England & Wales Health and social care

Viewpoint: Short Changed


Image supplied by: Independent Age

Andy Kaye, Head of Campaigns and Policy, Independent Age, speaks to LGiU about the unexpected consequences of the Care Bill and what this means for government, councils and ultimately care users.

The chairman of the New York Stock Exchange Richard Grasso once warned us to expect unintended consequences of any laws passed ‘in the heat of battle.’  He might have had the Care Bill in mind.

For while the bill is welcome it is also set to have some unexpected and even unwelcome consequences for the government, councils, care homes and ultimately care users.

Short Changed,  Independent Age’s new report, produced with the Strategic Society Centre, sets out the problem in some detail.

Over 350,000 older people in England live in residential care. Some of these people receive local authority funding for their residential care costs. Some pay their own fees, and a third group, who are entitled to some council funding, also receive a ‘top-up’ from a family member. However, there is a secret subsidy operating here, which means older people and their families are propping up care home providers that would become unsustainable without charging top-up payments.

‘Top-ups’ are fair and viable where they are being used to help an older person live in more expensive accommodation. They are unfair where relatives are placed under pressure to pay excess fees to pay for standard accommodation that should be paid for by their family member’s council.

In recent years, public spending cuts have put severe pressure on council budgets and the fees paid to residential care providers. The role of ‘top-ups’ in the care system therefore appears to have grown. Families pay so-called ‘third party top-ups’, even though they can ill afford hundreds of pounds to cover their older relatives’ care costs. And adults who pay their own fees are often asked to pay more than local authority-funded residents, even for a standard level of care.

The Care Bill will shine a spotlight on these practices. Independent Age is calling on local authorities to fulfil their legal responsibilities to some of the poorest families, by making sure residents are genuinely able and willing to pay ‘top-ups’ on behalf of their relatives. There will also be many more self-funders railing against the injustice, as they see it, that they have to pay more for their care than the rate their council would pay were they council-funded. Like council-funded residents, self-funders also need treating fairly. We are therefore also calling on government to produce tighter rules clarifying when top-up payments are permitted.

A final warning: many self-funders will come to the reasonable conclusion they would be better off were they to get their council arranging their residential care – at the council’s standard rate. That will place unprecedented pressure on local authorities, something ‘Short Changed’ warns central government it urgently needs to address.