RCVS Network Meeting - Health & Social
Care
3rd June 2014
Richmond Council Update
Cathy Kerr, Director Adult & Community Services
What I Will Cover
 Overview of policy direction for adult
social care
 Local elections
 Health partnerships
 Care Act 2014
 What all this means for Voluntary &
Community Sector (VCS)
Direction of Travel for Adult Social Care
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Focus on prevention
Promoting independence
Choice & control
Inclusion
‘Joined up’ care & support
Local Elections
 May 2014, Conservative party retain council control
 Seats - Conservative - 39, Lib Dem -15
 Cross party support for health & social care policy
direction
 Administration priorities include:
 Caring for vulnerable people, prevention, an age friendly
borough, tenants champion, role of voluntary sector,
commissioning council, sharing with others.
 National elections by May 2015
 Public sector financial position
Health & Social Care Integration
 Why?
 People want joined up support
 It makes best use of our collective resources
 New local authority powers arising from H&SC Act 2012
 Health & Wellbeing Board & HWB Strategy
 Public Health in local authority
 Integration
 Work with our health partners to integrate
 Commissioning – JCC
 Delivery – joint teams – RRRT
 Local joint strategies eg Better Care Closer to Home
The Care Act 2014 - What is it?
 Biggest change in adult social care legislation
for 60 years
 Based on principle of wellbeing
 Encompasses whole population
 A new policy framework (from April 2015) and
 A new funding framework (most from April
2016)
 Local implementation arrangements including
co production group. Newsletter imminent
The Care Act – key changes
 Personal budgets on a legislative footing and right to a
direct payment. Direct payments for residential care
 Carers rights on the same footing as the people they
care for.
 Changing eligibility criteria for services.
 New assessment framework
 Preventing and delaying needs for care and support
& providing these services for the whole community
 Provide comprehensive information and advice
including independent financial advice. A web based
resource directory
The Care Act – key changes
 Self funder rights to assessment, support plan and
care management (councils could charge)
 Adult safeguarding on a statutory footing.
 Duty to shape the market (wider than just the services
we commission directly)
 Ensure no one goes without care if providers fail,
regardless of who pays
 Transition from children to adults – right to assessment
before age 18
 Portability – for service users transferring from one
LA to another to ensure continuity of care
 Duty to promote integration running through all
The Care Act - Funding Reforms
 To give more certainty and peace of mind over the
costs of old age or living with a disability
 Everyone receives the care and support they need and
more support to those in greatest need
 End to limitless care costs
 People protected from having to sell their home in their
lifetime to pay for care
 Improved options for those who pay for their care
 Consistency between different areas and for nonresidential and residential care
What is changing? Funding Cap
 Capped Lifetime Care Costs - £72,000 –
currently no limit for people with assets
 Lower cap to be set for people with care
needs before old age
 No costs for people with on-going care
needs from childhood
What is changing? Extended Means Test
 More people to receive state-funded support
with changes to the means test
 Capital limit increased from £23,250 to
£118,000 (for care homes)
 Capital limit increased from £23,250 to £27,000
for non-residential care (Richmond’s current
limit is £35,000)
 Assets below are £14,250 are not included in
the means test - this will be £17,000
What is Changing? Care Homes
 Deferred Payments from 2015
 no one will have to sell their home in their lifetime
 Councils will be able to charge interest during the
period of the agreement – currently no interest
applies during care home stay
 Care Homes from 2016
 Contribution to Daily Living Costs (around £12,000
pa) separate from care costs
 Daily living costs not subject to the cap
 Direct Payments for Residential Care from 2016
Case study – Mrs B
 Has capital of £20k, property of 200k and weekly
income of £260 a week
 Has homecare of £100pw & contributes £64. After 3
years moves to care home @ £630 pw.
 Current system: in care home pays full cost of £630
until capital falls below £23,250
 New system: Reaches funding cap of £72k after 5years
8 months, after which she pays £230 pw. Care costs of
£400 met by the council.
The Care Act – Local Implications
 We expect substantial increase in demand from self
funders but impossible to accurately predict the
financial impact
 Self funders – occupy 51% of care home beds & only
13.5% of people 80+ currently receive care from the
council.
 Substantial growth in older population, high proportion
of people age 85+; many age 75+ living alone
What Does This Mean for the VCS?
 A Key Partner for the Council (and CCG)
 As commissioned provider of services:
 Particularly supporting independence and prevention
 Learning from work to date – CILS
 Future opportunities
 As voice of the sector and bringing service user / carer voice
 Engagement routes:
 Health & Wellbeing Board
 Contribution to strategy development and key programme
of work
 Care and Support Partnership