Sharp divide between people who do and do not qualify for social care
29 January 2008
People not receiving support from councils are struggling with a
poor quality of life, says the third report on the State of Social
Care in England published today by the social care watchdog,
CSCI.
Commission Chair, Dame Denise Platt said:
"Our report is in two parts. On the one hand we show that those
who qualify for council support are having a better experience than
before. On the other hand those people who fall outside the system,
including self funders, have a poor quality experience that can
leave them struggling to cope. People who only five years ago
qualified for council-arranged help are today excluded by the
system and left to fend for themselves. The poor experiences of
people and their carers trying and failing to get sufficient help
contrast starkly with those people who do qualify for council
arranged care".
Following concerns raised by the Commission last year, the third
State of Social Care in England report for the first time explores
the experiences of people not deemed eligible for state-supported
social care. It shows that many younger disabled people and frail
older people are being ‘signposted’ to voluntary services. Many are
forced to rely on help from family and informal arrangements which
can break down at short notice. People unable to rely on families
or friends and unable to pay for care services themselves are
simply left to cope with everyday life, while some become virtually
trapped in their own home.
Local councils increasingly only help those with ‘substantial’
or ‘critical’ needs. Although councils use a national set of rules
(called Fair Access to Care Services - FACS ) to decide who is
eligible for support, today’s report shows that who does or doesn’t
get help varies not only between but also within the same council.
In practice the criteria can be interpreted in different ways by
local staff.
Many people who pay for their own care can also be ‘lost to the
system’. They get little by way of information or advice about
their different care options. As a result some people end up
inappropriately in residential care.
There are clear improvements in the range and variety of
services for those who do qualify for council-arranged care.
Performance ratings of councils have improved for the fifth
consecutive year. The number of people using Direct Payments to
manage their own care has grown significantly. Individual budget
pilots have been set up. Councils are placing a greater emphasis on
helping people to remain in their own homes and the number of
carers receiving an assessment has increased. There are also
examples of people who have been helped through the Government
funded ‘Partnerships for Older People Projects’. At present,
however, these projects are not widespread.
CSCI Chief Inspector Paul Snell said:
"More people are now controlling their own care through the use
of direct payments and some through individual budgets. The advice
and assistance which supports them to do this needs to be available
to all people seeking care, including those who are self funders.
People tell us they want good information, advice, an assessment of
their circumstances and confidence in the quality of the available
services. They also want control over the nature of the care they
receive. Achieving this for everyone is the vision outlined by the
Government in their transformation programme "Putting People
First".
There has also been improvement, for the fourth consecutive
year, in the average percentage of national minimum standards met
by all care services, but this rate of improvement has slowed.
Paul Snell, Chief Inspector, CSCI, continued:
"Too many services are still not meeting the minimum standards,
five years after their introduction. Where services show a major
shortfall in meeting the standards they will be given specific
attention by our new regional enforcement teams".
Dame Denise Platt added:
"This, our third report, provides further convincing evidence
about the very variable experiences, which people have when they
are seeking care, particularly those outside the formal public care
system. There is now an urgent need to create a fair and equitable
social care system, which is sustainable and affordable".
Ends
Notes for editors
1. The numbers of older people using services has dropped from
867,000 people in 2003 to 840,000 in 2006. This is at a time when
the population aged 75+ increased by nearly 3%.
Fewer households are receiving supported homecare : 479,000 in
1997 compared to 358,000 in 2006 - although the total number of
hours has increased because the average number of hours that each
eligible person receives has increased.
It is estimated that 6,000 older people out of
the 2,450,000 older people with a disability or impairment in
2006-07, with high support needs received no services and no
informal care.
It is estimated that 275,000 older people with
less intensive needs received no services and had no informal
care.
It is estimated that 450,000 older people in
the current system, who do get support from family and friends, and
may also be receiving some services, have a shortfall in their
personal care.
Between May 2006 and April 2007, 23,699 individuals received a
service within the POPP programme.
Councils raising their eligibility thresholds to ‘substantial’
increased from 53% to 62% in 2006-07. The trend is expected to
continue as 73% councils anticipate they will be operating at
‘substantial’ or ‘critical’ level in 2007-08.
2. CSCI is the single inspectorate for adult social care in
England, responsible for regulating and inspecting social care
providers –whether in the public or independent sector – and for
assessing the performance of local councils in delivering their
personal social services functions.
3. The Commission’s primary aim is to improve social care by
putting the needs of people who use care services first.
4. The Commission is chaired by Dame Denise Platt DBE and has
five Commissioners. The Chief Inspector is Paul Snell. CSCI staff
work across seven regions in England.
5. Social care services for children are regulated and inspected
by the Office for Standards in Education, Children's Services and
Skills (Ofsted).