Self-funders make up a huge proportion of the social care system, yet little attention is paid to making sure they get the access they are entitled to. Everyone, including local government, stands to lose
More and more people contribute to the cost of their own social care. Nearly a quarter of a million older people pay in full or in part for residential and nursing care and nearly half of people in residential care are now full self-funders.
Local government might be forgiven for thinking that these people are the ones it doesn’t have to worry about it, but a new report from LGiU, supported by Partnership Assurance, argues that, on the contrary, self-funders are critical to the integrity of the care system as a whole and need more support from councils.
In the past, there has been a tendency for local authorities to regard self-funders in isolation from the publicly-funded care system. However, the increasing number of self-funders means that publicly-funded and self-funded care becomes increasingly interdependent.
This interdependence has two aspects. First, the financial sustainability of many of the local services that councils commission is reliant on the self-funder market. Self-funders therefore increase the choice, competition and efficiency of services for all older people.
Second, and arguably more importantly, the financial health of the adult social care system is increasingly dependent on both the ability of the state and older people to pay for care. Overall, this is hugely beneficial. In the current spending envelope, local authorities can only provide the current volume and quality of services to state-funded residents because of financial contributions from self-funders.
However, the interdependence of publicly-funded and self-funded care exposes councils to significant financial risk. Our research shows that 24% of self-funders of residential care fall back on state support at a cost of nearly half a billion pounds a year. This is more than four times the £104m worth of service reductions that adult service departments will make in 2013-14.
Some of this cost would be preventable if people received better financial guidance.
We’ve seen a huge increase in the amount of information and advice councils give to self-funders since we first looked at this issue in 2011 but there’s still room for improvement.
While most councils now provide some form of financial advice to self funders at the point of, or after, a care needs assessment and half of councils refer self funders to independent advice at this point, less than one in five are acting really proactively and connecting people to advice at an earlier stage.
That’s part of the crucial shift to a more preventative approach that we need to see in social care and, indeed, across public services as a whole. In the long term, this demand management approach is the only way we will bridge a worsening gap between resource and demand.
The forthcoming Care Bill will place a requirement on local authorities to improve access to financial advice for self-funders. We have argued that there are simple steps they can take to understand the numbers of self funders they have, improve the content of advice they receive, set up independent advisory services and work through third and public sector partners like GPs to ensure they are reaching everybody.
These are low cost, easy things to do, which save councils money and, most importantly, help older people live out their lives in a manner of their own choosing.
The best local authorities are already taking these steps: the rest must follow.
Jonathan Carr-West is chief executive of the Local Government Information Unit
