Funding reform needed to tackle care patchwork

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MAJOR reforms of funding for people with long-term care needs will be needed to eliminate patchwork provision for thousands of people across the Yorkshire region.

A Yorkshire Post survey has uncovered wide difference facing people in neighbouring areas in accessing help for basic needs including getting up, dressing and washing, cooking meals and cleaning, as well as night sitting or visits to day centres and meals on wheels.

A landmark review into long-term care funding is likely to recommend those who can afford it should pay between £35,000 and £50,000 before the state steps in to pay for care needs.

It is hoped the move will encourage the creation of an insurance market to cover the costs of future care and counter controversy over thousands of people each year being forced to sell homes to pay for the costs of residential and nursing care.

The review is likely to reject the provision of free personal care, which is available in Scotland, but could recommend a national system of assessment and eligibility replacing the existing postcode lottery.

Campaigners argue changes are desperately needed. Around one in four people need no care at all when they grow older but one in four face crippling costs of more than £50,000, while one per cent need care and support worth £400,000.

Social care, unlike NHS care which remains free to people whose main needs are health-related, has always been means tested.

Those requiring residential or nursing care have to pay for it in full if they have capital including a home worth more than £23,250 – accounting for the majority of pensioners.

People needing care at home or in the community pay for it if their income or savings are above the £23,250 threshold.

But people may not routinely get care from councils if their needs are not judged to be high enough and cuts mean fewer people are becoming eligible, with numbers receiving care dropping by nearly 40 per cent to 300,000 in the five years to 2009.

The charity Age UK claims that out of two million elderly people with care-related needs, 800,000 do not receive any formal support, predicting the number will exceed one million by 2014 due to cuts in council spending, which is down by £1bn or seven per cent this year, according to social services chiefs.

On top of this charges levied by councils have risen significantly in recent months.

The charity says some people with lesser needs no longer get help and are left to struggle on alone, while others who are worried about bills do not access all or some of care they need.

In Yorkshire, fewer than half of councils offer care to people with moderate needs – judged as being unable to carry out several personal care or domestic routines – but the remainder only provide it to those with substantial and critical needs.

In April, Calderdale Council became the last to withdraw support for those with low needs in the region, affecting 700 people.

Kirklees Council this week reversed a controversial decision to provide services only to those with critical needs following a legal challenge to a similar move in Birmingham.

Some 39 people who have had their support changed because of the original decision will have their previous care reinstated, while others refused care since April will now be reassessed.

The authority says it plans to invest £1.4m in prevention to reduce the amount of critical care needed in the future.

Vulnerable people in Barnsley pay among the lowest charges in the country but these were significantly uprated from yesterday. Previously everyone receiving social care regardless of income had their care subsidised but now they are charged the market rate unless they qualify for means-tested support, leading to a rise in homecare costs from £5 an hour to £13.

The changes mean the maximum new clients pay each week in the borough will rise from £60 to £90. This contrasts with four other authorities which charge unlimited amounts to people who do not qualify for means-tested support.

In North East Lincolnshire, the weekly maximum has recently been increased to £337. Officials say 60 per cent of clients have seen no increase but for 15 per cent the increase has been more than £25 a week.

In Bradford the maximum rate has increased from £110 to £199 a week but officials say the move had increased costs for only 70 of around 3,000 people in the city receiving help at home.