Agenda item

This report sets out the background to the Care Bill which was introduced into the House of Lords in May 2013 and summarises the potential financial impact upon the London Borough of Hammersmith and Fulham.

Ms Bruce presented the report, which set out the background to the Care Bill and summarised the potential financial impact upon the Council.

The Care Bill would take forward a number of separate commitments around social care inlcuding:

·         A full review of adults’ legislation;

·         Driving up the quality of care following the findings of the Francis Inquiry which identified failures across the health and care system;

·         Delivering commitments made in the ‘Caring for our future: reforming care and support’ White paper to put in place a modern care system that enables people to prevent and postpone the need for care and support;

·         Strengthening the rights for carers to access support;

·         Introducing a new adult safeguarding framework; and

·         Taking forward  recommendations made by the Dilnot Commission (on the funding of care and support) to introduce a cap on the costs that people will have to pay for care in the future.

 The Care Bill, if inacted, would implement the following key changes to the current care and support system:

·         A financial cap on the costs that people have to pay to meet their eligible care needs  set at £72,000 in April 2016 for people of state pension age and over.

·         The provision of means tested financial support to more people to help with care home costs. The lower threshold is set to increase from £14,250 to £17,000. The upper means-tested threshold is set to increase from £23,250 to £118,000 where property is included in the financial assessment and £27,000 where no property is included.

·         The option to defer paying for care costs until after a person’s death (from April 2015).

·         A personal contribution to living costs of around £12,000 a year will be introduced from April 2016, which will not count towards the cap.

Whilst some analysis and modelling had been undertaken locally in order to derive some early estimates of the likely impact upon the Tri-borough, there were a large number of variables and ‘unknowns’ and therefore these estimates were being treated with caution, particularly in relation to self funders.

Should the current Fair Access to Care Services (FACS) system be widened, this would have a major resource impact on Hammersmith & Fulham and Westminster City Council which do not currently provide support to all those with moderate care needs.

Ms Bruce stated that the financial implications were significant and the time scales were tight (the Care Bill was currenlty in the process of going through Parliament). Under the new burdens principle, Central Government was expected to provide funding to meet any increased costs on local authorities arising from legislative or policy changes. However, the detail of how the reforms would be financed in practice were not clear. There were risks in respect of the Council carrying increasing debt and the impact of deferred charges on the housing market.

In response to Members’s queries, Ms Bruce confirmed that significant additional funding would be required. Modelling had been used to provide an indication of the likely scale and extent of the financial impact of the Care Bill proposals, as set out in the report. An increase in the number of assessments, comprising assessments of carers and self funders aged 65 and over was anticipated.

Some modelling in respect of self funders had been undertaken, but there was not a clear definition and some people would be self funding for a relatively short time.

Should a person move area, their care package and associated cost, but not the funding, would transfer with them. The package could be reviewed and re-assessed after a year, in line with current practice and resources but, in the interim, the impact of portability could be a multi-tiered system. Whilst, under the Care Bill, the new borough would inherit provision of the assessed level of care, the detail of how this would translate into cost and provision in a different market was not known.

In respect of FACS, the national simulation events had indicated that the system could potentially be widened to require support to be provided to those with moderate needs.This would have a major resource impact on the Council, although it would be in line with the commitment to prevent and postpone the need for care and support  and could potentially drive savings.  

The Council currently supported people in the bandings of ‘greater moderate’ and above. Ms Bruce stated that ‘greater moderate’ was a local distinction and it was likely that FACS eligibility would have to be applied nationally on the basis of single bands.

Ms Bruce clarified that the £72,000 cap related to residential care, excluding food and lodging costs. Home care was not currently included. The Committee noted the significant cost increase in a few years time when more people reached the cap and requested that the modelling was circulated.

Action: Liz Bruce

Ms Bruce stated that Councils would be expected to use £185million of the £3.8billion Better Care Fund to cover the cost of new responsibilities created by the Care Bill. Adult Social Care would work with health service colleagues over the next few months. Whilst there would be some joint funding, health services would remain free at the point of delivery.

Ms Bruce responded to members’ comments in respect of the way in which the Care Bill was being implemented and the lack of funding. The Government was trying to address four key issues: support for an increasingly ageing population; funding of care over a longer period of time; allocation of funding in a fair way; and support for self funders who are often left to family and the care market. These were all issues which were difficult to address without a sensible funding framework.

Ms Bruce stated that there was concern in respect of the timescales, in that councils were required to have a system in place from March 2015, ready to go live in March 2016. There were difficulties in respect of, for example, the IT system required for implementation which could not be put in place until the specification was known.  The Care Bill process was taking longer than originally envisaged and the detail was quite complex.

Ms Bruce responded to queries in respect of carers that currrently Adult Social Care had a duty to assess carers, but not to provide. The Care Bill would introduce a duty to provide support. The implications, which would potentially have a greater cost, had not yet been modelled. Under the new burdens principle, Central Government was expected to provide funding to meet any increased costs on local authorities arising from legislative or policy changes.

Ms Bruce confirmed that the Council had responded to the consultation and agreed to provide the response to the Committee. Councillor Ginn added that he believed that there would be further opportunities for the Committee to feed into the formal consultative process. It was agreed that the minutes of this meeting would feed into the next consultation response.

Action: Liz Bruce

RESOLVED THAT:

1.    The report be noted.

2.    Regular updates be provided to the Committee.