Free Personal Care Issues from the Survey John Jackson Co-Chair Resources Network

Headlines from the survey Costs will be significantly more than the Government has assumed Minimum cost of the order of £1 billion Financial risks exclusively borne by local government …thus costs will double for us (may be more) Impact looks likely to vary significantly across the country Publishing our figures has informed the public debate and led to an informed discussion with DH

Financial Implications – 4 areas the loss of income from those currently paying for their care; the costs of providing care to those who are currently arranging their own care, or paying for residential care or who are doing without care because they do not want to pay for that care; the costs of offering re-ablement to all those with the highest levels of need; the costs of assessing new people who come forward or reviewing the circumstances of all those receiving care who currently self fund.

Income Results from the survey are the least reliable part of the survey. We used a figure of £209m Subsequent discussions with DH: alternative way of calculating possible cost using PSSEX1 Our calculations are that the loss of income is a minimum of £154m (probably more)

Number of service users Used the figures in the Impact Assessment Discussions with DH: numbers of older people are well founded Number of younger adults are unknown It appears that they are assuming 100,000 people already known to us (with 10,000 making a contribution) Possibly 10,000 coming forward who are not known to us. Do we have any better idea?

Costs of care Key area of disagreement with DH They are assuming that care for those with the highest needs can be done in 8 hours (not 6.54) Survey median hours: 14 OP; 20 Younger Adults We used lower quartile 11 and 14 hours = costs of £160/£204 week Most authorities do not appear to have included double handed care in their calculations RAS figure is higher - £209/week We intend to stick with our figures which are a minimum

Revised Minimum Costs £m Income154 Costs of care older people447 Costs of care younger adults106 Re-ablement130 Administration27 Total864

ADASS position We have always used the lower figure where there is a choice Actual costs very likely to be higher – possibly much higher Our stance: “mimimum costs of free personal care are of the order of £1 billion and possibly more than this" Risk is with us. £1 billion means that we pay £580m compared with to £250m – more than twice as much

Other issues: funding Only minority of respondents had included in budget at time of response Efficiency savings assumption is a breach of new burdens protocol It looks likely that the financial implications will vary enormously from area to area (even ignoring costs) Can the grant systems cope?

Other issues: eligibility Many people will not benefit It is free personal care not free social care Boundaries between personal and non-personal care Mental health problems Not simple or transparent (key principles in Green Paper) Incentive to use residential care

Other issues: re-ablement We will welcome this Age Concern, etc are concerned about possible compulsion Need for more work on this with them

Other issues: behaviour Currently focus on responsibility. Carers feel responsible for looking after their relatives Free care may mean a move to rights which may affect carer behaviour and lead to less personal care input from them “Cost” of carer input is huge in financial terms (tens of £ billions)

Other issues: timescales Government plan: 1 st October Tool only available in June Staff training and systems work Huge number of assessments Backlogs inevitable; service user/carer dissatisfaction LGA pushing for 1 st April 2011

An alternative approach Fixed sum per week for all those eligible Could be £100/week on top of attendance allowance (£70/£47 per week) Limited financial risk to either the Government or local authorities Consistent with the partnership model from the Green Paper Political acceptability?

ADASS Business Unit Local Government House Smith Square London SW1P 3HZ Tel: Fax: WEB: