The Government’s Care Bill is has been described as being like ‘the Titanic heading towards a massive iceberg in 2016’ while the care system is in crisis.
Its proposals to cap care costs won’t help older people until at least 2021 – and the vast majority of care home residents won’t benefit from the cap even then. That’s because older people will have to live in a care home for five years before reaching the £72k cap but most do not live in residential care for more than two years.
As a result many older people will stay have to sell their home to pay care home bills of £150-200k plus. “It’s a case of ‘the government’s new caps’ misleading older people and their families about how they will protect their home and improve care,” says United for All Ages.
In a submission to the Committee, United for All Ages urges MPs to ask five key questions:MPs are therefore urged to ‘scrap the cap’ as the Care Bill is scrutinised at its Committee Stage in the House of Commons and secure extra funding to tackle the care crisis.
Will the cap make the care system easier and simpler? No. It will make the current complex care system even more complicated – with two caps, a confusing means test, new eligibility criteria, qualifying care and multiple assessments.
Will the cap prevent older people having to sell their homes? No. The £72,000 proposed cap is on qualifying care costs only – in addition older people living in care homes would face large bills for the so-called ‘hotel’ costs eg food, accommodation, daily living expenses, plus any top-ups for care costs that exceed the local authority standard rate. An older person would probably have to live in a care home for five years before reaching the cap (the average stay is just over a year). So older people could be faced with bills of £200,000 plus and still have to sell their home – either while alive or after death to refund a deferred payment.
Will the cap meet growing unmet need? No. The plans do not bring extra cash into the care system – they substitute private spending by some (mainly wealthy) individuals with public spending – and they will do nothing to promote better quality care through better training, pay and conditions for staff. The cap will not meet current unmet needs (almost one million older people are not getting the support they need) let alone growing demands of our ageing population in the future.
Will the cap promote prevention and support the integration of care and health? No. It will not promote prevention – it is all about how crisis care, mainly towards the end of life, should be funded. We need a fundamental shift towards ageing well as well as better care for those who need it. The cap will not promote integration of care and health and community initiatives to support older people at home and prevent high level needs. It will create a new separate funding stream mainly to pay for expensive residential care.
Will the cap benefit those struggling to pay for care and help older people and their families on low-mid incomes? No. The cap is primarily about protecting the inheritances of wealthier families while impoverishing older people with low/mid value homes. The plans will leave many more older people struggling on their own, relying on family carers or using their own resources to pay for care. Even poorer older people with assets less than £118,000 will find that the tapered means test requires them to make substantial contributions towards their care costs.
Stephen Burke, director of United for All Ages and the Good Care Guide, says: “Care is in crisis. More older people need care and support, but fewer older people are getting any help. Councils are rationing care by tightening eligibility criteria and creating a postcode lottery. As a result, more older people are struggling on their own, more rely on family and friends, and more have to pay for care themselves.
“Already in 2013, almost a million older people can’t get the care they need. The total number of people receiving care services in 2012-13 was 1.3 million, down 9 per cent from 2011-12 and down 25 per cent from 2007-08. With our ageing population and the growing number of people with dementia, hundreds of thousands more older people will need care in the next three years.
“The coalition government’s answer to the care crisis is the Care Bill currently before the House of Commons.
“But if you think care is in crisis now, wait until 2016 and beyond when the Bill comes into effect. It’s like the Titanic heading towards a massive iceberg while the government rearranges the armchairs in a care home.
“Millions of older people and their families will get a rude shock when they discover how much they will have to pay themselves. And they will still face losing their home to pay for care despite government promises.
“There are some good intentions in the Care Bill which many have called for – like more support for carers, more focus on prevention, more integration of care and health, and a national framework for eligibility to end the postcode lottery.
“But without the necessary funding, we will increasingly move to a crisis service that fails to promote prevention, integration and early support. The cap on care costs being introduced in the Bill will primarily protect wealthier families’ inheritances and won’t stop many ordinary older people having to sell their home to pay for care.
“The government’s plans will make the care funding system much more complicated and unfair and will not provide the extra resources needed to support our ageing population.
“The £72k cap on care costs will mean that many older people and their families will still have to sell their home to pay care home bills – whether it’s in their lifetime or after the older person has died.
“Because the cap will only cover care costs, older people would have to live in and pay for a care home for up to five years before they get any financial support. Together with the ‘hotel’ costs of residential care, their bills could exceed £150-200k, so they would still have to sell their home. Also older people owning a home are very likely to be above the proposed threshold of £118k where they will get some state help and therefore subject to paying full costs until they reach the £72k cap on care costs.
“With the cap being introduced in 2016 and not applying retrospectively, no older person is likely to reach the cap before 2021. But most people don’t even live two years in a care home so almost 90% of care home residents won’t get help with their bills anyway.
“No wonder people are saying that ‘the government’s new caps’ feel like a con. Older people and their families need to look at these proposals very closely. They will find that very few people will benefit – some wealthy families and some poorer older people.
“New money won’t go towards the underfunded care system. The extra funding will go towards substituting private spending by wealthier individuals with public spending and it will pay for all the extra costs of running the new system such as IT, gatekeeping and assessments etc.
“With our ageing population and growing care needs, the government’s proposals won’t stand the test of time. The care system is already massively underfunded and by 2016 the care gap will be even larger. This new system with no extra funding will face substantially higher demands for care by 2016 as our population ages. Few people will benefit as the Government shifts the costs of care further and further onto older people and their families.
“The next government will have to pick up the pieces after the 2015 general election.
“We have called on the government to scrap its fundamentally flawed cap on care costs. We need a new system for funding care that is ‘simple, fair and sustainable’ to meet the care needs of our ageing population.
“The government owes it to older people and their families to ensure that funding is properly addressed through the Care Bill.
“Scrapping the cap and introducing a new funding system based on taxation would be fairer and simpler. Tax funding has to be the basis for a care system that delivers quality care for the growing number of older people who need it. The alternative is more isolation, more emergency admissions to hospital and more older people struggling on their own.
“MPs can scrap the cap before it’s too late. Better care for older people should be top priority.”