Could this be another way for Local Authorities to increase their housing stock?

What would the Conservatives’ proposed funding of social care mean for adults with learning disabilities? Most don’t have this scale of capital or own their house although we’ve had shared ownership models and some parents leaving them their house or providing a house… However parents and family carers do age and if they live long enough may need care themselves.

So assuming they have housing or capital, how would this impact on people and /or their families?

To my mind the proposal anyway is deeply flawed, unlikely to assist LAs desperately trying to make their books balance, as the continued cuts bite – worst as we know in the poorest more deprived areas. Might this actually raise money though?

It seems to me there’s no glimmer of hope in this. The main gainers could be those with property and the rich ofcourse, but the main losers are likely to be the Local Authorities on whom the burden will fall to manage the very heavy additional administrative burden, probably be expected to raise what they need from these charges and will have to manage the fall-out on the care market as the self-funders come to the LA to fund their care, given the limit on care costs from a cap. If there hadn’t been a cap, maybe the LA could have bought the house for £100k on the death of the person and increased their housing stock, or maybe it would have encouraged their families to gift the house across to the person, so it wouldn’t be lost in care fees for the parents’ older age!

What will the costs be on LAs of administering  the charges, and what will the impact be on the market?

Elderly people in residential care live on average for 2 1/2 yrs – the median being 15 months – as they tend not to go in until it is too costly to care for them at home – so mostly 85 and over. Hence current deferred charges collections on their house should not shift too far into the future so it’s not too burdensome for LAs to manage this debt. However, including the home care market means managing a changing valuation of the  property across many years as people supported at home may live for many many years receiving care – and before they go into a care home. Ofcourse depending on the cap, the LAs might do this financial assessment, track the valuation across the years and then end up finding the person has reached the capped amount on their ongoing payments – particularly if they are younger disabled adults! However one guesses that this will be complicated by the cap being uprated annually…

If you therefore add on a cap on total care charges, this is going to massively increase the costs on the Local Authorities – not only on the reduced income from those currently paying charges for their home care services based on the far lower figure of £23500 , but also because they will have current and future self-funders coming to them so as to limit their spend and so maximize what they leave in their inheritance.

At the moment people with significant resources don’t go through the LA, because they would have to pay the full charge, so  LA would now have the additional costs of social workers to assess their eligibility for care, and their financial contribution, and track their spend for when they reach the ceiling. Not only this but as is really clear from the market analysis (see Laing and Buisson quoted in the government briefing below), self-funders are paying well-above the LA rate for care and this is subsidising the LA placements which are below the level needed for companies to continue in business. The extent of subsidy also varies across the country but is significant so the impact will be higher in some areas than others.

So this move to cap charges is either going to cost the government a lot of money to keep the market working and engaged (probably more than they collect), or it will result in unprofitable businesses leaving the market….. and LAs already poised to be unable to meet their statutory duties, going bust. The care home system is already creaking from the fee squeeze, national “living” wage (NLW) increases and the social care workers’ recruitment crisis (likely to be further exacerbated by Brexit), but this could well break it as hedge fund-driven/investor funded private care services can no longer yield the percentage needed for investors and they switch to another sector.

In the end, this won’t be manageable and probably won’t raise the money needed. The people who’d benefit will be those who would normally not go to LA and buy their care direct.

One would have thought the way to manage this fairly and with least administrative burden on hard-pressed LAs would have been to raise inheritance tax and/or other taxation to be able to use directly instead of additional charges with all the complexity of administration and unintended destabilisation of the market consequences. This would impact fairly according to means and be directed into services,  as opposed to being diverted into unwieldy administration and debt management!

Government think again! If you are returned into Government and are pledged to deliver this, this maybe the worst mistake you could make in terms of value for money and impact on social care and the market.  It’s difficult to see what wriggle room you have though without another U-Turn….and I shudder to think of what impact this might have on the lives of other vulnerable adults, such as adults with learning disabilities. Presumably, they’ll be told their (statutory) needs have further shrunk as the LA can no longer pay for their proper support….and redefines what will “best” meet their needs.

Notes from  House of Commons Briefing Paper number: 07463 20 February 2017

  1. Private payers pay 43% private pay premium on average often for exactly the same room size and service

 

As the table below from LaingBuisson for 2014 demonstrates, the pool of self-funders varies region-by-region:15

 

 

Region Self-pay %
North East 18%
North West 36%
Yorkshire and the Humber 42%
East Midlands 43%
West Midlands 39%
East of England 45%
Greater London 30%
South East 54%
South West 49%
Wales 24%
Scotland 30%
Northern Ireland & Isle of Man 16%
United Kingdom 41%

 

Chris Hatton’s blog – institutional disablism

Today saw the publication of a landmark study by Australian academics Julian Trollor, Preeyaporn Srasuebkul, Han Xu and Sophie Howlett on deaths amongst a cohort of 19,362 people with learning (intellectual) disabilities in New South Wales, Australia. Their findings are in BMJ Open here, and are free to download and read. This article in the…

via It’s institutional disablism – deal with it — Chris Hatton’s blog

Purging

Thank goodness! What has happened to people’s lives that there’s developed all this jargon.It defies all reason as to why we don’t have the same features in our lives as the rest of us. Yes – that’s not to deny extra help some people’s communication needs may need but why do we not find ways for this to be as usual as possible. I have address books and calendars, diaries and even a file with my household bills etc in – but they wouldn’t be out on display either. PLEASE please can all services not think a lot harder about how they do support people’s lives! This is a good example…..

Love, Belief and Balls

I remember moving into my first flat at 20. One of the real joys was putting my own stamp on the place. Mark making his mark. Like all teenagers, my bedroom at my parent’s house was the space to express me but a whole flat was a much bigger space to fill.

I’ve had this very much in mind over the past few weeks during the move to Steven’s new house. I saw as my main task, how to help him create his own space.

Alongside the move, I’m aware that I’ve become obsessive about living as “normal” a life as possible. This puts me on a collision course with two of the themes I write about a lot – how (useful) services don’t exist anymore and how the social care system likes to frame the life of a learning disabled system. The latter theme covers a wide ground from…

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Doing It

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It’s so unhelpful and damaging when people are presented as objects of pity or problem. Many many years ago Mencap ran an advert showing I think he might have been called Simon as a pitiable picture – but they did see sense and change this. We do see so much better pictures of achievement these days. So much more powerful are the results of the right support – with help people’s talents can thrive, their contributions can be made and they (and their families) can develop good lives. Noone would deny the amount of effort that is needed for some people’s lives to change nor the amazing contribution of families to make this happen – far and beyond anything we might expect. However, surely we should be telling people what helps make it happen – not have people feeling they must contribute as it’s so awful. It’s the damage this does to all people with labels to make things so much harder due to the prejudices this feeds on. We should be presenting what’s possible with help not the worst moments of some. We also fail to help people understand what we might be like did we have some if the experiences people have had simply because of the lack of help and understanding. No wonder we get so little urgency to get people him from ATUs – we will make people imagine the worst unless shown the real picture. AND some of us might find ourselves locked up had we the same weight of prejudicial attitudes on us, the lack of understanding and with less resources and no power to change things.

Love, Belief and Balls

You either do it or you talk about it (passionately).

The NAS have launched their Christmas 2016 campaign. Here is the launch photo:

nas3

Anyone got any idea what the message is? Autistic people and their families have shit Christmases? Sibling’s lives are ruined? I haven’t a clue what the message is.

But let’s make a donation anyway.

In the meantime, I (amongst several other campaigners) am still blocked by Jan Tregelles, the CEO of Mencap. It’s no big deal. The corporate Mencap world is about as far away from my world as it is possible to be. If I am passionate, it must be a very different kind of passion:

mencap1

As long as the big national charities continue their idea that their role is to give learning disabled people a voice, we’re fucked. Always on the outside looking in. Always the victim.

Two stories of people having a voice:

This…

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