In Focus: Protecting the nation  

Social care: learning from the past and looking to the future

  • Communicate historic developments around social care provision
  • Explain the current political situation around social care
  • Identify ways social care funding could be tackled in the near future
CPD
Approx.30min

Away from funding, there has been progress on rethinking the system to make it fit for the 21st century.

The 2014 Care Act brought in deferred payment agreements, allowing care costs to be deferred but then repaid from the sale of a property or other asset after death. 

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And it brought in improvements to the governance and structure of the care system to promote individual choice and control, making care provision less an end in itself and more a way to support people to live fuller lives as part of the community.

In recent weeks, the new Labour government has announced its ambition to tackle staffing problems by introducing a "fair pay agreement" for social care, setting out minimum pay and conditions.

We have also seen stakeholders work together to create a social care workforce strategy for the next 15-years, with the aim of driving up staff recruitment, retention and training.

What was the plan with the cap?

The idea of a cap on personal care costs was not without critics. As well as the expense, there was a feeling that it would have allowed wealthier people to safeguard more of their assets for inheritance while the less wealthy were still facing significant costs. 

As part of the research among the over-45s for our annual care report, we consistently found broad support for a cap compared with other options.

Asked who should pay for care, last year’s report found 51 per cent supported a cap (with 15 per cent against) while just 45 per cent said the state should fund the full cost (with 22 per cent against).

Even the cap would have left a significant problem in that it only covered personal care costs, narrowly defined as professional help with personal hygiene, eating and drinking, taking medicine and mobility.

It would not have included things such as food, accommodation or utilities, although the idea was for a national rate of such daily living costs, which would be set at around £200 a week nationally and paid for by all those who could afford it.

In reality, people requiring extensive care would have run up tens or even hundreds of thousands of pounds worth of costs before hitting the cap, and would still have kept paying afterwards.

The reforms could have at least helped create an environment where people could plan by either putting aside or insuring some of the cost.

We are back at square one with limited options.

Funding can come from one or a combination of voluntary or compulsory sources – general taxation, social insurance schemes, means-tested public assistance, private insurance, personal assets and savings.

There may be tax rule changes that could provide incentives, such as making pension payments non-taxable if paid to an approved care provider.