Transcript Slide 1

Your future care and its costs
Findings from qualitative work with social care ‘self-funders’ in Surrey
31 January 2014
© Ipsos MORI
Contents
• Background and context
•
The landscape of public opinion around social care
•
The policy context
•
• Self-funders’ information needs and expectations
•
What appetite do self-funders have for information on social
care?
The challenge for Surrey County Council
•
What are the needs of those in receipt of informal care?
•
Project objectives
•
Personalised information and support
•
Methodology
•
Experiences of those providing care
•
Interpretation of the data
•
The role of Surrey CC in providing information
•
What role should Surrey CC have as an information source?
•
What information on Social care do self-funders want from the
council?
•
Signposting vs. provision
•
Using case studies
•
The ‘personal care and support’ booklet
• Self-funders’ understanding of social care services and
funding
•
What does social care mean to self-funders?
•
What do self-funders understand about how care is
funded?
•
How do self-funders anticipate their care will be paid for?
•
What do self funders know about the provision of social
care in Surrey?
•
What experiences of social care do self-funders have?
• Self-funders’ preparedness for care they may need in
later life
•
Difficulties associated with talking about care
•
What plans are self-funders making for their own care?
•
What is most important to self-funders when thinking about
planning for their needs in old age?
© Ipsos MORI
• Recommendations and next steps
•
What does this mean for Surrey CC?
1. Background and context
© Ipsos MORI
Background – the current landscape of public opinion about
social care
 Awareness and understanding of social care amongst the British public is
low. Ipsos MORI research highlights just how little consideration the
public gives to care in old age, and that there is low awareness of, and
common misconceptions about, who is responsible for looking after older
people in need(1).
 Awareness of how care and support services are funded – and how
much they cost – is low, and many people continue to (wrongly) assume
that the state will automatically pay for their care in old age(2).
 Further, expectations of government are high. When polled, a majority of
the public agree that responsibility for funding social care should rest with References
the state, rather than families and individuals. The consequence of this is 1) Ipsos MORI (July 2011): The future
funding of social care: Qualitative research
that people often have no plans to save for future care needs.
2)
 According to the Government’s Care and Support White Paper(3), around
eight in 10 people aged 65 will have care needs in the future. Yet it
appears only a minority are actually planning financially for it in reality,
including those reaching retirement age.
 This presents big challenges for both central and local government in
planning for ageing populations.
© Ipsos MORI
3)
for Age UK. A report on behalf of Age UK
Ipsos MORI (February 2011): Public
opinion research on social care funding. A
literature review on behalf of the
Commission on the Funding of Care and
Support
Gov.uk – Care and Support white paper
https://www.gov.uk/government/publication
s/caring-for-our-future-reforming-care-andsupport
Nationally, only a minority of people have thought about planning
for their future care needs, and even fewer are actually preparing
Q Many people will need to use social care services
when they are older and it is likely that they may have
to contribute towards the cost. Before today, to what
extent had you thought about preparing financially to
pay for social care services you might need when you
older?
% To a great extent
% To some extent
Q To what extent are you already preparing financially
to pay for the social care services you might need
when you are older?
% Hardly at all
% Not at all
Thought about preparing
1 6%
Already using social care
services
Already preparing
Those saying to
some/ a great extent:
Those saying to
some/ a great extent:
14%
All = 28%
Aged 55-64 = 37%
All = 35%
Aged 55-64 = 46%
24%
30%
44%
56%
16%
19%
Base: Adults aged 16+ in England, December 2012 (1004)
© Ipsos MORI
Source: Ipsos MORI/DH Perceptions of the NHS Tracker
Furthermore, only a minority see it as their responsibility to
save so they can pay towards their care when they are older
Q Please tell me whether you agree or disagree with the following statement:
“It is my responsibility to save so that I can pay towards my care when I am older”
Don’t know
Strongly disagree
22%
Strongly agree
2%
8%
33%
Tend to disagree
Tend to agree
19%
15%
Agree
41%
Disagree
41%
Net agree
0
Neither agree nor disagree
Base: Adults aged 16+ in England, December 2012 (1004)
© Ipsos MORI
Source: Ipsos MORI/DH Perceptions of the NHS Tracker
The policy context
 Despite low awareness about the realities of paying for care in old
age, the onus will remain on individuals to carefully plan for their
care needs in the future - even with the Government’s forthcoming
cap on care costs.
 To address some of these challenges the Government’s new Care
Bill(1) sets out clear legal duties for local authorities to provide
residents with information on ageing and social care so they can
better plan for their future care needs.
 According to the government, people should be able to access
good information in a suitable format which includes information on
the costs of care, the financial support available, on financial
products and other options, and on practical arrangements such as
appointing a lasting power of attorney.
 Further to this, the rules on charging for community and social care services are
complicated. Pending the funding reform and the set-up of national minimum eligibility
criteria, thresholds differ across individual local authorities, making it all the more important
to produce appropriate information for the public at the local level.
1) http://services.parliament.uk/bills/2013-14/care.html
© Ipsos MORI
The challenge for Surrey County Council
 In Surrey, the proportion of the population aged 65 years and over looks set to increase from 16.5%
to 23% by 2033, placing huge pressures on local public services.
 It is estimated that 80% of the population will be ‘self-funders’ (i.e. ineligible for means tested care
paid for by the Council). In meeting its duties under the new Care Bill, it is important that the Council
understands the information requirements that this group has.
 Furthermore, as Surrey is a county with pockets of great
affluence there is likely to be disparity within this group of
self-funders in terms of their likely quality of life and ability to
pay for care in later age. This will likely mean different
information needs for different people.
 The Council also acknowledges that people are largely
unaware of the range of options available for their/ their
family’s care and support. They tend to think about care
homes as the only option, when there are many other
(cheaper) services available.
This research project therefore aimed to establish how much local self-funders know
about paying for social care, and their understanding and awareness of the support
available, to inform how the Council can meet the information needs of local
residents in line with the obligations for local authorities set out in the new Care Bill.
© Ipsos MORI
Project objectives
1. To understand what self-funders know about social
care services and how they are funded and provided.
2. To understand the extent to which self-funders
have made preparations for the care they may need
in later life and motivations behind this.
3. Drawing on this, establish the information needs
and expectations of Surrey residents who would
have to fund their own care.
4. To understand the role of the Council as an
information source on social care and the best ways
it can meet its obligations under the Care Bill.
© Ipsos MORI
Methodology
 Four two hour discussion groups were conducted with self-funders in
Dorking and Farnham in January 2014. There were 10 participants in
each discussion group.
 Participants were recruited at random in-street.
 Groups were recruited according to age and life stage given these
are seen to be important drivers to how people are likely to think and
plan for old age. Two groups were conducted with self-funders aged
40-59 and two with self-funders aged 60+.
 Groups were also recruited according to home ownership and the
total value of their capital assets to ensure we talked to those
people who would be classified as ‘self-funders’. One group in each
age range had capital assets of £25,000-£75,000, while the other
group had assets worth £75,000+. These asset bands were set at a
level to ensure that we could realistically assess relative levels of
wealth and include this as a differentiator.
 Prior to this, four depth interviews took place in-home with existing
carers who provide informal care to relatives to establish what it is
like for self-funders who have already tried to navigate the social care
system in Surrey and where any lessons can be learned.
© Ipsos MORI
The discussion groups had a
deliberative element,
whereby participants were
asked for their unprompted
understanding around social
care funding and eligibility
before being presented with
the factual information and
asked to reflect on this. This
was important for
understanding self-funders’
pre-conceptions and how
they might be addressed.
Interpretation of the data
 This report presents a summary of the findings from
a small-scale qualitative research exercise
conducted by Ipsos MORI.
 Analysis was carried out through detailed
brainstorming sessions, and reading of the
transcripts and notes.
 Qualitative research is designed to be exploratory
and provides insight into the perceptions, feelings
and behaviours of people. It is important to note that
qualitative findings are not statistically
representative of the views of the general public.
 The perceptions of participants make up a
considerable proportion of the evidence in this study,
and it is important to remember that, although such
perceptions may not always be factually accurate,
they represent the truth to those who relate them.
© Ipsos MORI
2. Self-funders’ understanding of social care
services and funding
© Ipsos MORI
Understanding of social care - key headlines
 Reinforcing messages from previous research, when thinking about social care, participants tend to
think about residential care, specifically care homes. There is limited understanding of the range of
other care services available to self-funders.
 Linked to this, many believe that social care becomes necessary only at the point of acute need or when
an individual becomes reliant on ‘round the clock’ care.
 In contrast to wider research findings, most participants understand that they will need to pay for their
own care in older age. However, confusion arises in relation to the wider system, including eligibility
criteria for receiving ‘free’ care.
 Many perceive an over-simplified system of binary care provision – either care is provided entirely free
of charge or not at all. There is a lack of understanding that some people will still need to contribute
towards their care costs. And a perception exists of a ‘two tier’ level of provision – a basic state
funded service vs. a much better privately funded service.
 Any existing exposure to the care system tends to be the result of needing to make plans for parents.
 Few have experience of, or are aware of, domiciliary and community care services. Help provided in
the home is not perceived as social care as it is too ‘light touch’.
 Those participants who have investigated residential care tend to complain about the inconsistency of
quality, due to the behaviour and performance of individual care workers, and this can help to shape a
generally negative view of the wider residential care sector.
© Ipsos MORI
What does social care means to self-funders?
 During the initial discussions, participants were asked to define what
the term ‘social care’ meant to them.
 When responding, most initially thought of residential care,
specifically care homes.
 Few had experience of, or knew much about, other services
available including domiciliary and community care.
 For many, the help provided in home (such as meals on wheels or
day care) was not perceived as social care due to its infrequency or
its ‘light touch’ nature.
Farnham
40-59 group
 Many believed that social care was necessary only at the point
where an individual is physically or mentally incapable of looking
after themselves and becomes reliant on ‘round the clock’ care.
 There was a clear difference in perceptions of social care between
different age groups. Older participants were more likely to be more
positive about the subject and mention the range of services
available. Younger participants were more negative, believing that
the service was patchy and inconsistent.
Farnham
60+ group
© Ipsos MORI
What do self-funders understand about how care is funded?
 In contrast to national polling, most participants were aware
that they will have to pay for their care in old age. They
accepted social care will not be provided free of charge.
 However, there was still confusion and misunderstanding
about exactly how the system worked - even amongst those
who had looked into social care for their parents.
 Many simply felt that home ownership made them ineligible
to receive free social care.
 Generally speaking, participants knew about the national
‘cap’ on care costs.
 But there was little understanding about needs
assessments, or that only those with ‘critical’ or ‘substantial’
needs would be eligible for free care (or what these terms
meant).
“It’s interesting that a nursing
home’s £35,000 a year and the
limit is £72,000 a year. So after
two years who’s going to pay for
it?”
Male, 60+, Dorking
© Ipsos MORI
“Unless you live in a council
flat or something and you
haven’t got any savings, you
pay for all that; it’s not cheap.”
Female, 40-59, Dorking
How do self-funders anticipate their care will be paid for?
 Most participants assumed that if they required more intensive
care, such as a residential care home, they would either need to
use their savings or sell their house to pay for it.
 There was little understanding of the current thresholds in place for
receiving funding towards care from the Council. Understanding of
eligibility thresholds was particularly low among the younger group
in Dorking, who had higher levels of capital assets (perhaps
because they are younger and more affluent).
“Actually [the
thresholds] are slightly
lower than I thought
they would be. What is
the basis for that
£23,000?”.
Male, 60+, Farnham
 However, when these thresholds were explained, all participants
felt they were acceptable.
 Participants wanted to know more about the rationale behind the
threshold amounts – why they were set at the levels they were.
 Indeed, for some, the information presented in the groups about
eligibility and exemptions, though useful, raised more questions
than it provided answers (e.g. where a spouse still lives in a
property and so the property value is not counted within the
definition of capital assets). Participants seemed very interested in
understanding more about what such exemptions might mean for
them.
© Ipsos MORI
“It’s overcomplicated –
a minefield of
information ‘oh yeah,
you get this, you’re
allowed that and if
you’ve got £23,000
you can’t get that’”.
Female, 40-59,
Dorking
What do self-funders know about the provision of social care
in Surrey?
 Participants were confused about exactly what the ‘state’ provided
as opposed to what was privately available.
 Participants tended to think that state support for social care was
binary – either it was provided entirely free of charge or not at all.
They did not realise that some people were asked to contribute
towards their care costs.
 There was also confusion about public versus private funded care.
Many perceived an over-simplified system of binary care provision
whereby those who can afford to pay privately receive better
quality care from a private provider, whilst those reliant of statefunded support receive poorer quality care from state providers.
 They were not aware that the local authority could arrange support
for self-funders to save them the burden of having to arrange their
care themselves.
 Participants were unaware that some private sector care providers
might receive public sector funding, and assumed that there were
simply ‘council’ care homes and ‘private’ ones.
© Ipsos MORI
What experiences of social care do self-funders have?
 For most, the key first hand experience of the social care system
came when making plans for their parents.
 However, most of those whose parents had care needs had
looked after them at home.
 The minority who had had to investigate residential care tended to
complain about the inconsistency of quality.
 Some had been forced to relocate their parent between different
care homes, or had been forced to spend a lot of time ‘shopping
around’ between different providers before they found somewhere
more appropriate.
 Much of this variation in quality was attributed by participants to
the behaviour and performance of individual care workers, and
often this helped to shape a generally negative view of the
residential care sector.
 First-hand experience of neglect and mistreatment featured just as
frequently as glowing reports of excellent care.
“It’s not till you’re thrown into that position, or that
you have a mum, dad or a relative that’s in that
position, you start very quickly learning all the
things that you have to know about it.”
Female, 60+, Farnham
© Ipsos MORI
“She’d have some carers
who would come and were
brilliant and she’d love it,
and others who only ever
turned up once and she
just went ‘I don’t want to
have anything to do with
them again’.”
Female, 40-59, Farnham
Self-funders’ understanding of social care
– key learnings for SCC
• Better information about the range of services available is needed beyond simply care homes
• Better information is also needed about domiciliary and community
care options for those with less acute needs
• Better information is needed about how care is funded, and what this
means for self-funders
• Providing clarity about the role of private vs. public sector social care
provision may also be helpful
• Even though they may not qualify for state support, wider information
. who qualifies for state support will
about general eligibility criteria and
be useful for residents in understanding what they are entitled to
© Ipsos MORI
3. The extent to which self-funders have made
preparations for the care they may need in later
life
© Ipsos MORI
Preparing for social care – key headlines
 Few self-funders are making provisions for their care in later life. Many simply assume that their care
will be provided informally by their partners or children.
 Many anticipate they will only need professional paid for care if they have severe or acute needs,
meaning their children can no longer look after them. Ultimately, they want to be able to stay in their
home for as long as possible.
 Despite their age, many feel that it is ‘too soon’ to start worrying and planning for care they may need in
the future; it is a reminder of ageing and their mortality. Some worry particularly about the loss of their
mental faculties.
 As such, many find it easier to engage with the topic in the context of the care needs of their parents.
 There is also a sense that eligibility and other criteria will likely change under successive governments
anyway, so do not feel they need to worry about it at this point in time.
 Those who have had to access the care system for a parent are often the most negative towards the
system, as they have experienced inconsistency in service first hand. This can make them even less
willing to discuss their own social care needs (but, conversely, they are more likely to be making plans
for it).
 Legal matters such as power of attorney and placing their property in trust are the most important
issues for participants in thinking about older age. This is where information would be most useful.
© Ipsos MORI
Difficulties associated with talking about care
 It was apparent throughout the group discussions that most participants found it
very difficult to talk about the care that they might need in later life. For some,
this was because the future was unknown, but for others it was a reminder of
mortality and the ageing process.
 Though many claimed that it was too soon, or futile, to start planning for the
care they might need, this masked anxieties they had, e.g. they spoke
particularly of their concerns about losing their mental faculties after hearing
stories about dementia and Alzheimer’s disease, and the sense of helplessness
that this brings.
 For many, the easiest way to think about and discuss care in later life, was by
talking about their parents; it was much easier to talk about the subject when
they were discussing it through the prism of their parents’ experience.
 Those who had to look into the different options for their parents were often the
most negative towards the system, as they had experienced an inconsistency
in service first hand.
 By extension, this made them less willing to want to discuss their own social
care (but conversely, more likely to have made plans for it).
“I haven’t given it any thought – maybe it’s just me but I don’t really think about it
because I don’t want to think about the ordeal”.
Female, 60+, Farnham
© Ipsos MORI
What plans are self-funders making for their own care?
 Across the groups, few had made many, if any, provisions for their care in later
life.
 Some older participants had had casual conversations with family members, whilst
many younger participants felt they were fit and healthy so there was no need for
them to worry about having to be looked after.
 Many simply assumed that their care will be provided informally by their partners
or children – and this was their preference. Accordingly, they had made no
investigations whatsoever about what might be available to them from public or
private providers.
 Participants assumed they would only require professional care if they reached a
state of mental or physical decline which meant that their children would no longer
be able to look after them. At this point, they assumed that they would live out their
final days in residential care, and sell their property in order to fund this (though
selling their property was seen as a last resort).
 This lack of preparedness also seemed linked to a sense that – despite the new
Care Bill - eligibility and other criteria will likely change under successive
governments anyway, so do not feel they need to worry about it at this point in time.
 As such, it was not felt to be worthwhile investigating eligibility or service provision.
 Participants who were not married or whose families lived further afield were more
resigned to the idea of having to pay for residential care, should they need it.
© Ipsos MORI
“What is the point of
trying to make plans
now for twenty,
twenty five years
ahead when the
goalposts are
probably going to
shift four or five
times?”
Male, 40-59,
Farnham
“We have to accept
responsibility for
looking after our
families. Because
the welfare state has
virtually run out of
money and the only
alternative is for
family to look after
family.”
Male, 60+, Farnham
What is most important to self-funders when thinking about
planning for their needs in older age?
 One of the most important considerations for participants when asked to
think about planning for old age were the legal considerations – providing
power of attorney and the possibility of placing their property and assets
in trust should they need to due to mental incapacity. There was a strong
sense that this would be the first area that they would look into if they
were to start looking into care in later life.
 This interest was driven by a number of concerns – chiefly that, if they
were rendered mentally incapable, that plans would not be in place to
provide suitably for their care.
 Coupled with this were concerns that their relatives would not be able to
agree on how their money was spent and that their children may lose out
in terms of their entitlement if the necessary preparations were not made.
 This said, no participants were yet making plans or provision in this way.
“Well I think also what people should be made aware of (but they’re not) is how they can make
provision for themselves. One big issue and you need to get professional advice, is actually putting
property in trust.”
Female, 40-59, Dorking
© Ipsos MORI
Self-funders’ understanding of social care
– key learnings for SCC
• Many self-funders are reluctant to engage with the subject, so
careful consideration needs to be given to how the Council
communicates with this audience about planning for care in old age
• The subject should be approached delicately and appropriately,
whilst still underlining the importance of forward planning
• Consider the use of ‘parents as proxies’ when engaging with selffunders
• There is an opportunity to underline the importance of planning for
different eventualities - most assume that their children will look after
them in old age
• It should be underlined that, though different governments may make
alterations to the system, this is not a reason not to save and plan
.
• There is particular interest in the legal and financial matters relating to
getting older
• This may provide a ‘hook’ for engaging self-funders with the social
care issue more generally
© Ipsos MORI
4. Self-funders’ information needs and expectations
© Ipsos MORI
Information needs and expectations – key headlines
 Self-funders are aware of their lack of preparedness for old age – in terms of both the practicalities
and the emotional aspects. Despite this, they do not necessarily want to receive lots of information
about the subject.
 They believe the onus is on them to look for information about social care, when they are ready for it.
This is likely to be when the need is more immediate.
 However, there is great interest in the ‘loopholes’ and exemptions associated with social care funding
(e.g. in terms of when their home is taken into account), and correspondingly legal and financial
considerations they may need to make. There is certainly a desire to know more here.
 Due to the complexity of the system, there may be a need for more personalised information through
one-on-one support from an advisor when self-funders come to access the system. Existing care
recipients comment that they would have found more information throughout the process helpful and
for someone to have visited them to talk through the various options available to them.
 Even carers themselves are not as aware of the different care options available to them as they might
be. There seems to be interest in knowing more about some of the community care services available
such as days out, lunch clubs etc. – particularly when these are provided for free/ for low cost.
 The four carers we spoke to saw the NHS or GP as their main port of call for information and support
relating to their care needs. Should their needs change in the future, they seemed unsure about who
they would go to.
© Ipsos MORI
What appetite do self-funders have for information around
social care?
 Generally, participants were aware that they knew very little about
social care and the system of funding associated with it. Taking part
in the groups underlined to them their lack of preparation for old age –
in terms of the financial and practical, but also the emotional aspects
associated with it.
 However, this did not necessarily mean that they wanted to receive
lots of information about the subject. They felt that the onus was on
the public to look for information about social care, rather than for the
Council (or any other agencies) to inundate them with information.
 As participants demonstrated in the groups, getting self-funders to
accept that they might have social care needs in the future and need
to plan ahead is difficult. Therefore, it was felt that self-funders will
look for information when they are ready for it – usually when the
need is immediate, and this was reinforced from the findings from the
depth interviews with carers.
 That said, there was, amongst participants, great interest in the legal
‘loopholes’ associated with social care funding and the corresponding
legal and financial considerations they may need to make. In
particular, this focused on the possibility of selling their property and
giving the proceeds to their children to avoid having to pay for their
residential care. There was certainly a desire to know more here.
© Ipsos MORI
“But to bombard
everybody, this is very
costly. So it might be
more relevant to make
sure Surrey Matters gets
to more of the Surrey
residents who pay
rates.”
Male, 60+, Farnham
What are the needs of those in receipt of informal care?
 In discussion with carers, it became clear that, though they had, in
most cases, been providing care for some time, and felt that they
were ‘clued up’ about care options, they were still unaware of the full
range of care services available.
 Two interviews were with couples where one partner provided care
for the other. Because of the serious conditions of their cared for
partners, these carers seemed much more up to speed with
treatments and condition management than they did with the
different care possibilities available to them.
 When prompted, they were particularly interested to know more
about some of the community care services such as days out, lunch
clubs, etc. – particularly when these were provided for free or at little
cost.
 These participants admitted to being quite comfortable asking for
help without necessarily knowing who to go to. Yet the NHS or GP
always seemed to be the first port of call for them.
 They seemed less sure about what help the Council could provide
and what information was available. As such their expectations of
the Council were quite low. They seemed unsure about where to go
should they need more information about more intensive care
support in the future (e.g. residential care).
© Ipsos MORI
“If it got to the point
where we did need help
it’s not clear where the
first port of call is – do
you phone the council or
a charity.”
Female, carer, Redhill
Sources of information
• As group participants were more likely to work, or to have recently
retired from full time work, many were comfortable using the internet.
Indeed, it catered for a large amount of their other information needs
around transport, shopping, etc.
• However, this use of the internet tended to be for leisure – few saw
it as a trusted source of information about matters of personal
finance, and would have been unlikely to use it to investigate social
care.
• For most, the preferred source for information about important
issues such as finances and care would be a discussion with a
professional, either over the telephone, or, preferably, face-to-face.
• Both Farnham and Dorking seemed to be well served by third sector
organisations and community advice centres – many assumed that
such organisations would be the first ports of call for information
about social care.
• They were felt to be able to offer independent and impartial advice.
• That said, those who had experience of looking into adult social care
on the council’s website were positive about the general information
that it contained, but this tended to be followed up by a call or visit in
person.
“When you phone the council as well, you
kind of get that feeling they’re not on your
side.
You always feel that they’re kind of like,
‘oh she’s pulling a fast one again’.”
Female, 40-59, Dorking
“Whereas if you go to Age UK or Age
Concern or Citizens Advice, they’re doing it
for your behalf”’.”
Female, 40-59, Farnham
© Ipsos MORI
Personalised information and support
 Due to the complexity of the system the need for personalised
information was felt to be paramount (though there was little appetite
for detailed information until the point of need).
 Participants felt that the only way for them to fully understand their
rights and responsibilities, and the support available, was through
one-on-one support from an advisor.
 Some felt that the Council should provide advisors whereas, for
others, this was inappropriate due to a potential conflict of interest
given the Council’s role as a social care ‘provider’. In any event, it was
felt to be appropriate for the Council to at least signpost them.
 Another idea was that the Council could produce a flow chart, or
decision tree, showing how an individual should navigate their way
through the system based on their individual circumstances.
“Yeah, so when they send all the stuff out to us all, they need to
put a phone number and department in the Council and say this is
your first port of call - and we’re happy to discuss with you.”
Male, 40-59, Farnham
© Ipsos MORI
Case studies: experiences of those providing care
Bill and Sheila
Bill has diabetes and has had both of his legs amputated as a result. Sheila, his wife, is his full-time carer.
Their only external source of advice and information about Bill’s care has been through their local hospital where Bill stayed when he
was recuperating. They felt that more information throughout the process would have been helpful and for someone to have visited them,
taking into account the fact that they were traumatised by what had happened and not always able to make the right decisions.
They particularly need impartial advice on making adaptations to the house, and the costs associated with this. The only contact they
have had with the council was an enquiry about their driveway. Other than that all the support that they received was through an
occupational therapist provided through the hospital. They gave an impression of being proud, independent people, but who would
nonetheless would have benefited from timely interventions.
Sandra and Suzie, Sutton
Suzie has looked after Sandra, her partner’s mother, since she moved in with her partner about 6 years ago. Sandra has Alzheimer’s
and this has accelerated in the last year. At the moment she is able to look after herself for much of the day, but needs to be supervised
when cooking and when taking medicines, etc.
They require very little support. The GP and practice nurse think that they are doing a good job in looking after her – she has experience
in this area as her father had MS. However, she feels that there is insufficient training for the public when providing care for their
relatives.
However Suzie, though aware of the medical treatments available to Sandra, feels she requires information and help with such a largescale change to their lives. She believes people do not need information in advance but do need to know where they can go if they do have
problems – and that there will be somebody available to talk to who will be able to listen to their problems and explain what help might be
available. She feels that the personal face-to-face approach is important as everybody will have different circumstances and experiences
and people can find leaflets confusing – too much jargon, etc.
NB. Names, etc. have been changed so as not to identify individual respondents
© Ipsos MORI
Case studies: experiences of those providing care
Geoff and Tracy, Horley
Geoff and Tracy are both in their 60s and are retired. Tracy had to retire some years ago due to ill health – she has very severe
rheumatoid arthritis which means that she is unable to walk, confined to a wheelchair and seldom able to leave her property.
Geoff spends much of his time caring for her without describing himself as a ’carer’ – he retired from work last year, but did not want
to – but Tracy’s condition made it necessary for him to do so.
They have developed a rather ‘DIY’ attitude to the care that Tracy receives. For example, she manoeuvres around the downstairs of her
property in an old office chair with crutches. The manifestation of her condition is severe, and quite specific to her, meaning that her
mobility needs cannot be met by a normal wheelchair. However, they cannot afford to buy a customised wheelchair and don’t seem to
have investigated any options around free provision. The only contact they have had with Surrey County Council was when an
occupational therapist came to see them, to advise about building a wet-room in their property and the costs associated with this.
Clearly, much of their needs are medical, but they would perhaps benefit from (at the very least) the advice of a professional carer but
do not seem to have made any investigations beyond their dealings with the NHS around medical care.
Bella and Judith, Horley
Bella is in her late 70s and has recently moved back to Surrey, where she is originally from, to live with her daughter Judith, who is
married with two children. They have a large family home and Bella lives in the downstairs bedroom. Bella has arthritis, and has had
a hip replacement, and now finds it very difficult to get up the stairs. Despite this, she is reasonably healthy, and, though Judith
spends most of her time with her, this is not out of need, but because she is looking for part-time work. Bella suffers from anxiety and
is scared about leaving the house by herself, even just to walk down to the shops at the end of the road.
As she spent much of her life in Northampton, she doesn’t know anybody in the area and would love to make new friends. She has
thought about day centres or community transport but does has not made any steps to investigate what options are available. Both
Bella and Judith would benefit from information about what community care services are available – many of which would benefit
Bella greatly and help her to get out of the house a little more often. Bella would benefit from a guiding hand to direct her to this
information and to see how she could benefit from the services on offer.
NB. Names, etc. have been changed so as not to identify individual respondents
© Ipsos MORI
Self-funders’ understanding of social care
– key learnings for SCC
• There is little appetite for lots of information about social care –
self-funders are more likely to engage with the matter when they are
ready and on their own terms
• The Council should be judicious about what it provides on the
subject, although more information about ‘loopholes’ and associated
financial matters would be welcome
• It is important to provide personalised information that pertains to an
individual’s circumstances and needs, perhaps done in discussion with
an advisor
• Those who already provide informal care for relatives are interested
to know more about the range of services available, particularly the
ones that are provided free of charge
• Health providers seem to be the default information source, so it will
be worth considering how they can support information dissemination
on behalf of the Council
.
© Ipsos MORI
5. The role of Surrey CC in providing information
© Ipsos MORI
The role of Surrey County Council in providing information –
key headlines
 There is a perceived conflict of interest for Surrey County Council in providing information
about social care to self-funders.
 As such, preferences for information relate to better signposting, rather than direct provision.
This particularly relates to areas of funding, including information about loopholes and
exemptions.
 Case studies are seen as a useful way of presenting often complex information.
 The Council should combine information with other publications rather than sending it out by
itself…
 … after which, more personalised information can then be made available for self-funders as
and when they want it.
 Such personalised and impartial advice is seen as better coming from independent agencies
such as Age UK and CAB, rather than the Council itself.
© Ipsos MORI
What role should Surrey CC have as an information source?
 Some participants were concerned about a perceived
conflict of interest that Surrey County Council might have in
providing information about social care.
 They argued that it is in the Council’s interest for residents
to be ‘in the dark’ about the funding mechanisms for social
care so that they do not try to find loopholes to avoid paying
for care themselves.
“Well, they can’t give you the same [information], can they? If
you go to Surrey and say what are we going to do, they can’t
go, well, I tell you what, if you move to Hampshire it’s going to
be an awful lot cheaper for you. They can’t do that
professionally, whereas Age Concern or someone else, they
can.”
“It’s in detriment to the Council
because if you put your
property in trust and then after
seven years, God forbid, one
of your parents gets dementia
then legally you don’t have to
sell the family home because it
belongs to you. So therefore
the Council will then have to
fully fund your mum’s care.”
Female, 40-59 Dorking
Male, Farnham 40-59
“Because we haven’t thought about it, we suddenly get
this information and we go, ‘do you know what, I think I
don’t really want to do that, I think I might take some steps
so I don’t actually have to pay that…’. That would actually
educate me and actually focus me onto the subject to
actually look at the measures that I need to take to avoid
it, basically.”
Male Farnham 40-59
© Ipsos MORI
What information around social care do self-funders want
from the Council?
 Participants disagreed with the idea of the Council
arbitrarily sending information to all its residents in order
to meet its statutory responsibilities.
 There was a broad agreement that saturating residents
with information about social care would be costly and
ineffective.
 There was a consensus across groups that it was much
more appropriate to combine information about planning
for future care needs with existing communications such
as ‘Surrey Matters’.
 General awareness raising is important – there was
agreement that, though the ‘system’ may change in future
years it is fundamental that the public starts saving for the
future – irrespective of whether they will need care or not.
 For some, detailed information is less necessary than
conveying the important fact that social care is not
provided free of charge.
© Ipsos MORI
“Young people don’t need a lot of
this information because it’s not yet
relevant to them - if you’re 25
you’re not going to spend your time
reading those, you’re going to be at
the pub and it’s not going to happen
to you for 40 years, so when it
happens you’ll have forgotten about
it anyway. What you do need to
know is that you either have to be
encouraged to put money aside, or
forced to put money aside.”
Male, 60+, Dorking
Signposting vs. provision
 Because of the concern about a perceived conflict of interest,
participants argued that it was more appropriate for the Council to
signpost, rather than provide information to its residents.
 This was, in the main, due to issues of impartiality and a perception
that other, non-governmental sources, would provide more trustworthy
and independent information (e.g. Age UK and the Citizens’ Advice
Bureau).
 This was not universal, however. Many felt that there was no harm in
the information being provided by the Council, but that it should, at
least, be supported by information from other impartial organisations.
 As discussed, one of the key information needs that participants had
was around the possibility of loopholes exempting them from having to
pay for their care if the time came. This information, participants felt,
should not come from Surrey County Council as it is in SCC’s best
interest for people not to know this.
“We want one document which … CAB will set out, power of
attorney, simply, cheaply, and Surrey County Council should be
saying, go to your CAB..”
Male, 60+, Farnham
© Ipsos MORI
Using case studies
 Another suggestions for disseminating information about social
care was through the use of case studies.
 These were felt to be an easier way of digesting some of the
more complex information.
 A two stage approach was suggested: the case studies
(containing information about what it feels like to go through the
process), could be publicised widely, and then, in turn, residents
could be invited to find out more information about social care.
 Surrey County Council would be well placed to provide these
case studies, as it is in touch with users of care and support
already.
“But why not make it part
and parcel of the
magazine, Surrey
Matters? And invite
contributions from people
who are actually
experiencing it?”
Male, 60+, Farnham
 After this point, more personalised information could then be
made available through agencies such as Age UK and CAB as
and when residents and self-funders want it.
“Surrey County Council could put up a series of online web
tutorials on, if you find yourself in this situation, i.e. a parent is,
gets dementia or whatever, this is what you’re looking at.”
Male, 40-59, Dorking
© Ipsos MORI
The ‘Personal care and support service’ booklet
 An example of the type of literature that SCC currently produces
was shown to participants (currently available in pdf form online).
 Tying in with earlier discussions about the importance of local
contacts, some of the key elements participants liked with the
document was that it clearly outlined the social service provision
by district. It also signposted external agencies – though
participants noted that they seemed to be relevant mainly to
those with disabilities.
 Many would have preferred a shorter, less ‘glossy’ booklet, which
simply spelt out the options and contact information for those
looking for care in the future.
 Younger participants found that the booklet was too idealistic –
even sales-oriented - in its depiction of care.
 Some participants also felt that there was too much empty space
in the document, which was a waste of paper, and they disliked
the beige font on white backgrounds as it made it harder to read.
“And why all the pictures? All that information could go on about two sheets
of paper, and plus the fact the pictures will be a cost to them, of printing
them. So they need to be creative in thinking about that.”
Female, 40-59, Dorking
© Ipsos MORI
Surrey CC’ role in providing information
– key learnings for SCC
• Make more use of existing publications for disseminating information
• Use case studies to find a more user-friendly way of communicating
complex information
• Work in partnership with local independent agencies who are seen as
more impartial
• This includes signposting self-funders to other information sources
• Consider the level and kinds of information provided about financial
and legal issues – can the Council be seen as an impartial provider of
this sort of information?
• The Council should be clear in its communications that it has a
statutory duty to inform residents about social care so there is no
confusion about its motives
NB. Be clear on the complexities, e.g. when the national minimum eligibility criteria is published, it will
also be important to inform residents that the £72,000 cap only applies to eligible care needs and that
monies spent to meet low level needs will not count toward the cap
© Ipsos MORI
5. Recommendations and next steps
© Ipsos MORI
What does this mean for Surry CC – key messages
“Don’t burden your children with the responsibility”
• Tying in with a concern that participants have that their affairs will
not be in order if they become incapacitated and that their
children may either have to make decisions on their behalf, or will
be worse off because a detailed plan was not in place
“You lay the guilt
on, say ‘do you
want to land
your children
with this
decision?’”
Female, 60+,
Farnham
“Tomorrow might be too late”
• Participants admitted to procrastination when it came to
preparedness for their later life and there is therefore an
opportunity for Surrey CC to demonstrate some ‘tough love’ and
strongly persuade them to start making plans.
“Personal one-on-one support is available”
• Many do not engage with information as they do not feel that it will
be relevant to them and their situation at this point in time.
• Where personal advice is available this should be promoted to
help self-funders engage with the process when the time comes.
© Ipsos MORI
“Draw people’s
attention to their
responsibility to
look after
themselves in
their old age.”
“Frighten us in the
nicest possible
way.”
Participants,
60+, Farnham
What does this mean for Surrey CC – finding the ‘hook’
 Be realistic: there is little appetite for lots of information about social care
amongst self-funders. They are more likely to engage with the matter when
they are ready and on their own terms.
 People struggle to think about getting old: consider the use of ‘parents as
proxies’ when engaging about these difficult issues.
 Underline the importance of planning for different eventualities – selffunders should not assume that their children will look after them in old age.
Though different governments may change the system, this is not a reason
not to save and plan for old age!
 There is particular interest in legal and financial matters relating to getting
older: more information about ‘loopholes’ and associated financial matters
would be welcome, albeit not necessarily from the Council.
 Given the important role of health providers, consider how they can support information
dissemination with and on behalf of the Council.
 Work closely with independent local organisations such as Age UK and CAB – they seem to be
trusted sources of information and impartial advice.
 Differentiate between your audiences: e.g. life stage is important. There is more appetite to know
about the range of care services available amongst older self-funders and those already in receipt of
care; for younger audiences it is more about financial planning.
© Ipsos MORI
For more information please contact
[email protected] | 0207 347 3295
Victoria [email protected] | 0207 347 3186
© Ipsos MORI
This work was carried out in accordance with the requirements of the international quality standard for market research, ISO 20252:2006 and with the Ipsos MORI Terms and Conditions
31 January 2014