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A cap that fits: the 'capped cost plus' model
- Author:
- LLOYD James
- Publisher:
- Strategic Society Centre
- Publication year:
- 2013
- Pagination:
- 76
- Place of publication:
- London
The government has committed to implementing reform of care funding in England in April 2016. However, detailed analysis of the ‘capped cost’ reforms suggests they are unlikely to meet any of their objectives. Consequently, people’s care costs will not be capped; and a market in pre-funded care insurance is unlikely to emerge. Rather than providing peace of mind to the population, annual increases in the ‘cap’ may insttead cause worry and concern. With less than three years until the reforms are due to be implemented, this report examines in detail the issues facing the ‘capped cost’ model’ and identifies the options for policymakers to fix these problems. The report concludes by assembling a range of options into an alternative package of measures that could be implemented in April 2016: the ‘capped cost plus’ model. The model comprises: a ‘cap’ on the assessed care costs that individuals are expected to pay for out of their own pockets; changes to means testing thresholds and the financial support individuals receive, proportional to their level of wealth; and a standardised expected contribution by individuals to ‘living costs’ in residential care. (Edited publisher abstract)
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)
Politics and the care conundrum: why does England have a problem funding social care?
- Author:
- LLOYD James
- Publisher:
- Strategic Society Centre
- Publication year:
- 2011
- Pagination:
- 29p.
- Place of publication:
- London
This discussion paper explores the underlying causes of England's long-term care funding problem. It argues that the state, the older population and wider society have sufficient wealth to finance a properly funded social care system. The persistent problem of funding care in England therefore poses what can be termed the ‘care conundrum’. This paper seeks to explain this 'care conundrum', and its root causes in issues of politics and governance. Using ideas and theories drawn from political science, the paper identifies multiple factors that may explain the 'care conundrum'. These factors include: the varied, ‘indefinable’ nature of social care; the illogical, complex ‘mess’ of institutions overseeing social care policy; public ignorance of what social care is and what outcomes represent quality; and the interests of politicians in avoiding unpopular measures. The paper calls for the creation of an Office for Care and Living which would undertake a number of strategic functions, such as public education and data provision, in order to address the failure of democratic accountability alone to ensure a properly funded social care system. It argues that, even in the face of voter disinterest toward social care, the government does have an opportunity to reposition public and political discourse on care funding to create the conditions for sustainable long-term reform.
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)