Transcript Slide 1

Review and Development of Adult Social
Care Relative Needs Formulae
Jude Ranasinghe, Director
17 September 2013
Presentation Overview








Current adult social care spending/funding
Care Bill and future funding implications
Remit of our research/timescales
Impact assessment
Activities to date
Local authority funded clients
Self-funders
Modelling local financial implications
Planned Expenditure 2013/14
 Total planned expenditure in 2013/14 of £14.650bn
Younger Adults with
Learning
Disabilities
£5.1bn
34.9%
Younger Adults with
Physical Disability
or Sensory
Impairment
£1.5bn
10.1%
Older People
including Older
Mentally Ill
£6.6bn
45.1%
Younger Adults with
Mental Health
Needs
£1.1bn
7.3%
Other Adult Social
Care
£0.3bn
2.2%
Adult Social Care
Strategy
£0.1bn
0.4%
Current Adult Social Care Funding
 Funding received through council tax; fees and charges; specific grants;
and general grant
 Significant funding received through general grant via Relative Needs
Formulae (RNF) – part of Business Rates Retention system
 RNF are a set of formulae accounting for relative differences in costs of
delivering services – younger adults and older people
 But formulae currently ‘frozen’ and not expected to be updated until next
reset (at least 2020/21)
 Specific grants – NHS funding for social care (£859m) Local Reform and
Community Voices (£42m), Community Capacity (capital £129m) – all
use the current RNF
Current Adult Social Care RNF
 Current formulae developed in 2005, implemented in 2006/07
 Younger adults (18-64):
 Basic amount for all resident adults aged 18-64
 Deprivation top-up (DLA, never worked/l-t unemployed, routine
occupations, no family)
 Area Cost Adjustment
 Older people (65+):
 Basic amount for those aged over 65
 Age top-up aged 90+
 Deprivation top-up (AA, Income Support/Pension Credit, rented
accomm, living alone)
 Low income top-up (LA charges)
 Sparsity top-up (domiciliary care)
 Area Cost Adjustment
Care Bill and Implications for Future Funding
• Reform currently taking place in relation to ASC funding
• May 2013 - Care Bill incorporating clauses to implement Dilnot
proposals placed before Parliament
• July 2013 - DH consultation paper, “Caring for our future: Consultation
on reforming what and how people pay for their care and support”
• Essentially, affects eligibility for social care support in terms of:
• Care need
• Means test
• Particular issue is that people currently self-funding their care will need
to be assessed and will become eligible for LA support
Care Bill and Implications for Future Funding
1. Care plan/account: to assess and monitor
needs/outcomes/spending
2. Cap on lifetime costs of care, with full state support after the
cap: older adult cap £72k from 2016/17, younger adult cap TBC
3. Free support for those transitioning into adult social care:
zero cap for clients turning 18 with eligible care/support needs
i.e. no means test
4. Extend the means test: upper limit changing from current
£23,250 to £118,000 in 2016/17 for home owners receiving
residential care
Care Bill and Implications for Future Funding
4. Standardise general living “hotel” costs: from 2016/17,
contribution of £12,000 p.a. for residential care living costs
5. Standardise national eligibility criteria: national minimum
eligibility threshold in Care Bill from 2015/16 (level TBC)
6. Deferred payment scheme should be extended to a universal
entitlement: will be nationally available from 2015/16
Remit of our Research - Formulae
1. Local authority funded clients, although not currently planned to update
until next reset of system (2020/21). However, is currently used for DH
specific grants and NHS funding for social care
2. Introduction of the universal deferred payments scheme from 2015/16
3. Assessment/metering costs from 2015/16 (£335m in total for 2. and 3.)
4. Introduction of the cap on eligible care costs from 2016/17
5. Changing the capital limits for people in residential care from 2016/17
 We are not looking at quantum of funding
 Impact assessment by DH on costs of social care funding reform
Impact Assessment of Funding Reform
2010/11 prices (£m)
2016/17
2019/20
2025/26
Older people – cap and means test extension
360
1,150
1,940
Older people – assessment, case mgt, review
210
230
290
Working age – all costs
100
210
420
Total costs
660
1,590
2,640
(130)
(250)
(340)
530
1,340
2,300
Reduction in AA/DLA benefit costs
Net costs
Source: DH Social Care Funding Reform Impact Assessment, April 2013
Impact Assessment
Source: DH Social Care Funding Reform Impact Assessment, April 2013
Impact Assessment
Source: DH Social Care Funding Reform Impact Assessment, April 2013
Project Timetable
Project
initiation/
engagement
Autumn 2012
LA contact,
feasibility
work and
data
collection
piloting
Spring 2013
LA and care
home data
collection –
Summer/
Autumn 2013
National
data
collection,
local data
verification,
analysis
Winter 2013
Analysis and
modelling
Spring 2014
Peer review/
consultation/
formula
outputs
Summer
2014
Activities to Date – General and LA Funded
 Engagement with ASC stakeholders – Steering Group (monthly) and
Project Advisory Panel (quarterly)
 Approval from National Research Ethics and local Research &
Governance Committees
 Pilot process for LA data collection with c.10 LAs
 Development of data guidance/definitions/templates
 Now working with 65 LAs to actually collect data
Activities to Date – Self-funders
 Feasibility study on availability of self-funder data
 Asked LAs about information held on self-funders
 Investigating potential data sources on domiciliary care
 Draft survey for distribution to private sector residential care homes on
self-funders
Local Authority Data Collection – Volunteers by Type/Deprivation
Authority Type
Number
Deprivation Level: Low
Deprivation Level: Medium
County Council
14
Buckinghamshire
Cambridgeshire
Hampshire
Oxfordshire
Surrey
Essex
Gloucestershire
Suffolk
Inner London
9
Camden
Kensington and Chelsea
Westminster
9
Merton
Sutton
Outer London
Metropolitan Borough
13
Unitary Authority
20
Total
65
Kirklees
Leeds
Sefton
Solihull
Stockport
Bracknell Forest
Cheshire East
Cornwall
Isle of Wight
Isles of Scilly
Shropshire
Wiltshire
York
23
Hammersmith and Fulham
Bexley
Hillingdon
Hounslow
Coventry
St. Helens
Deprivation Level: High
Derbyshire
East Sussex
Kent
Lancashire
Lincolnshire
Nottinghamshire
Hackney
Haringey
Islington
Newham
Tower Hamlets
Croydon
Ealing
Enfield
Waltham Forest
Birmingham
Manchester
Oldham
Rochdale
Sandwell
Wolverhampton
Bedford
Milton Keynes
North Somerset
Northumberland
Reading
Swindon
Torbay
Blackpool
Durham
Hartlepool
Leicester
Peterborough
16
26
Local Authority Data Collection – Volunteers by Region
Region
County
Council
Inner
London
Outer
London
Met.
Borough
Unitary
Authority
Regional
Total
% of
All Auth.
EAST
3
2
5
45%
EAST MIDS
3
1
4
44%
18
55%
3
3
25%
2
9
39%
9
LONDON
9
NORTH EAST
NORTH WEST
1
6
SOUTH EAST
6
4
10
53%
SOUTH WEST
1
6
7
44%
WEST MIDS
5
1
6
43%
YORKS & HUMBER
2
1
3
20%
43%
Auth. Type Total
% of All Auth.
14
9
9
13
20
65
52%
64%
47%
36%
36%
43%
Data Collection from LAs
 Collecting data at small area level (Lower Layer Super Output Area)
 Using activity data from national returns for consistency/control
totals by client group and care type
 Residential care – ASC Combined Activity Return (admissions in
2012/13, care home address and pre-care address)
 Non-residential care – Referrals, Assessments and Packages of
Care Return (clients as at 31 March 2013)
 Separated requirements into ‘core’ and ‘supplementary’
 Team of 10 researchers, range of on- and off-site support to LAs
 Secure data transfer portal managed by University of Kent
Data Collection from Care Homes
 Also seeking data at LSOA level from private sector care homes
 Interested in numbers of self-funders and publically supported
 Numbers from outside the LA area
 Room price data
 Length of time self-funders have been resident
 Will combine this information with other data e.g. wealth
characteristics, to identify nature of self-funder population and likely
implications for future LA support
Modelling Local Financial Implications of the Care Bill
 Also offering separate support to LAs looking to undertake more
detailed local modelling
 Reviewing range of national and local data sources
 Advising LAs on key local data
 Building a bespoke local long-term model, with guidance
 Will allow for ‘what-if’ scenarios
 Reporting summary implications
Next Steps
 Continue work with 65 LAs on LA-funded clients
 Run self-funder survey with care homes
 Verify and analyse data
 Analyse/collate national datasets e.g. Census, benefits
 PSSRU will develop formulae
Further Information
 Dedicated project website at www.adultsocialcarernf.co.uk/
Contains a range of information/documentation/latest news
 Contact directly at [email protected]
or on 01908 424387
This research has been commissioned and funded by the Policy Research Programme in
the Department of Health. The views expressed in this presentation are not necessarily
those of the department.