National Commissioning Conference Stuart Cartwright Director Care Asset Management National Commissioning Conference

Agenda The Process The Results Marketing & Development Care Fees Funding Example In Summary

National Commissioning Conference The Process National Commissioning Conference

The Process Access to CAM via “air gap” CareAware triage enquires Provides access to “free” information Refer back to Suffolk, if necessary Reduce risk - Disconnect Suffolk from CAM Impartiality & independence

National Commissioning Conference The Results National Commissioning Conference

Enquiry Sources December 2011 to September 2012 No. %age F2F Teams 33 (25%) Customer First 27 (21%) CareAware Direct 41 (31%) Non Council Routes 30 (23%) Total 131

Results to date Enquiries 133 Referrals 31 1:4.3 Instructions 14 1:2.2 December 2011 to September 2012 Enquiries 133 Referrals 31 1:4.3 Instructions 14 1:2.2

Estimated savings December 2011 to September 2012 Client Suffolk Client Weekly Annual Life Est. Tariff Cont. Tariff Tariff Expectancy Liability A £480.00 £174.26 £305.74 £15,898 5.89 £93,642 B £348.00 £221.15 £126.85 £ 6,595 3.24 £21,372 C £480.00 £115.76 £364.24 £18,940 3.70 £70,080 D £348.00 £124.71 £223.29 £11,611 3.00 £34,833 E £348.00 £133.28 £214.72 £11,165 3.92 £43,768 ______ _______ ________ Totals £1,235 £64,212 £263,695

Marketing & Development National Commissioning Conference

Marketing & Development Design, produce and print bespoke leaflet Issue as part of the referral process and to be available throughout the county Provide supporting information such as an FAQ document Initial print run of 10,000 leaflets

Marketing & Development Method of Contact Allocate a “Freephone” number to Suffolk County Council at our expense Allocate an email address for Council contact and for client contact Allocate senior member of staff to Suffolk to co-ordinate all project communications

Marketing & Development Develop Awareness and Provide Training in the following Key Areas. For example: Customer Service Centre Develop “scripts” and a referral handover process to CAM/CareAware - Confidence Establish “rapport” between key staff Agree customer service standards & reporting and good outcomes for service users

Marketing & Development Develop Awareness and Provide Training in the following Key Areas. For example: Council “Face to Face” Locations Bury, Lowestoft, Ipswich etc Leaflet Supply and Referral Processes Possible Advice Surgeries

Marketing & Development Develop Awareness and Provide Training in the following Key Areas. For example: Residential & Nursing Care Providers Issue marketing letter & response to 184 Care Homes & 50 Nursing Homes. Provide leaflets and other support to include training, seminars & surgeries Explain Benefits to Care Provider

Marketing & Development Develop Awareness and Provide Training in the following Key Areas. For example: Home Care Providers Crucial Longer Term Strategy – Majority of providers in the Private Sector Aged 65+ 5000 approx – Physical disability/frailty 600 approx - Dementia

Marketing & Development Develop Awareness and Provide Training in the following Key Areas. For example: Home Care Providers (cont.) Issue marketing letter & response to all Home Care Services providers Provide leaflets and other support to include training, seminars & surgeries Explain Benefits to Care Provider

Marketing & Development Develop Awareness and Provide Training in the following Key Areas. For example: Council Websites Register Offices Relevant Council Departments Communications/ Marketing Departments

Marketing & Development Community Support Groups. For example: Awareness Days & Carers Week Provide Literature and Support Events throughout Suffolk Raise Awareness with Services Users Provide an information hub & support County Council Services

Marketing & Development Community Support Groups. For example: Develop Wider Community Group Mailings Establish database of Key People within the County and issue monthly/quarterly bulletin CareAware current circulation Nationally is 40,000 per quarter Promote the service, report good outcomes & recognise achievement of staff etc.

Marketing & Development Known Liabilities. For example: For immediate benefit, service should be immediately introduced to the following categories. Deferred Payments Contracts Twelve Weeks Property Disregard Respite or Temporary Care

National Commissioning Conference Residential Care Funding Example National Commissioning Conference

Residential Care Example Mrs Smith, 88 years old and lives in Suffolk Following sale of her home now holds £195,000 on deposit Residential care fees £36,400 per annum (£700 per week) Net income £12,478 per annum Care fees funding shortfall of £23,922 in first year

Residential Care Example Purchase a Care Fees Funding Annuity Trade a lump sum for a guaranteed income Underwritten to establish accurate mortality risk Risks to capital if death within estimated mortality, increased care needs or higher care fees inflation Annuity paid free from income tax

Residential Care Example Care Fees Funding Options: Purchase an Immediate Needs Annuity Purchase a Two Years Deferred Annuity Purchase a Partial Immediate Annuity Invest ALL Available Capital

Residential Care Example 1. Purchase an Immediate Needs Annuity. Most competitive premium £94,801 5% per annum compounded increases, payable monthly in advance Breakeven after three years & eight months £94,801 / £195,000 = 48.6% cost to capital Or 51.4% preservation of capital

Residential Care Example 2. Purchase a Two Years Deferred Annuity Fund first two years of care £49,040 Purchase 2yr Deferred Annuity £43,428 Breakeven after three years & seven months. Earlier mortality - reduced cost to estate £92,468 / £195,000 = 47.4% cost to capital. Or 52.6% preservation of capital

Residential Care Example 3. Purchase a Partial Immediate Annuity Purchase Partial Annuity £ 70,041 Invest Balance of Capital £124,959 Breakeven each year if care fees increase <= 5% pa & investment return >= 5% pa. Earlier mortality - reduced cost to estate £70,041 / £195,000 = 35.9% initial cost to capital. Or 64.1% preservation of capital

Residential Care Example 4. Invest All Available Capital Available Capital £195,000 First Year Shortfall £ 23,922 Required Return 12.26% Net Assuming care fees increase <= 5% pa & investment return >= 5% pa Earlier mortality - reduced cost to estate Longevity Risk

Residential Care – Funding Options

Residential Care – Funding Options Assumed Inflation 5% per annum Annuity Rate 25.23% Investment Immediate Care Plan 2 Year Deferred Partial Care Plan Available Capital 195,000 Cost of Care Plan NIL 94,801 43,428 70,041 Opening Balance 100,199 151,572 124,959 Year 1 Shortfall 23,922 - Investment Return on Balance 8,554 5,010 6,383 Balance End of Year 1 179,632 105,209 134,033 Year 2 Shortfall with 5% 25,118 7,726 5,260 5,446 Balance End of Year 2 162,239 110,469 114,360

Paying for Care – Funding Options Assumed Inflation 5% per annum Annuity Rate 25.23% Investment Immediate Care Plan 2 Year Deferred Partial Care Plan Balance End of Year 3 142,959 115,993 120,078 124,959 Balance End of Year 4 120,714 121,793 126,082 Balance End of Year 5 96,219 127,882 132,386 Balance End of Year 6 68,972 134,276 139,005 Balance End of Year 7 38,780 140,990 145,959 Balance End of Year 8 5,354 148,040 153,253 Balance End of Year 9 155,442 160,916 Balance End of Year 10 163,214 168,962

Residential Care Example Summary Risk of Longer Life Expectancy and Certainty of Self-Funding Care mitigated by the annuity options In this example, Annuity Breakeven reached after approximately Four years In this example, Investment Option risks capital depletion after approximately Seven years

Residential Care Example Notes Care Fees funding for illustrative purposes only. This case study does not constitute advice and should not be construed as such. Personalised advice should be sought in each individual instance. The example assumes care fees increases each year of 5% Net per annum compound throughout. It also assumes investment returns of 5% Net per annum compound throughout. Escalation of benefits is included at 5% Net per annum compound each anniversary in arrears. The benefits are payable monthly without proportion. No capital protection has been included in the event of death. This illustration is provided by Care Asset Management Limited, Authorised and Regulated by the Financial Services Authority. This illustration should not be amended or reproduced without the express permission of Care Asset Management Limited. E&OE.

National Commissioning Conference Thank You Stuart Cartwright 0161 786 6100 info@careasset.co.uk National Commissioning Conference