Care White Paper – pre-publication thoughts and hopes

Cash

Finally the Adult Social Care White Paper will be published today. There have been a number of ‘leaks’ and there is a fair bit of information we know already. I wanted to collate what I know is coming with some hopes about what is contained.

Funding

We’ve known since the weekend and suspected for far longer that the bulk of the Dilnot recommendations will be shelved. The government while supporting the idea of a cap have been unable to find the money ‘in the pot’ for it and so any significant changes to the funding systems are going to be put on hold until the next Spending Review which conveniently will make it too late for anything to be done in the Parliament.

Care Home Fees

Oh look. The Government have worked out this REALLY CLEVER plan to allow people to pay for their care home fees after their death. Oh, so that would be completely different from the system already in place that allow people to pay.. um.. care home fees after their death.

Well done, clever little government, you’ve managed to bring out as a headline something that is already fairly standard practice across local authorities in England. Oh wait, you are now allowing the local authorities to charge interest.

I don’t understand how selling a home after death is better than selling it during a lifetime if it is still being ‘lost’ to potential inheritors. Remember, the value and asset of the home is discounted if there is a spouse or dependent still living in it. Making the process all about the inheritance is disingenuous at best.

Reducing ‘adult social care’ to ‘residential care’ is also enormously deceptive. There’s a lot happening to and with people who don’t own properties.

Carers

There is expected to be a broadening and firming up of rights of carers and duties of local authorities to provide support. I will be very glad to see this. There are enormous complexities in the systems that we are often not very good at explaining to people who are unfamiliar with the jargon. While ‘powers’ to provide support are all well and good, ‘duties’ are better and can be challenged.

Personalisation

We’ve heard Burstow make noises about increasing choice and moving away from minute by minute commissioning. I am really excited to see what will be proposed to avoid this and particularly seeing the focus more heavily fall on the commissioning by local authorities which favours block contracts with large companies. In fact, oddly for me, this is the area which I hold out the most hope for in terms of the content of the White Paper – with a look at the way the processes of commissioning can bring in more local organisations to provide more interesting/creative and most importantly – individually tailored support.  I expect a lot in this and I hope for a lot too.

Safeguarding

This is another area I think will be shored up. The current processes of adult safeguarding can be frustratingly flimsy at times and it is very hard to bring some prosecutions or to take speedy action as would be the case if the age of those who are being abused were under 18. I think we need to look at streamline the procedures and pathways in terms of safeguarding so it doesn’t become meaningless in terms of a process – and we need teeth that can bite in terms of protection of adults who may potentially be abused.

It’s can be a difficult balance often but it’s really important to be able to get this right and can be improved considerably.

Access to Support

I don’t expect many significant changes to the eligibility frameworks although I can’t help hoping for it. I do expect to see more entitlements to support/information/advice to those who fund their own care and are not reliant on local authority to pay some or all of the costs. I will be very glad to see this. It is an enormously complex system to navigate and everyone is entitled to help to access and understand it, regardless of income/assets.

Legislative Frameworks

We know the legislative framework is going to be ‘tidied up’ so we aren’t needing to hark back to legislation from the 40s (National Assistance Act (1948) I’m looking at YOU). I expect the new composite Adult Social Care Bill will encompass previous legislation. It will be interesting to see the specified roles around assessment/entitlements to services and how they are updated in the context of ‘self-assessments’ and ‘call centre assessments’. I hope they are.

Final Thoughts

While reading and thinking about the White Paper,. I’m going to conclude with five key points to remember.

Adult Social Care is not just about older people.

Adult Social Care is not just for ‘other people’

Adult Social Care is not just about funding possible residential care.

Anywhere ‘choice’ is mentioned I want to see how it will be extended to all, even those who may not be able to engage with decision-making processes individually.

Adult Social Care isn’t free. You don’t get it paid for if you ‘pay into the system all your life’. The funding stream doesn’t work like that. The funding stream needs to change and the governments and parties (all of them) need to bang their heads together in order to improve the quality of life for some of the citizens who rely most on the state to provide support/guidance/assistance and quality of care.

I’ve said it before but I want to work in a system which offers quality and excellence in terms of support – not the minimum amount at the minimum cost.

I’ll read the White Paper with interest and am sure I’ll be back tomorrow to comment on it.

picture by Bashed at Flickr

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2 Responses to “Care White Paper – pre-publication thoughts and hopes”

  1. Look forward to your comments on the White Paper. And like your five points!

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