physical health problems. A more inclusive understanding of vulnerability would be more empowering to these people and others, in policies concerned with mistreatment and abuse.

Source: Fiona Sherwood-Johnson, 'Constructions of "vulnerability" in comparative perspective: Scottish protection policies and the trouble with "adults at risk"', Disability & Society, Volume 28 Number 7

Links: Abstract

Date: 2013-Oct

Principles for health and social care reform

A report outlined the views of local authority chief executives and senior managers on the shape of future health and social care reform. It called for a 'transformative' approach that placed people at the heart of the system. There should be one person overseeing all of an individual's health and care needs, and working with them to co-ordinate these; better co-operation and information sharing among the people involved in their care; and one accountable, local body to go to if they had concerns. The preferred goal was shared commissioning, shared budgets, and shared management teams, with local health and wellbeing boards providing local strategic leadership across the whole system. But local areas also needed to move beyond treating ill-health and supporting people with care needs, and to think about how to improve the health of their whole population through prevention.

Source: Principles for Health and Social Care Reform, Society of Local Authority Chief Executives and Senior Managers

Links: Report | SOLACE press release

Date: 2013-Sep

Reversing coalition health and social care policies

A collection of essays examined whether the health and social care policies of the coalition were irreversible. They highlighted the complexity of issues throughout the system, ranging from the measurement of National Health Service performance to the creation of a robust incentive system for prevention of illness.

Source: Dan Wilson Craw and Martin Edobor (eds), Irreversible? Health and social care policy in a post-coalition landscape, Fabian Society

Links: Report

Date: 2013-Sep

Warning over care costs reform plan

A think-tank report said that reforms to social care funding proposed by the coalition government were unlikely to meet any of their objectives. People's care costs would not in fact be capped; a market in pre-funded care insurance was unlikely to emerge; and rather than providing peace of mind to the population, annual increases in the 'cap' might stoke worry and concern. The report considered an alternative package of measures that could be implemented in April 2016 – a 'capped cost plus' model.

Source: James Lloyd, A Cap that Fits: The capped cost plus model, Strategic Society Centre

Links: Report | Summary | Community Care report | Guardian report

Date: 2013-Sep

Determining the price of social care

A think-tank paper explored the way in which the price of care was determined and its implications for social care policy. It said that, in order to address problems with the existing system, the government should: ensure financial sustainability among care providers; strengthen the link between prices and quality across the market; boost public knowledge of the price of care in their area; improve 'consumer knowledge' among families paying for care; and improve public understanding of local authority commissioning of care and the prices paid.

Source: James Lloyd, Right Care, Right Price, Strategic Society Centre

Links: Discussion paper

Date: 2013-Sep

Cap on eligible social care costs – consultation

The coalition government began consultation on proposals for (from 2016) a new cap in England of £72,000 on eligible social care costs, additional financial help for people of modest wealth with less than £118,000 in assets including their home, and (from 2015) a scheme to prevent anyone having to sell their home in their lifetime to pay for care costs. It revealed that the cap would benefit only 1 in 8 people.

Source: Caring for Our Future: Consultation on reforming what and how people pay for their care and support, Department of Health

Date: 2013-Jul

Health and Social Care Act 2012 – 'new professionalism'

An article said that the 2012 Health and Social Care Act did not represent, as some had suggested, a radical break with the past: instead it was an extension of the previous Labour government's neo-liberal reforms of the public sector. In particular, the Act invoked the principles of 'new professionalism' to undermine professional dominance, and attract private providers into statutory healthcare at the expense of public providers. In turn, this extension of new professionalism might encourage public distrust in the medical profession and absolve the state of much of its statutory healthcare obligation.

Source: Ewen Speed and Jonathan Gabe, 'The Health and Social Care Act for England 2012: the extension of "new professionalism"', Critical Social Policy, Volume 33 Issue 3

Links: Abstract

Date: 2013-Jul

Social Services and Well-being (Wales) Bill – AM report

A report by a committee of the National Assembly for Wales examined a Bill designed to promote greater integration in health and social services in Wales. It welcomed the general principles underlying the Bill and the need for legislation: but it expressed concern that the policy objectives of the Bill might not be realized in practice.

Source: Social Services and Well-being (Wales) Bill: Stage 1 Committee Report, Health and Social Care Committee, National Assembly for Wales

Links: Report | NAW press release | OPCW press release

Date: 2013-Jul

Policy implications of integrated health and social care

A collection of essays (edited by the Labour party's shadow spokesperson on health and social care) examined the policy implications of integrated health and social care services.

Source: Andy Burnham MP (ed.), Together: A vision of whole person care for a 21st century health and care service, Fabian Society

Links: Report | Summary

Date: 2013-Jul

Personal care savings bonds

A report said that the development of a new financial savings product, called personal care savings bonds (PCSBs), could help ease the social care funding crisis. Similar to premium bonds, PCSBs could be bought by any adult at a nominal value of £1. Unlike premium bonds, they would accumulate interest as well as pay monthly prizes. But they could only be cashable when the owner passed a social care assessment or died.

Source: Les Mayhew and David Smith, Personal Care Savings Bonds: A new way of saving towards social care in later life, International Longevity Centre – UK

Links: Report | Summary | ILC press release

Date: 2013-Jun

Strengths-based approaches to social care

A think-tank report examined strengths-based approaches to social care. It said that social care had been dominated for too long by a 'deficit model': services had often focused exclusively on needs and vulnerabilities, ignoring people's strengths and their networks of relationships with friends, families, and communities. Yet it was these social resources that underpinned the majority of social care and support, with unpaid family care alone holding a value equivalent to ten times the state's care budget.

Source: Alex Fox (ed.), The New Social Care: Strength-based approaches, 2020 Public Services Hub (with Shared Lives Plus)

Links: Report | 2020 press release

Date: 2013-May

Care Bill published

The coalition government published the Care Bill. The Bill was designed to:

• Introduce a cap on the cost of social care in England, and give carers the legal right to support from their local council.

• Provide protection to people whose care provider went out of business.

• Give everyone over 65 a legal entitlement to a personal care budget.

• Introduce a rating system for hospitals and care homes, and give new powers of intervention to the chief inspector of hospitals.

• Create two new public bodies, Health Education England and the Health Research Authority, designed to provide additional training and support for health professionals.

Source: Care Bill [HL], Department of Health, TSO | The Care Bill Explained: Including a response to consultation and pre-legislative scrutiny on the Draft Care and Support Bill, Cm 8627, Department of Health, TSO

Date: 2013-May

Care cap 'not enough' to solve social care crisis

A think-tank report said that the coalition government's proposed cap on the amount individuals contributed towards the cost of social care (following the Dilnot Commission in 2011) would provide welcome protection for people from the catastrophic costs associated with long stays in residential care – but that much more should be done to meet mounting financial pressures. The report called for a stronger focus on the challenge of eligibility – ensuring that more people were able to access the right level of support. It also raised concerns that unmet need, and its impact on carers, would place further pressure on a National Health Service already under significant strain.

Source: Richard Humphries, Paying for Social Care: Beyond Dilnot, King s Fund

Links: Report | Kings Fund press release | BBC report | Telegraph report

Date: 2013-May

Economic value of adult social care sector

A study found that the direct economic value of the adult social care sector in England in 2011-12 was more than £20 billion per year. The sector directly contributed 1.8 per cent of all gross value added in England and provided jobs for 6.4 per cent of the total workforce.

Source: Andy White and James Kearney, The Economic Value of the Adult Social Care Sector in England, Skills for Care

Links: Report | SFC press release | Community Care report

Date: 2013-Mar

Social care reforms 'not thought through' – report by MPs/peers

A report by a joint committee of MPs and peers said that the coalition government had not fully thought through the implications of its social care reforms in England, and might leave local authorities open to a 'deluge' of disputes and legal challenges. It warned that without greater integration with health and housing, and a focus on prevention and early intervention, the care and support system would be unsustainable. It called for a nationwide campaign to educate people about the need to pay for their own care, saying that adult care and support were poorly understood.

Source: Draft Care and Support Bill, Report (Session 2012–13), HC 822 and HL 143, Joint Select Committee on the Draft Care and Support Bill, TSO

Date: 2013-Mar

Coalition announces plans for reforming social care funding

The coalition government announced its plans for reforming social care funding in England, in response to the Dilnot Commission report. It said that from 2017 there would be a lifetime cap of £75,000 on an individual's social care costs (compared with £35,000 recommended by Dilnot). Some degree of taxpayer-funded support would be available for people with assets worth up to £123,000, compared with around £23,000 under existing arrangements. The £1 billion cost would be paid for in part by freezing the inheritance tax threshold for a further three years from 2015.

Source: Policy Statement on Care and Support Funding Reform and Legislative Requirements, Department of Health

Notes: Dilnot report

Date: 2013-Feb

Social Services and Well-Being (Wales) Bill

The Welsh Government published a Bill that provided for unified legislation bringing together local authorities' duties and functions in relation to improving the well-being of people who needed care and support, and of carers.

Source: Social Services and Well-Being (Wales) Bill, Welsh Government, TSO

Date: 2013-Jan

Labour calls for NHS and care budgets to be merged

The opposition Labour Party said that the National Health Service and social care budgets in England should be combined. It said that the money – £119 billion in 2012-13 – could be used to provide more joined-up care across the hospital, mental health, and social care sectors.

Source: Speech by Andy Burnham MP (Shadow Health Secretary), 24 January 2013

Date: 2013-Jan

Long-term care in Europe – new book

A new book examined how the construction of long-term care systems in Europe could be taken forward.

Source: Kai Leichsenring, Jenny Billings, and Henk Nies (eds), Long-Term Care in Europe: Improving policy and practice, Palgrave Macmillan

Links: Summary

Date: 2013-Jan

Call to means test winter fuel payment to pay for care costs

A think-tank report (edited by a former minister in the coalition government) called for the winter fuel payment to be taken away from most pensioners, and for the money saved to be used to pay for a cap on long-term care costs.

Source: Paul Burstow (ed.), Delivering Dilnot: Paying for elderly care, CentreForum

Date: 2013-Jan

Social care funding reform – effect on public costs and financial gains to care home residents

An article examined how alternative assumptions on care home fees in England (following anticipated reforms) affected projected public costs and financial gains to residents. Raising the local authority fee rate to maintain income per resident would increase the projected public cost of the reforms by between 22 per cent and 72 per cent in the base year. It would reduce the average gain to care home residents by between 8 and 12 per cent. Raising post-reform fees for remaining self-funders, or requiring pre-reform self-funders to meet the difference between the local authority and self-funder fees, reduced the gains to residents by 28-37 per cent. For one reform, residents in the highest income quintile would face losses if the self-funder fee rose.

Source: Ruth Hancock, Juliette Malley, Raphael Wittenberg, Marcello Morciano, Linda Pickard, Derek King, and Adelina Comas-Herrera, 'The role of care home fees in the public costs and distributional effects of potential reforms to care home funding for older people in England', Health Economics, Policy and Law, Volume 8 Issue 1

Links: Abstract

Date: 2013-Jan