Well done Panorama (Monday 26 July 2010) for provoking some very valid questions about the future funding of adult social care in the UK and particularly to Joan Bakewell for emphasising the point that those in need of care now do not have the time to await yet more political handwringing about how to address the issue.

While solutions for the future remain as Jeremy Vine put it “ a thorn in the side of many governments to come”, attention must surely focus on what is available now and the needs of those currently going through the process of arranging care. “Death, Taxes and Care Fees Planning! There’s never a convenient time for any of them” Margaret Mitchell put it so well in her novel Gone With the Wind (although was of course referring to Death, Taxes and Childbirth!) the sentiment, however, seems appropriate.

Those entering this ‘arena’ will experience a bewildering number of agencies frequently working at odds with each other. Indeed obtaining accurate information is in itself a challenge. I would clarify that the Asset Means Test Threshold for England is £23,250 and not £23,000 as stated in this evenings programme. It may also help to clarify what is meant by the reference to FREE personal care in Scotland, this is a reference to the payment of both a ‘Nursing Care Allowance’ and a ‘Personal Care Allowance’ and does not mean that ALL care in Scotland is ‘Free’.

We believe the first step to empowerment is knowledge and through our ‘Guide to Care Fees Planning’ we provide a truly comprehensive overview of the system you are entering.

We are also tremendously proud of our recently launched ‘Care 2 Plan’ tool, this enables those wanting information specific to their own situation to create an ‘Options Report’ based entirely on their own individual circumstances. Simply go online to www.carefeesplus.co.uk/care2plan .

I would love to hear of your experiences, both good and bad, of the care system if you have or are in the process of arranging care. This helps us model our services to the public need and to lobby government and the financial providers to find solutions for tomorrow, today. Email me please on rene@twcp.co.uk.

Background

On the 14^th July 2009, Andy Burnham, the Health Secretary announced in the House of Commons the long awaited Green Paper on Adult Social Care.  He is proposing that everyone in England will have access to a National Care Service that is “fair, simple and affordable”.

This, of course, is only the Green Paper, which sets out the Government’s proposals. Nothing becomes law until the White Paper is ratified in Parliament. Indeed, it is not expected to be effective until 2014.

There will now be a consultation process running up to mid-November and it is expected that a detailed White Paper will be published in 2010.  The General Election will have to take place before June 2010. It will be up to the new Government, perhaps a change in colour, to carry these proposals forward, or not.

Tony Blair, the former Prime Minister, told the Labour Party Conference in 1997 that he did not want children “brought up in a country where the only way pensioners can get long term care is by selling their home”.

Twelve years on, we have finally got the Government’s proposals but we have not got any real progress. Families currently dealing with long term care for their loved ones have to act now to protect their family’s capital from erosion.

Proposals

The Secretary of State for Health is proposing that everyone in England will have access to a National Care Service that is “fair, simple and affordable”.

The National Care Service is aiming to create a level playing field and end the postcode lottery of care services currently affecting those needing long term care.

 The Wealth Care Partnership fully endorses the setting up on such a service and feel it is well overdue. The current situation is totally unacceptable where families are bounced around Government agencies with no-one taking full responsibility of guiding and helping those thrust into dealing with a loved one needing care. It is our experience that the levels of service provided by Social Services and The Primary Care Trust differs widely across the country and this simply should not be the case. We do hope that the National Care Service does not turn into yet another inefficient, expensive and confusing, state-funded institution. It simply must be primarily a “Care” service.

Andy Burnham also claims that everyone in England will be guaranteed:

• Prevention services - the right support to stay independent and well for as long as possible and to delay care needs getting worse. 

Karen Rayner, Partner at The Wealth Care Partnership says “Until the Government are prepared to accept that the NHS is not helping an aging population by treating an illness once it has happened, and only then by the over use of prescription drugs and surgery, there will never be a world without long term illness. Substantial investment into educating the population about preventing illness through healthy living, from school age onwards is what is required. This is a “slow burner” and this is unlikely to happen in my lifetime let alone those currently in retirement”.

• National assessment - care needs will be assessed and paid for in the same way across the country.

“We do hope the National Care Service will remove the current Postcode Lottery affecting everyone who is facing long term care”. Ms Rayner continues, “It is to be remembered that Andy Burnham is talking about care costs and not living costs being covered by the new proposals. Living costs for those continuing to stay in their homes are likely to increase. For those moving into a care home the living costs will need to be paid for by the elderly person and may be higher than if they stayed in their own homes.”

• Joined-up services - all the services will work together smoothly.

Tim Anstee, Partner at The Wealth Care Partnership comments, “If Andy Burnham is able to pull this off, he will be seen as the next Nye Bevon, founder of the NHS in 1948.” He continues, “It is a terrific objective, but 60 years of the NHS has proved that it is totally unworkable.”

• Information and advice – the care system will be easy to understand and navigate.

Tim Anstee agrees that this is a wonderful objective. “There is a confusing maze of legislation and information depending on the levels of care and support an individual needs. People are genuinely confused about what is right for their loved one. Even those who work within Social Services or the NHS can find themselves lost in the maze and it is so difficult to know that you are doing the right thing for the elderly person concerned.”

• Personalised care and support - services will be based on personal circumstances and need.

Is this not something that should already be in place?

• Fair funding - money will be spent wisely and everyone will get some help meeting the high cost of care.

Again, these are wise words and make a good political soundbite. However, the reality is that whatever is paid to the care providers it will not be enough to give a high level of care to all. The Government are proposing they will pay towards the cost of care for all, but care costs vary from provider to provider and the support being offered will not be about everybody getting the same. Many care homes now insist on “third party top up” arrangements whereby family members must fund some of the care fees charged because the homes simply cannot provide the high levels of care their residents deserve, on Government payments alone. We cannot see the proposals changing this position.

It is interesting to note that the Government has been running a scheme in Scotland, whereby the person requiring care is able to receive Personal Care at £153 per week. If a person qualifies for Personal Care they are no longer eligible to receive Attendance Allowance (a form of tax free disability benefit worth up to £70.35 per week regardless of capital and income levels).

The Wealth Care Partnership believes that it is likely that this system will be adopted in England and many will not be able to claim this very valuable state benefit in the future if these proposals are adopted.

The Options

The Green Paper has proposed three options to be consulted on:-

The first option would be a Partnership Service, where the State would offer a proportion, possibly a quarter or a third of the cost of elderly care and the individual would fund the rest privately.

The second would be a voluntary Insurance Scheme, where people invest into a scheme before they have to be taken into care with the State part funding the programme. The Government says around 20 per cent of people could take up this option.

The third option would be a compulsory Comprehensive model, where all those over the age of 65 contribute to a national scheme that would, if necessary, offer everyone full state funded health care.

The Green Paper also states that both a fully state funded scheme and fully privatised programme would not be recommended.

Andy Burnham says the Government has calculated that the Partnership Scheme would cost an individual around £22,000. The insurance scheme could cost between £20,000 and £25,000 as a lump sum and he says the comprehensive scheme will cost around £17,000 to £20,000. He also says these proposals will not result in an increase to National Insurance and says the White Paper will include details for those currently in need of care.

The Wealth Care Partnership’s Tim Anstee states, “Each of the proposals are suggesting a cost of around £20,000, paid either during our working lives or towards the end of it. We would question the quality of care that this would provide. In certain parts of England a typical care home costs in the order of £35,000 to £40,000 per annum (including living costs) and we believe the Government has seriously underestimated the ongoing costs of care. People are living longer and spending many more years in a care environment.  It is also not clear whether social care is included, which is particularly important for the growing numbers of people suffering from dementia, who require no nursing care but cannot live on their own.”

Mr Anstee concludes, “The result of the debate will be released with a White Paper which is forecast to become effective in 2014. It is crucial that those in care now or about to go into care seek advice on the best way to plan for the costs involved. It is my belief that whatever option is chosen, although the Government are proposing to provide some support to all, we are still going to be paying for our care.”

Paying for the cost of care in difficult economic times.

Going into a residentual care home is a difficult enough decision for the individuals and family concerned, but this decision is becoming even more difficult with the pressures built by the uncertainty in the economy.

Let there be no doubt that care home costs are going to rise above the cost of inflation.

To run a good care home you need trained staff, a quality building with enough space for the residents, good food and a good heating system. Increased regulation has meant that staffing levels have had to go up and these staff, who have typically been offered low wages, are looking for higher pay. Food costs are on the increase and energy bills are rising. As a result the cost of care is increasing.

Faced with these increased costs, the difficulties are further enhanced because there is a slump in the housing market which can effect the sale of the home. Many people are not getting what they thought their property was worth, that is if they are lucky enough to receive an offer. New residents who are going to pay for their own care fees – the Local Authority will only start to fund residents who have capital of less than £22,250 – are often concerned about how they can meet the cost of care and whether their savings are going to last until the property is sold.

It is true that the Local Authority may help some families for the first 12 weeks in care and they do offer an interest free loan facility through a deferred payment scheme. The problem here is that the first option does not last indefinately and with the second a debt is being built up.

Given these concerns our office is now increasingly busy with callers worried about how they can cap the cost of their, or their loved ones, care fees. The answer to this is to purchase an Immediate Care Plan – a special type of annuity to fund the cost of care. If there is not sufficient capital to purchase the care plan but you are waiting for the house to be sold, it is possible to borrow funds from a specialist company.

If you are concerned about the increasing cost of care please give us a call on (Freephone) 0800 6528232 or visit the website www.twcp.co.uk