The Care & Support Alliance (CSA)

Briefingdate

The Care & Support Alliance (CSA)

The Care & Support Alliance was set up in July 2009.The CSArepresents over 75 of Britain’s leading charities campaigning for a properly funded care system alongside the millions of older people, disabled people and their carers who deserve decent care.

What is social care?

Social care support is essential in meeting the needs of disabled and older people and their families to lead healthy and fulfilling lives. It would not be overstating the case to describe social care as 'life support' for disabled and older people.

As well as relying on care and support for help with everyday tasks, like washing, dressing and eating, social care plays a vital role in supporting recipients and their carers to move into, or stay in, employment, and in preventing avoidable expenditure by the health, welfare and criminal justice systems.

Population changes mean more people need care – but we know that fewer people receive it. There has been a 26% reduction in the number of older people receiving state funded services despite the Personal Social Services Research Unit (PSSRU) predicting that demand would increase by 17% between 2010 and 2020. The picture is the same amongst working age disabled people – 90,000 of whom lost access to state support for their care needs between 2008 and 2013.[1] We estimate that at least £3.2bn additional funding is needed to meet the needs of those people currently cut out of the care system.[2]

The public care about care

The CSA recently commissioned YouGov to carry out polling to assess the public’s attitude towards social care. The results show that social care is a clear priority in the minds of the public and, as such, will be an important issue in the 2015 General Election:

• 47% of respondents would like to see more money spent on social care, with this figure only being bested by the 67% in favour of further NHS spending.
• One in three respondents either had a direct experience or had come into contact with the care system through the care of a friend or close family member.
• 71% of respondents were not confident that they would be able to afford care services if they weren’t provided by local or central government.[3]

Funding

There is a chronic and historic underfunding of care. The Office for Budget Responsibility estimates that approximately 1.2% of GDP is currently spent on social care, whilst 7.9% is spent on health.

With local authorities having to find significant savings because of reductions in government grants, there have been further cuts to social care budgets in recent years. The Association of Directors of Adult Social Services (ADASS) and the Local Government Association (LGA) project that around £3.53 billion has been taken from adult social care budgets over the past four years.[4] In the last year alone, 40% of the total savings made by local authorities were made through reducing adult social care services.[5] This has resulted in a tightening at a local level of eligibility for care and also a reduction in the size of care packages for those who are eligible.

Moreover, a survey of local authorities conducted by the LGA suggests 9 out of 10 Councils are concerned that lack of funding could jeopordise vital reforms to the care system with the implementation of the Care Act 2014.[6]

The Barker Commission, set up by the Kings Fund and chaired by Dame Kate Barker, has recommended that over the next 10 years the proportion of GDP spent on health and social care should rise to between 11 and 12%. While the decision about exactly how we find the additional funding is ultimately one for Government, the public have made it clear they want more investment in social care. The Commission have set out options as to how that money might be found, but most importantly have made it clear that this is spending which is both essential and affordable.[7] What is no longer an option is to continue the current chronic underfunding of care.

National Eligibility

Eligibility is the most crucial aspect of the social care system. It determines who is – and who is not – eligible for local authority-funded social care support. The Care Act 2014 introduces a new national eligibility criteria for care, which is welcome in helping to end the care-postcode lottery across England. However, we believe that the criteria, as currently drafted, is set too high.

The new threshold combined with cuts to local authority budgets is expected to exclude 340,000 people who struggle with basic tasks such as getting up, getting washed, getting out the house and managing bills.[8] We believe that the national eligibility threshold should be set at the equivalent of ‘moderate’, as defined by the Fair Access to Care Services (FACS) framework.

Without support, these individuals will most likely re-enter the care system at a later stage, when in crisis. It is increasingly clear that this escalation of need will have a significant financial impact on local authorities and the NHS. Introducing a lower eligibility threshold would ensure that disabled and older people with care needs are captured in the social care system and receive the support they require to prevent their needs from escalating. To meet moderate level needs, at least £3.2bn would need to be invested per year by 2020, according to research carried out by the PSSRU.[9]

[1]Personal Social Services Research Unit (2013) Changes in the patterns of social care provision in England: 2005/6 to 2012/13, London: London School of Economics. Available from

[2]Fernandez, Snell, Forder and Wittenberg (2011); “Implications of setting eligibility criteria for adult social care services in England at the moderate needs level.” PSSRU Discussion Paper DP2851:

[3]For full results of the poll conducted September 2014, visit

[4] ADASS (May 2014) Annual Budget Survey of English adult social services. Available from

[5]National Audit Office (November 2014) The impact of funding reductions on local authorities. Available from

[6]LGA (August 2014) LGA Community Wellbeing Board Paper. Available from

[7]Commission on the Future of Health and Social Care in England (September 2014) A new settlement for health and social care: Final report. Available from:

[8]PSSRU (2013) Implications of setting eligibility criteria for adult social care services in England at the moderate needs level. Available from:

[9]Fernandez, Snell, Forder and Wittenberg (2011); “Implications of setting eligibility criteria for adult social care services in England at the moderate needs level.” PSSRU Discussion Paper DP2851: