National assessment is way forward for social care, King’s Fund report says

A national assessment system is one of the key recommendations of a new report from the King’s Fund looking at social care reform in England.

The report Fixing social care: the six key problems and how to tackle them states that the forthcoming Casey Commission should specifically consider the benefits of this approach, as it might provide greater consistency and limit the risk of individual authorities ‘rationing’ care due to budget constraints.

This national system is already used in Australia, Germany and Japan. Currently in England, each local authority conducts its own assessment of people’s needs and finances using national criteria, leading to wide variations in the number of people accessing care across different parts of the country.

Unlike the NHS, each local authority makes its own decisions about budgets and services, so some spend more per head and/or provide more short or long-term support than others.

Six key problems in social care

The recommendation is part of an analysis of key problems in social care: access, quality, workforce pay, market fragility, disjointed care and the ‘postcode lottery’ in access and performance. It includes an assessment of options for improvement in all these areas.

According to the report, the six key problems are:

1. Access: means testing, unmet need and selling homes to pay for care
2. Quality of care: 15-minute care visits and neglect
3. Workforce pay and conditions: underpaid, overworked staff
4. Market fragility: care providers struggling to stay in business
5. Disjointed care: delayed transfers of care and lack of integration with health
6. The postcode lottery: unwarranted variation in access and performance

The King’s Fund recommends that the cost of providing care should be more of a partnership between the individual and the state than it currently is, with the state covering most of the cost while the individual contributes if they can afford it.

It adds that the government’s proposed £500 million as part of the Fair Pay Agreement for the care workforce is a welcome first step on a long-term solution. However, it will not solve long-standing issues of recruitment by itself.

In addition, it states that it is unsustainable for social care providers to face cost increases that far exceed the fee increases they receive from local authorities.

Simon Bottery, Senior Fellow, The King’s Fund and author of Fixing social care: the six key problems and how to tackle them, said:  “It would be a major change to shift away from the principle that people’s social care needs and finances should be assessed by local authorities. However, it works well in other countries and now is the time to explore whether it would be an improvement here as well.

“The Casey Commission should consider this and other ideas in this report. However, there is also much that the government could do in the meantime ahead of the commission reporting, including ensuring that local authorities have the finances they need to run the current system fairly and effectively.”

Alison Bloomer

Alison Bloomer is Editor of Learning Disability Today.

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