Tag Archives: residential care costs

Small print reveals continuing costs of residential care

So, Conservative shadow health secretary Andrew Lansley has pointed out that the government’s plans for funding residential care doesn’t include the ‘hotel’ costs of it.

For those of us that have followed this closely, this is not a revelation. This debate is about paying for care – board and lodging doesn’t come into it. When the green paper on adult social care funding was released last June, some people in social care pointed out that the proposals wouldn’t mark the end of people having to sell their house to pay for care. Interestingly, at the time, this was largely ignored.

Even in Scotland people in residential care have to pay ‘hotel’ costs – something which isn’t pointed out as often as it should be when people in England moan about ‘free’ care north of the border – and older people do still in some cases have to sell their house to pay for it.

But with the government set to shelve plans for the “Death Tax” this week, according to the Guardian, this seems to be the latest attempt to derail plans for reform.

Again, Lansley seems to be at the heart of this. While this smacks of another attempt at cheap political points-scoring ahead of the looming election, it does raise (albeit in a not-too-helpful way) a legitimate point.

One of the aims of any reform of adult social care funding, according to government messages when the green paper came out, is to eliminate people having to sell their homes. The options listed in the paper didn’t seem to do that.

It is still a problem – many voters see the practice as unfair and penalising those who have worked to own their own homes and leave an inheritance – and if it isn’t addressed many will see any white paper as a failure.

However, the green paper was only a consultation, and the white paper – apparently coming this week – may have a solution. We shall wait and see – and expect Labour’s opponents to seize upon it if it doesn’t.

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Scandal of selling homes to pay for care

Over the past few days, one of social care’s great recurring stories reappeared, as it seems to do every few months; the ‘scandal’ of old people having to sell their homes to pay for residential care and/or not being funded by the state for their care.

This time, it was the Daily Mail, which ran with a typically hyperbolic headline of ‘3,000 victims of home snatchers: Record numbers of elderly are forced to sell their homes to pay for care’ .

As usual with these stories, the gist was how scandalous it is that people who have worked hard all their lives to save money and/or buy a house now have to lose/sell it to pay for residential care in their old age, while people who never saved get it for free.

Leaving aside the rights and wrongs of this – there are good arguments on both sides – it again shows that politicians cannot afford to ignore this issue.

Social care has been getting a higher profile in recent months – the green paper on the future of adult social care funding was published in June, for instance – but little action has so far be forthcoming.

While Labour has announced its free personal care at home bill, this doesn’t address the problem of people having to pay for residential care and could even create other issues.

For example, it is likely to encourage older people to stay in their own homes for longer, knowing that if they move into residential care they will have to pay for it and possibly give up their home. As a result, some people may not go into care when they need to, and could suffer as a result, whether in the form of injuring themselves in an accident or fall, or in terms of isolation if they are housebound.

And for those who say ‘well, in Scotland they get it free’; they don’t. There, while the care element might be free, the ‘hotel’ costs of residential care – food, board and lodgings etc – isn’t, so many older people still have to stump up money to pay for their care, including selling their home.

This issue is hugely emotive and could become an issue in the upcoming election. Any party that offers a solution to this ‘problem’ would be onto a sure-fire vote-winner.

The options mooted thus far by Labour and the Conservatives involve insurance schemes, which involve paying a lump sum up front. Labour’s idea is a £20,000 scheme, which would cover the costs of personal care at home and residential care, and while the Tories’ response only costs £8,000, it just covers residential care.

The Liberals meanwhile have sat resolutely on the fence, calling for an all-party commission to come up with a solution, rather than posit any ideas of their own.

None of these options seem to have garnered much public approval so the way forward is unclear.

All it does mean is that the current system creaks on and the reform of it – desperately needed, as organisations within the sector have said time and again – is delayed again.

Perhaps if it does become an election issue, then something might get done. If not, then the Daily Mail, as well as the other national newspapers, will have a guaranteed headline article to publish every few months.

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Big Care Debate – any closer to a solution?

The Big Care Debate closed last Friday (the 13th, ominously, for those of a superstitious bent) ending the consultation on the government’s green paper, Shaping the future of care together , which set out the government’s options for the future funding of adult social care.

Now, the Department of Health will go away and contemplate the results, before, in theory, coming back with a White Paper, possibly in early 2010.

But with an election looming, I wonder if any of it will actually get through and make it into law.  

A spokesperson from the DH told me earlier in the year that if there is no consensus from the Big Care Debate on the best way forward, then it may go to a further period of consultation.

Looking at the reactions to the green paper from various groups, there seems to be little consensus; there have been criticisms, notably from mental health and learning disability groups, that the green paper focused on too much on older people. Indeed, much of the media focus has been on old age care funding and people not having to sell their homes to pay for residential care costs.

But then, older people’s groups, such as the National Pensioners’ Convention, have also voiced dismay over the government’s dismissal of the option to pay for care from direct taxation.

This option also found favour in a Joseph Rowntree Foundation survey. But then other organisations have supported the partnership and comprehensive models of funding the government suggested, which involve insurance and some state provision or the creation of a National Care Service.

If this is reflected among the wider responses, then we could be in for further consultation, which neatly kicks the debate into election time, when nothing concrete will happen because every politician will be scrapping for votes.

So, it seems like the social care industry will be in limbo for some time to come. And all the while the current regime will continue to creak along, and the problems within it will continue to mount, and – crucially – service users will continue to suffer at the hands of a much-disliked and over-complicated funding system.

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