Should Lancashire's elderly get free personal care?

How much should the elderly have to pay for a helping hand
How much should the elderly have to pay for a helping hand
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Personal care should be provided free of charge to those who need it, Lancashire county councillors have said.

The radical policy revamp won cross-party support at a full council meeting – but the power to implement any change lies in Whitehall, not County Hall.

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The authority will now write to government calling for an overhaul of the personal care system, which helps elderly people with basic needs like getting washed and dressed, going to the toilet and preparing food.

The move follows a recent House of Lords select committee report which concluded that personal care costs should be scrapped within five years. It also echoes a campaign by the charity Independent Age which wants to see people provided with support to remain in their own homes for longer – and to reduce the risk of their property having to be sold to pay for it.

Currently, personal care is paid for by the individuals who need it if they have income and savings totalling more than £23,250. Beneath that figure, costs are shared with the council on a sliding scale until a person’s level of income and savings drops below £14,250 – at which point the local authority pays in full.

The value of an individual’s home is not part of the means testing process for care provided within their own four walls.

However, the worth of their property is considered when determining whether they are eligible for financial support to live in a care home – and, crucially, there is a personal care element to the cost of a residential care place.

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Labour opposition leader John Fillis led the call for a rethink of how the country treats its elderly residents.

“[They] should be supported with dignity at all times and they should not have to pay out their hard-earned money to cover that dignity.

“I believe anybody in this chamber would support [that intention], but the question is – where is the money coming from?

“We have international internet companies who siphon off billions in profits every year. They should be made to pay.

“We have offshore companies again siphoning off millions – they should be made to pay.

“We all pay and the people we represent pay – but these people avoid tax by [avoidance] schemes and moving away,” County Clr Fillis said.

He found support from the ruling Conservative group, with cabinet member for adult services, Graham Gooch, agreeing with much of his analysis.

But County Cllr Gooch said the authority should not simply sign up to a charity’s campaign on the subject – and instead needed to send a specific message to the government about the direction which it should take.

He put forward an amendment calling on ministers to scrap the current means testing regime and no longer take into account the value of an individual’s capital, such as their savings and income. Means testing for social care costs – both domestic and residential – should be limited to a person’s income, County Cllr Gooch said.

“Lancashire is not in the crisis position of some other parts of the country and I don’t want it to get there.

“The welfare state that we’ve had since 1948 was based on the premise that we would accord to the biblical standard and expire after three score years and ten. However, we are disobligingly living much longer – and I’m hoping to continue that trend.

“There does seem to be support for [the move to free personal care] from across the political spectrum – Cllr Fillis and Jacob Rees-Mogg are singing from the same hymn sheet,” County Cllr Gooch said.

Speaking after the meeting, the cabinet member suggested that he would like to see a wholesale review of social care which considered making all residential care costs free.

The government’s promised green paper into the future of the social care system has now been delayed by more than two years.

Independent Age claims that the care needs of 1.4 million people across the UK are currently going unmet.

George McNamara, Director of Policy and Influencing at the organisation, welcomed Lancashire County Council’s decision to write to the government.

“Thousands of older people across Lancashire are being let down by a social care system that doesn’t work for them.

“Free personal care is the best and most effective way of ensuring all older people are given the help they both need and deserve, and would virtually eliminate catastrophic care costs that many hard-press individuals and families have to face when paying for care. This would take a huge burden away from them and their families, and would show older people that society values their dignity and independence.”

“Having the council’s support will play an important role towards putting pressure on the government to end the unfair lottery of care which older people face. The more councils, like Lancashire, that get behind this campaign, the more chance we have of showing the government that the future of social care is in making personal care free at the point of need.”

WOULD SOCIAL CARE REFORM ENABLE YOU TO KEEP YOUR HOME?

The value of an individual’s property is incorporated into the means test of their ability to pay for social care only if they move into a residential home – not if they continue to live in their own.

But because there is a personal care element to the cost of a residential placement, the charity Independent Age claims that making personal care free would reduce the bill for those living in residential care by more than a third – meaning it would be less likely that people would have to sell their own home to cover the costs.

County Cllr Tony Martin told the County Hall debate on the subject that the change could not come soon enough – but, for his parents, would be too late.

“My father died two years ago – his care costs were £60,000. My step mother is now in a care home and her costs are currently running at £40,000.

“And they are in the lucky position of having savings, but the value of their house is already gone – it’s a shame and a tragedy.

“I think some of this could have been avoided if, collectively, government had implemented [reforms suggested by a previous commission on the issue].

“This is a step forward and hopefully the pressure [for change] will mean my generation won’t face the same difficulties as my parents’ generation did,” County Cllr Martin said.

A DECADE OF DELAYED DECISIONS

A commission looking into the social care system was set up within weeks of the coalition government coming to power in 2010. When the group – led by Lord Andrew Dillnott – reported a year later, it suggested an increase in the threshold of savings and assets which a person should be able to hold before having to pay full residential care costs from £23,250 to £100,000.

The commission said the threshold for personal care should remain at £23,250 and also recommended a cap on lifetime care costs – other than those for general living – of £35,000.

The proposals were accepted, but never implemented and, in 2017, the Conservative government said it would launch a review of the social care system and publish a so-called “green paper”.

During the general election the same year, Theresa May was heavily criticised for a plan to raise the threshold for all social care costs to £100,000 – but extend the means test for care within a person’s home so that it included the value of that property.

There was anger from some quarters that the proposal promised a floor through which income and assets would not fall, but no ceiling to cap total lifetime contributions.

The policy was dropped before voters went to the polls, prompting Mrs. May’s now infamous “nothing has changed” comment.

The green paper is now two years overdue.

Personal care has been free in Scotland since 2002.

IN NUMBERS

£169.7m – Lancashire County Council’s adult social care budget (2018/19)

£2.6m – overspend in county’s adult social care budget (2018/19)

£8bn – extra investment in adult social care needed nationwide this year, according to House of Lords Economic Affairs Select Committee.

CALCULATING CARE COSTS

An individual has to pay the full cost of their care if they have income and assets over £23,250. The figure excludes the value of a person’s home if they are to remain within it. Earnings and some benefits are also discounted from the calculation.

If they move into a residential home, the worth of their own property is taken into account – but not if they have a spouse, partner or close relative still living there.

It is possible to set up a deferred payment agreement with the local authority to repay the costs of your care after you have passed away.

WHAT THE GOVERNMENT SAYS

A spokesperson for Department for Health and Social Care the social care system should continue to operate on the “principle of shared responsibility – and that people should continue to expect to contribute to the cost of their care as part of preparing for later life”.

“Social care charging is based on a number of key principles, including that people should not be charged more than it is reasonably practicable for them to pay.

“However, those that need additional support from the state also benefit from the means-tested safety net, which is available to everyone, including those with dementia.

“Where a local authority choose to charge someone, they must undertake a financial assessment of what the person can afford to pay to ensure the approach fits with the principles for charging.”

The department added that it will set out plans to reform the social care system “at the earliest opportunity to ensure it is sustainable for the future”.

Lancashire County Council received the joint-largest share of a nationwide grant to ease pressure on adult and children’s services late last year. The authority was handed almost £15m.