Dilnot provides foundation for wider social care reform says ADASS

The announcements from the government concerning implementation of the Dilnot Commission’s report will put in place one of the key components required for the full scale reform of adult social care and how it is funded, according to the Association of Directors of Adult Social Services (ADASS)

ADASS President Sarah Pickup said: “The commitment to implement the reforms proposed by the Dilnot Commission provides a response to one of the key questions the country has faced in relation to adult social care. The application of a cap on the amount an individual would have to contribute towards the cost of their care and the implementation of a more generous means test will remove the risk of catastrophic costs of care falling on individuals in a way which was completely unpredictable and also uninsurable.”

She continued: “It is true that the cap has been set higher than the Commission proposed. But it is important to remember that people already contribute to the costs of their care, and sometimes have to meet the costs in full. No-one will pay more for their care as a result of these reforms, and the application of the new means test alongside the cap will mean that relatively few people will pay as much as £75,000 for their care. Those that do will almost all have paid more under the current system."

According to ADASS while the main focus of these changes has been on older people, there are important implications for people of working age who require care and support due to disability or mental illness. People who are born with disabilities or who acquire them before they become adults will receive free care in the reformed system with an effective cap of zero in place. For people who acquire disabilities after becoming an adult the cap level will be lower than for those who do not need help until they are older.

"It is also important to see these proposals in the context of the wider reform of adult social care." Said Sarah Pickup. "The care and support White Paper and supporting Draft Bill, currently under scrutiny, propose a system which will seek to focus more on prevention and recovery and on what people are able to do as much as the things they need help with.

“If seen through, these wider reforms will see more people supported in their own homes, with a reduction in the proportion of people requiring higher levels of care  and in those having to move into care homes. These reforms should serve to reduce the costs of care for both the state and the individual while offering people a better quality of life as they grow older.”

However, ADASS warns that the need properly to fund preventative services and services that support recovery and rehabilitation must not be forgotten. Adult social care services are currently under severe financial pressure and meeting the wider White Paper aspirations in terms of prevention and recovery - but also in terms of quality of and access to services - will require investment over and above the costs of implementing the Dilnot reforms.

“The government will not serve its citizens well if it makes the way in which people contribute to care fairer while care and support that can really make a difference remains inaccessible or doesn’t measure up to the standards we should all be able to expect.

“So today’s announcement is welcome as a step on a journey, as a piece of a puzzle, addressing a question that needed to be addressed. But we must be clear that the journey needs to continue: the puzzle needs to be completed. The Dilnot reforms address the question of who should pay and the extent of individual risk. They do not provide any new money for the system to actually pay for care. This is a question that also needs an urgent answer so that we can see the end of the Poor Law and the creation of a fair social care system based on citizenship.

Sarah Pickup went on to commit ADASS to working `as closely as possible’ with the Department of Health and others both to help work through detailed implementation plans for funding reform and also to maximise efficiency through greater integration with other agencies, and to contribute sound, comprehensive information* concerning the state of social are funding to the current Spending Review.

Making further, more detailed points, Mrs Pickup pointed to the need not only to quantify the costs of implementing the funding reforms but to consider how such funding needs to be distributed as the impact will vary significantly across the country and the costs to different local authorities will vary widely.

The fact that local authorities have had to make significant reductions in spending on adult social care as part of the reduction to council budgets. Across England, £1.89 billion savings have been made in the last 2 years. There will be further cuts to government grant to local authorities in 2014/15 and adult social care will not be immune to the need for further spending reductions.