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Care eligibility rules are 'inconsistent'

29 January 2008

The Commission for Social Care Inspection (CSCI) has published its annual report on the state of social care in England. The report says there are inconsistencies in how councils decide who gets help and how much they get.

The report finds a sharp divide between people who do and do not qualify for social care and says that people not receiving support from councils are struggling with a poor quality of life

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.

The report also shows how 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.

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."

Improvements

However the report also says there have been 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

The number of carers receiving an assessment has increased.

Statistics from the report

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 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.

Councils raising their eligibility thresholds to 'substantial'  increased from 53% to 62% in 2006-07. The trend is expected to continue as 73% of councils anticipate they will be operating at ' substantial'  or 'critical'  level in 2007-08.

What is the CSCI? Commission for Social Care Inspection 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.
Visit the Commission for Social Care Inspection website www.csci.org.uk

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