Call for radical changes as care bill to rocket

The Care Quality Commission (CQC) said a major overhaul was needed in the way services were organised and delivered to tailor them to individual needs and also deal with massive pressures on public finances.

Its report came as Government plans to expand free home care for the elderly triggered furious exchanges at Prime Minister's questions.

Council leaders had earlier attacked Labour proposals to provide 400,000 vulnerable elderly people with free care at home as flawed and unfunded, warning they would lead to cuts in existing services.

Tory leader David Cameron demanded to know where the funding was coming from. He claimed Prime Minister Gordon Brown wanted the "benefits" of the policy before the election, leaving the costs to afterwards, amid speculation a compulsory levy on the elderly or their estates could be imposed.

But Mr Brown hit back, attacking the Opposition leader for breaking cross-party "consensus" on the issue. He said they did not have a policy on elderly care, adding: "This is a big challenge... this is no time for a novice."

Yesterday's CQC report said tailoring services to meet individual needs would save money and allow people to remain independent.

Chairwoman Dame Jo Williams said: "Trends such as increasing demand and rising expectations will be exacerbated by pressure on finances. To cope, we need some radical changes in the way that we organise and deliver services.

"This means shifting the culture away from a one-size-fits-all approach to care that puts the needs of individuals and carers at the centre of everything. A key part of this will involve helping people maintain their independence and health."

Stephen Burke, from the charity Counsel And Care, said: "Older people and their families want to know what care they will get and how much they will have to pay.

"One way to fund better care would be a care duty on estates but it must be done fairly through a percentage on all estates above a certain value."

Simon Lawton-Smith, of the Mental Health Foundation, said: "An often-overlooked benefit of treating people as individuals and focusing on maintaining their independence and health is that it has the potential to save money. The hope now is that the likely need to reduce funding might concentrate minds on reform."

The CQC report found fewer people were living in care homes last year than in 2005 because more were being helped to live independently at home but there was still a three-fold variation in elderly placements in long-term residential care by councils.

It said investing in services to help people to stay independent could save up to 2bn a year if repeat emergency admissions of elderly people were cut.

Another 2.7bn could be saved by helping people better manage long-term conditions and avoid visits to hospital.

David Rogers, chairman of the Local Government Association's community wellbeing board, said: "It has been thoroughly proved that investing early in care to keep people healthy and active will save just as much money in the long term. What is needed now is the necessary reform of the system."