RCVS Network Meeting - Health & Social Care 3 rd June 2014 Richmond Council Update Cathy Kerr, Director Adult & Community Services

What I Will Cover  Overview of policy direction for adult social care  Local elections  Health partnerships  Care Act 2014  What all this means for Voluntary & Community Sector (VCS)

Direction of Travel for Adult Social Care  Focus on prevention  Promoting independence  Choice & control  Inclusion  ‘Joined up’ care & support

Local Elections  May 2014, Conservative party retain council control  Seats - Conservative - 39, Lib Dem -15  Cross party support for health & social care policy direction  Administration priorities include:  Caring for vulnerable people, prevention, an age friendly borough, tenants champion, role of voluntary sector, commissioning council, sharing with others.  National elections by May 2015  Public sector financial position

Health & Social Care Integration  Why?  People want joined up support  It makes best use of our collective resources  New local authority powers arising from H&SC Act 2012  Health & Wellbeing Board & HWB Strategy  Public Health in local authority  Integration  Work with our health partners to integrate  Commissioning – JCC  Delivery – joint teams – RRRT  Local joint strategies eg Better Care Closer to Home

The Care Act What is it?  Biggest change in adult social care legislation for 60 years  Based on principle of wellbeing  Encompasses whole population  A new policy framework (from April 2015) and  A new funding framework (most from April 2016)  Local implementation arrangements including co production group. Newsletter imminent

The Care Act – key changes  Personal budgets on a legislative footing and right to a direct payment. Direct payments for residential care  Carers rights on the same footing as the people they care for.  Changing eligibility criteria for services.  New assessment framework  Preventing and delaying needs for care and support & providing these services for the whole community  Provide comprehensive information and advice including independent financial advice. A web based resource directory

The Care Act – key changes  Self funder rights to assessment, support plan and care management (councils could charge)  Adult safeguarding on a statutory footing.  Duty to shape the market (wider than just the services we commission directly)  Ensure no one goes without care if providers fail, regardless of who pays  Transition from children to adults – right to assessment before age 18  Portability – for service users transferring from one LA to another to ensure continuity of care  Duty to promote integration running through all

The Care Act - Funding Reforms  To give more certainty and peace of mind over the costs of old age or living with a disability  Everyone receives the care and support they need and more support to those in greatest need  End to limitless care costs  People protected from having to sell their home in their lifetime to pay for care  Improved options for those who pay for their care  Consistency between different areas and for non- residential and residential care

What is changing? Funding Cap  Capped Lifetime Care Costs - £72,000 – currently no limit for people with assets  Lower cap to be set for people with care needs before old age  No costs for people with on-going care needs from childhood

What is changing? Extended Means Test  More people to receive state-funded support with changes to the means test  Capital limit increased from £23,250 to £118,000 (for care homes)  Capital limit increased from £23,250 to £27,000 for non-residential care (Richmond’s current limit is £35,000)  Assets below are £14,250 are not included in the means test - this will be £17,000

What is Changing? Care Homes  Deferred Payments from 2015  no one will have to sell their home in their lifetime  Councils will be able to charge interest during the period of the agreement – currently no interest applies during care home stay  Care Homes from 2016  Contribution to Daily Living Costs (around £12,000 pa) separate from care costs  Daily living costs not subject to the cap  Direct Payments for Residential Care from 2016

Case study – Mrs B  Has capital of £20k, property of 200k and weekly income of £260 a week  Has homecare of £100pw & contributes £64. After 3 years moves to care £630 pw.  Current system: in care home pays full cost of £630 until capital falls below £23,250  New system: Reaches funding cap of £72k after 5years 8 months, after which she pays £230 pw. Care costs of £400 met by the council.

The Care Act – Local Implications  We expect substantial increase in demand from self funders but impossible to accurately predict the financial impact  Self funders – occupy 51% of care home beds & only 13.5% of people 80+ currently receive care from the council.  Substantial growth in older population, high proportion of people age 85+; many age 75+ living alone

What Does This Mean for the VCS?  A Key Partner for the Council (and CCG)  As commissioned provider of services:  Particularly supporting independence and prevention  Learning from work to date – CILS  Future opportunities  As voice of the sector and bringing service user / carer voice  Engagement routes:  Health & Wellbeing Board  Contribution to strategy development and key programme of work  Care and Support Partnership