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The bigger picture: policy insights and recommendations
- Author:
- LLOYD James
- Publishers:
- Independent Age, Strategic Society Centre
- Publication year:
- 2014
- Pagination:
- 50
- Place of publication:
- London
This report evaluates the performance of government policy on care and support of older people who struggle with day-to-day activities in England during the period 2011 to 2013, using the data and insights from ‘The bigger picture: understanding disability and care in England’s older population’. Part 1 of this report examines the reach of publicly funded support; the unmet need in the older population; and variation and consistency of care and support. Part 2 considers the implications of the Care Act implementation and looks at policy development beyond 2016, focusing on eligible needs after the Act, financial eligibility and the means test after 2016 and mapping, identifying and engaging older population groups. The report concludes that given the feasibility and budget challenges implied by the sheer numbers of older people experiencing difficulties with activities of daily living, a rethink and revolution is required among national and local policymakers around how individuals and families are engaged and supported. This will mean revisiting the balance between consistency and variation in services organised by local authorities, as well as fully integrating and exploiting the different ‘touch points’ and ‘gateways’ available for engaging the older population. It will also mean evaluating which aspects of the vision of the Care Act need to be fulfilled by local authorities directly, or can be devolved to empowered, third-party charities and organisations at a local level. (Edited publisher abstract)
Rebooting the cap: improving protection from catastrophic care costs
- Author:
- LLOYD James
- Publisher:
- Strategic Society Centre
- Publication year:
- 2016
- Pagination:
- 28
- Place of publication:
- London
The government has postponed the ‘capped cost’ reforms to care funding in England until April 2020. This report explores the options for the government in rebooting the capped cost reforms, arguing that the current pause in implementation presents an opportunity to adapt the reforms to developments in health and social care policy, and address potential downsides to the ‘capped cost’ model. This report outlines the background to the government’s decision to postpone the implementation of the ‘capped cost’ reforms and explores why it is the responsibility of the state to cap people’s care costs, discussing the issues of catastrophic care costs and the difficulties of private insurance companies in protecting people from this risk. It then summarises the ‘capped cost’ model incorporated into the Care Act (2014) and outlines the limitations to the reforms, such as its complexity and potential for unintended consequences. It then puts forward some alternative options for capping care costs that could be implemented during the current parliament. These options relate to capping the years of residential care that people must fund; the cost of care annuities; the scope of social care means testing; weekly expenditure on care; the price of care that people have to pay; the share of weekly care fees individuals must pay; and the costs of providing unpaid care to families. (Edited publisher abstract)
The bigger picture: understanding disability and care in England’s older population
- Authors:
- LLOYD James, ROSS Andy
- Publishers:
- Independent Age, Strategic Society Centre
- Publication year:
- 2014
- Pagination:
- 90
- Place of publication:
- London
Explores disability and care at a national, regional and local authority level in England. The report brings together data from Census 2011, DWP and HSCIC ‘administrative data’, as well as from Wave 6 of the English Longitudinal Study of Ageing, to look at the prevalence of disability, need and care of different types, and to paint a picture of the lives of different groups. In particular, Chapter 3 provides a snapshot of disability and care in the older population in England, identifying key results. Chapter 4 looks in detail at the lives of older people with limited day-to-day activities, from their health characteristics to their living situation. Chapter 5 explores the characteristics of older people receiving unpaid and paid care including the overall adequacy of their care, as well as older people with substantial levels of disability who experience difficulty undertaking three or more ‘activities of daily living’. Chapter 6 explores the interaction of older people experiencing limited day-to-day activities with public support, i.e. disability benefits and the local authority care and support system. Chapter 7 examines the prevalence of unpaid older carers and the outcomes they experience, as well as the extent of local authority support for them. The report shows that around half of the 65+ population in England reported their day-to-day activities were limited. Of the 6.7 per cent of the older population living at home in England who reported difficulty undertaking three or more activities of daily living, around 70,000 did not receive any care, and could therefore be classed as experiencing substantial unmet need. Around 20 per cent of older carers experienced self-care (ADL) difficulties themselves. (Edited publisher abstract)
Right care, right price: a discussion paper exploring the way in which the price of care is determined and its implications for social care policy
- Author:
- LLOYD James
- Publisher:
- Strategic Society Centre
- Publication year:
- 2013
- Pagination:
- 36
- Place of publication:
- London
This discussion paper explores issues about the way in which the price of care is determined in local care markets, including local authority monopsony power (that is, the local authority is the only "buyer"). It examines the relationship between price and quality, and identifies how the way in which the price of care is determined affects the broader objectives of social care policy, for example that the public does not understand the price of care or know what local authorities pay for care. The report argues that to correct these problems, the government should:ensure financial sustainability among care providers coherent with investment and quality; strengthen the link between prices and quality across the market; improve the public’s knowledge of the price of care in their area; improve ‘consumer knowledge’ among families paying for care; and improve public understanding of local authority commissioning of care and the prices paid. (Edited publisher abstract)