Review and Development of Adult Social Care Relative Needs Formulae Jude Ranasinghe, Director 17...
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Transcript of Review and Development of Adult Social Care Relative Needs Formulae Jude Ranasinghe, Director 17...
Review and Development of Adult Social Care Relative Needs Formulae
Jude Ranasinghe, Director17 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
Adult Social Care Strategy£0.1bn0.4%
Older People including Older Men-tally Ill£6.6bn45.1%
Younger Adults with Physical Disability or Sensory Impairment
£1.5bn10.1%
Younger Adults with Learning Disabilities
£5.1bn34.9%
Younger Adults with Mental Health Needs
£1.1bn7.3%
Other Adult Social Care£0.3bn2.2%
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 RNFCurrent 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 Reform2010/11 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
Reduction in AA/DLA benefit costs (130) (250) (340)
Net costs 530 1,340 2,300
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
Analysis and modelling
Spring 2014
Peer review/ consultation/
formula outputs Summer
2014
National data
collection, local data
verification, analysis
Winter 2013
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 Deprivation Level: High
County Council 14
Buckinghamshire Cambridgeshire
HampshireOxfordshire
Surrey
EssexGloucestershire
Suffolk
DerbyshireEast Sussex
KentLancashireLincolnshire
Nottinghamshire
Inner London 9Camden
Kensington and ChelseaWestminster
Hammersmith and Fulham
HackneyHaringeyIslingtonNewham
Tower Hamlets
Outer London 9MertonSutton
BexleyHillingdonHounslow
CroydonEalingEnfield
Waltham Forest
Metropolitan Borough 13
KirkleesLeedsSeftonSolihull
Stockport
CoventrySt. Helens
BirminghamManchester
OldhamRochdaleSandwell
Wolverhampton
Unitary Authority 20
Bracknell ForestCheshire East
CornwallIsle of WightIsles of ScillyShropshireWiltshire
York
BedfordMilton Keynes
North SomersetNorthumberland
ReadingSwindonTorbay
BlackpoolDurham
HartlepoolLeicester
Peterborough
Total 65 23 16 26
Local Authority Data Collection – Volunteers by RegionRegion County
CouncilInner
LondonOuter
LondonMet.
BoroughUnitary
AuthorityRegional
Total% of
All Auth.
EAST 3 2 5 45%
EAST MIDS 3 1 4 44%
LONDON 9 9 18 55%
NORTH EAST 3 3 25%
NORTH WEST 1 6 2 9 39%
SOUTH EAST 6 4 10 53%
SOUTH WEST 1 6 7 44%
WEST MIDS 5 1 6 43%
YORKS & HUMBER 2 1 3 20%
Auth. Type Total 14 9 9 13 20 65 43%
% of All Auth. 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.