The Queen’s Speech

This blog was contributed by Camilla Williamson, Public Affairs Adviser in Age UK’s Public Affairs team.

In advance of the Queen’s Speech Age UK was clear that the most important single element for older people was the social care bill. While a draft bill on social care is some progress, the announcement of legislation now would obviously have been far better. Social care is in crisis – the system is chronically under funded and in urgent need of reform. Without this, too many older and disabled people will be left in desperate circumstances: struggling on alone, many living in misery and fear. With a predicted increase in demands on the system, this situation is only likely to worsen. It is therefore vital that the Government ensures that following the consultation on the draft bill, legislation to reform social care, alongside funding reform, is introduced as a matter of urgency.

On other matters related to people in later life, we were pleased by the announcement of a Pensions Bill to reform the State Pension, creating a fair, simple and sustainable foundation for private saving. We welcome the proposals of the single-tier pension and are very supportive of the aims. However, as proposed, current pensioners would not benefit from any improvements to state pensions. The Government must not forget the 1.8 million older people who are in poverty now.

The Financial Services Bill offers the opportunity to ensure the financial services industry provides safe, fair and accessible products and we believe the Bill should be strengthened to ensure the FCA and Government have the tools they need to address market failure and establish a marketplace in which firms compete to provide all types of consumer with the products and services they need.

The Government also announced a Small Donations Bill which will provide a top-up payment similar to Gift Aid to charities that receive small cash donations of £20 or less, enabling them to claim 25p for every £1 collected in the UK, on up to £5,000 of small donations. This will make a particular difference to smaller local Age UKs and Age UK friends, which as independent charities rely on these kinds of donations to help them to provide a range of support to people in later life.

Find out more about how the legislative programme relates to people in later life

Read our full government and stakeholder briefing

The lost generation – a quarter of a century of failure in social care

1986 saw the birth of email as we know it today, the announcement of a tunnel to be built between Great Britain and France and the publication of a report showing that the social care system was unsustainable and needed major reform. A quarter of a century on, email is truly embedded into daily life, France is a mere train journey away and the Dilnot report published in July 2011 showed the social care system is on the brink of collapse and in desperate need of reform.

Successive governments have ducked and dodged the issue, creating a confusing and conflicting legal framework and consistently failing to fund adequately fund social care.

The combined result is a crisis in care of epic proportion, with a broken system of care that cannot cope with people living longer with illness and disability. As politicians try to reach consensus in cross party talks on social care and the Government prepares the white paper on social care, the weight of historical failure will hang heavy.

The last set of cross party talks prior to the 2010 General Election ended in disarray. Politicians cannot afford a repeated breakdown in talks. According to a You Gov poll of 1,726 English adults commissioned by Age UK in January 2012, four out of five people believe the Government is not doing enough for older people.

The question is whether, set against the backdrop of austerity measures, the Government will now have the courage and conviction to create a lasting legacy of care and support.

This once in a generation opportunity to put pressure on the Government to properly fund social care is the reason why Age UK is asking everyone to sign our Care in Crisis petition.

Age UK are calling on the Government to reform the adult social care system. Find out more about our Care in Crisis campaign and how to sign up to our petition.

Missed opportunity to address social care funding

The Institute of Fiscal Studies has delivered a fairly scathing analysis of the Budget and have cast doubts on the sums. There was an unexpected shock for pensioners who will see a freeze of the cash value of their tax allowance until it aligns with the personal allowance for the working age population – the so called ‘granny tax’.

Rather than being announced in the Budget speech, this was presented as an aside and a note from HMRC that detailed the implications for pensioners. The note says that in 2013-14, 4.41 million people will be worse off in real terms with an average loss of £83. Within the total, 360,000 individuals aged 65 will lose an average of £285, reflecting the changes in entitlement to age related allowances. It also means 230,000 people will be brought into income tax.

It is an unpalatable but imperative reality that we all have to pay more in the coming years, and those older people who can afford it must also be prepared to contribute.

However, it seems extraordinary that this budget offered a tax break of at least £10 000 to the very wealthy while penalising many pensioners on fairly modest incomes, who are already being squeezed by perpetually low interest rates and inflation that has been running well above the Government’s 2% target. Continue reading “Missed opportunity to address social care funding”

Care in Crisis – time for action!

 At Age UK we’re getting excited about the Care and Support Alliance mass lobby of Parliament happening tomorrow (6th March).  We’re expecting about 1,000 people to descend upon Parliament to lobby their MPs. They want to tell their MPs know that they care about how the care and support system is failing them, their friends or relatives and to call for change.

The reason we’re lobbying is that social care is in crisis.  The current system has been underfunded for decades, which means that demand for services outstrips the available care from Local Authorities.  Some people face losing their homes and savings because of soaring care bills and many disabled people are unable to get the support they need to live their lives independently and be part of society.

Many families providing care are being pushed to breaking point because of a lack of support.  And because there is not enough to go around services are rationed, charges are high and many people simply go without the care they need to live independently.

We are calling on the Government to make care reform a priority.  In the current economic climate it will be too easy for the Government to shy away from making tough decisions about the future of social care. We need to show MPs how important it is that Government addresses the failings in the current system.

 Take action!

We’d love to see you tomorrow at the lobby itself.  Come to Church House after 2pm to register.

Alternatively if you can’t be there in person, you can take part in our Twobby– the world’s first Twitter lobby!  We’re inviting people to Tweet their MP with a question about social care and showing your support for the campaign.  We’re hoping that we can get the hashtag #twobby trending so that more people than ever get behind the campaign and put pressure on the Government to reform the system.  There’s loads more information here about how you get involved.

Tomorrow is a great opportunity to take action to end the care crisis. Age UK’s vision is of a system where all older people who need it receive high quality social care that enables them to live with dignity and gives them the ability to plan ahead.  We hope that tomorrow will bring us one step closer to making that vision a reality.

Find out about more about the mass lobby and twobby

Read our guide to twitter

Care in Crisis 2012; the Architecture of Reform

Age UK’s Care in Crisis report is not only focused on the current funding crisis in social care; it also sets out what Age UK wants to see from a reformed care system. This vision has its origins in the detailed consultation and engagement which we undertook with older people in the run up to the 2010 social care white paper.

Vision is that everyone who uses care should be able to say the following;

  • I receive the care and support I need with no chance of being left without it:
  • My care and support services are high quality and safe:
  • I am able to live safely and with self-respect:
  • I am able to plan in advance before needing care:
  • I am able to pay for care in a fair and transparent way:
  • The system is clear and easy to understand:
  • No family member or friend is forced to sacrifice health, career, social life or future economic security to care for me

These priorities are based on the belief that older people, like everyone else, need to change, to grow, to adapt and to play a full role in society as citizens. The current system all too often seems to assume that all of this ends at the age of 65, after which care and support just needs to keep people safe.

In reality, however, many people face major transitions in older age. The onset of illness or disability, being diagnosed with dementia, loss of close family members, or entering a care home are all major trials of life which call into question people’s identity and future aspirations .  Care and support should be available to support people at all stages of their lives and to help people to manage transitions and life changing events.

Older people who need support may want to move to be nearer to relatives. However if someone depends on local authority care and support, moving to another local authority area can be a bureaucratic nightmare; so care packages should be portable.

Older people still want to be active, to be involved in society, the community and family and to make a contribution. Being able to achieve these aspirations is often important to people’s self image, and to their conception of dignity. So care and support should help older people to live with dignity, to be part of a community and to maintain family and social relationships.

People also need to be active as citizens. In our society, in theory if not always in practice, people should be able to challenge arbitrary decisions by the state. For people who need care and support it is particularly important that decision making is transparent and open to challenge, as the results of poor decision making by public bodies can be catastrophic for the individual. So the recommendations of the Law Commission review of adult social care law – which are to a large extent about clarifying and rationalising decision making by public bodies – should be fully implemented.

No one should ever be refused care without a proper individualised assessment of their needs, and it must be clear where accountability for decisions made by statutory bodies lies.

Many older people welcome the opportunities to manage their own care and support (though others may not). So people should be able to obtain appropriate information and support to negotiate the system and if they wish, to arrange their own care. This includes access to advocacy, and to new roles such as support brokers or care navigators.

The full set of policy calls are set out in Care in Crisis 2012.

Age UK are calling on the Government to reform the adult social care system. Find out more about Age UK’s Care in Crisis campaign and how to sign up to our petition.

Read Care in Crisis 2012

 

 

 

 

 

Guest Blog – Four things you never knew about social care ?

 This guest blog was contributed by Richard Humphries, Senior Fellow at The King’s Fund. Richard joined The King’s Fund in March 2009 to lead on social care. His professional background is social work, having worked in a variety of roles including Director of Social Services and Health Authority Chief Executive (the first combined post in England).

Age UK’s new report – Care in Crisis 2012– is the latest clarion call to sort out a care system which even Government ministers accept is broken. The report sets

Richard Humphries

out in stark detail just how many people are going without the care they need. Public spending on care for older people is actually going down even though numbers are going up – especially frail very old people who need the most care. England is no different from all advanced countries in the world that need to devote a bigger share of the national wealth to an ageing population – itself a sign of social and economic success. Yet we are finding it remarkably difficult to rise to the challenge.

Here are four things you may not know about England’s social care system. It has its origins in the 1948 National Assistance Act when the world was a different place, with much lower standards of living, health and wealth. 64 years on, the care system must be the only public service that has never been fundamentally reformed to keep up with changing times (although it has been frequently reorganized, which is not the same thing). We wouldn’t dream of running any other major service as though we were still in the 1940s. The system has suffered from years of policy tinkering instead of sensible long term reform.

Second, if you have savings or assets of more than £23,250, you will be entirely responsible for the full cost of residential care, a cliff-edge so steep it makes Beachy Head look like a gentle slope. Many people do not realize this until it is too late. Some think , wrongly, that the NHS will pick up the bill.

Third, that even if you are relatively poor, it is unlikely that your local authority will help you. 82% of councils limit the help they provide to those with ‘substantial’ or ‘critical’ needs i.e. you will need to have become very dependent indeed before you can get help. England must be unique in simultaneously restricting help to those with the highest needs and the lowest means.

And finally, that your chance of needing care and support in later life is much higher than you think – one third of men and a half of all women will have a significant care need at some point in their retirement. So we all have a stake in seeing a better system fit for the 21st century.

The King’s Fund has been arguing the case for change, alongside many other charities, since our major review by Sir Derek Wanless in 2006. Since then White Papers and Green Papers have passed like ships in the night. The Government pledged to set up an independent commission to look at how care is funded. It delivered on that commitment and the commission headed by eminent economist Andrew Dilnot has produced proposals that command almost universal support from organisations involved in older people’s care. We agree that they offer a sensible framework in which the costs of care can be met. But reform of funding must go hand in hand with reform of how care is delivered.

The Age UK report sets out seven major building blocks for change including quality, safety and dignity in care. The Government will soon set out its stall in a White Paper and accompanying response to the Dilnot report – its authors could do worse than make sure Care in Crisis 2012 is top of their preparatory reading list.

Age UK are calling on the Government to reform the adult social care system. Find out more about Age UK’s Care in Crisis campaign and how to sign up to our petition.

Read Care in Crisis 2012

The Future of Care Homes?

This blog was contributed by David Richardson, Strategic Programmes Delivery Manager for Age UK. David develops and tests innovative services that address the needs of older people.

There’s an expectation, almost a mantra, that the future of caring for individuals with increasing support needs lies in their own homes. Tailored care packages will be delivered seamlessly and altered to meet changing individual need and preference. Care homes are redundant. Does it not sound a little utopian?

What does this mean for real people living in real communities?

Most domiciliary care packages address physical needs, although of varying quality and quantity. They are less successful in meeting psychological and social needs. Being at home all day with a succession of “help” is still a lonely and isolating experience with long term consequences for wellbeing. We are very good a deciding what is best for older people (that is those at least 20 years older than one’s self). But do we really know? The recent Joseph Rowntree Foundation (JRF) report A Better Life – what older people with high support needs value casts some much needed light on this neglected area.  

Is the move to providing yet more care in a person’s own home possibly driven by other considerations, perhaps the often expressed guilt of “have to put mother in a care home?”

There is another way. Residential care homes have provided safe havens for those with high support needs for many years. A few, rightly vilified by the tabloid press, have produced appalling experiences for their residents. Rather more provide a “satisfactory” level of care while a minority provide exemplary support. What defines satisfactory I don’t propose to unpack here – not least since it depends on your perspective.  There is another way.  The other way is emerging from the collaboration between City University and Age UK which is My Home Life.

My Home Life works towards just that – where living in a community is the chosen home for each individual, in the same way that they might have chosen to move house. Hence this initiative. In their new home residents are able to express voice, choice and control over their care and support. Still too utopian? Over 4,000 registered home managers, the National Care Forum together with other key care home organisations and regulators don’t agree.

Over the last four years My Home Life has developed an extensive evidence base of existing best practice in care homes. It promotes care homes as a positive accommodation option for older people where resident centred care delivers profound improvements to the quality of life experienced by care home residents. The chosen agent for change is care home managers themselves.

Care home managers undertake a structured leadership and management training programme which helps them to take a different view of their own domain. A common thread from their action learning groups is their identification that task-based approaches to delivering care are restrictive, not just for residents but actually for their staff; tasks become activities.

Typically, it takes two years to change the philosophy and practices of care delivery in a care home. Philosophy? Empowering care staff to think about what they need to do rather than processing tasks takes time. Adopting best practise over ‘drugs rounds’; embracing risk-taking for residents and opening the doors to the wider community also take time and challenges “but we’ve always done it this way”.

Putting residents firmly at the centre of all activities is empowering for the whole care home community – residents and their families, care staff, visiting health and social care professionals, regulators and commissioners.

The nagging utopian theme is still there, especially for care home operators and owners who have to get a return on their investment. There is strong anecdotal evidence that My Home Life has a positive impact on the ‘bottom line’. Staff turnover reduces, retention improves, sickness absence reduces. Void rates improve. This combination has a strong effect on margins and encourages investment in the training.

Commissioners in a number of local authorities have identified this collaborative programme as a powerful tool to improve safeguarding in care homes by driving up positive practice. Effectively, every member of the care team becomes a champion for residents who also have their own voice heard.

Improving the lives of some of the most frail and vulnerable older people approaching the end of their life is challenging. My Home Life provides a gateway to doing that. The future needs for those with increasing physical and emotional needs can be met in their own home – a home in the community where others are on hand to provide support.

Age UK are calling on the Government to reform the social care system. Find out more about Age UK’s Care in Crisis campaign and how to sign up to our petition.  

Read more about the My Home Life programme

View a presentation about My Home Life