Many 'excluded from social care'
Elderly and disabled people are increasingly relying on family and friends to care for them, inspectors have warned.
Councils in England are restricting access to social services such as home care, day services and respite care.
The Commission for Social Care Inspection warned this was happening by default, and without debate.
The problem was being caused by increasing demands on social services and tension developing with the NHS.
Commission chairman Dame Denise Platt said services for those who qualified for care were actually improving.
But she said many people were being left to make their own arrangements because access to services was being tightened to include only those deemed to be in the most serious need.
She said: "In some cases people rely on family and friends, in others they pay for their own care.
"Some people have no option but to do without.
"It is also clear that external pressures on the sector are hindering progress in making services better for the people who use them.
"In particular NHS budget deficits are putting a strain on relationships and potentially under-mining essential partnerships."
Demand growing
The proportion of people who are over 65 is growing - over the next 20 years projections indicate it will rise by 53%.
The number of young disabled people is also increasing. Between 1975 and 2002 it rose by 62%.
To cope two-thirds of councils only offer support to those with substantial needs.
The Local Government Association predicts over the next few years no local authority will provide low or moderate support, including general home care support.
The Commission said family and friends are helping to fill some of the gaps.
Nearly five million people are classed as carers, with 1.5 million of those providing over 20 hours of care per week.
Dame Denise said: "They are doing this without the proper infra-structure in place.
"It is a complex sector, but they are often given no help navigating through it."
Neil Hunt, chief executive of the Alzheimer's Society, said the system was in crisis, and accused the government of being unwilling to provide sufficient funds to help people with serious medical conditions.
"Additional investment in the NHS has not been mirrored in social care. Inevitably the result has been that as need increases, local authorities skew what care there is available to people with high levels of need.
"Thousands of people who need extra help to remain independent are being ignored."
The Department of Health said social care was improving in many areas.
But a spokesman added: "We are concerned about the potential effect of rising eligibility criteria.
"Local authorities need to put a greater emphasis on preventive services - helping people with lower needs to avoid admission to hospital or residential care."
Story from BBC NEWS:
http://news.bbc.co.u...lth/6247367.stm
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Many Excluded From Social Care System
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, Jan 10 2007 12:30 PM
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Posted 10 January 2007 - 06:14 PM
Q&A: Social care 'exclusion'
As inspectors warn that elderly and disabled people are increasingly relying on family and friends to care for them, we look at why councils in England are restricting access to social services.
How are councils restricting care?
The Commission for Social Care Inspection (CSI) says access to care is being tightened to include only those deemed to be in the most serious need.
In its report, The State of Social Care in England 2005-6, the commission warns of the "ever-rising eligibility criteria for access to services".
In response to an increase in the number of older and disabled people, many councils have raised the threshold people have to pass before they are entitled to council-funded services, the report says.
Two-thirds of councils set the threshold for care in 2005/6 to those whose needs were deemed "substantial" in 2005/6. Other councils are expected to raise their eligibility threshold in 2006/7.
This means fewer people are receiving services, and those who do qualify have a higher level of need.
"Substantial" includes people needing round-the-clock or other very high levels care, such as people unable to feed themselves or get out of bed.
Who is missing out on council-funded care?
People deemed as needing "moderate" or "low" levels of care, where the council's qualifiying level is set at "substantial".
They will then miss out, have to rely on family or friends, or pay for private care. This includes people who need help with getting out and about outside the house and help with housework.
The definition for those needing "low" levels of care includes when "there is an inability to carry out one or two personal care or domestic routines".
Why is demand for care increasing?
Expenditure by councils in England on social care rose to more than £19 billion in 2004/5, with the upward trend continuing in 2005/6.
A range of factors have resulted in a demand for council care which includes home care, day services and respite care.
The proportion of people over 65 has grown, and projections suggest it will rise by 53% over the next 20 years.
Meanwhile, the number of admissions to nursing and care homes has continued to decline, reflecting government policy to support more people to live independently in their own homes.
The number of young, disabled people has also increased - between 1975 and 2002 it rose by 62%.
Are National Health Service finances having an impact?
Yes, there is increasing tension with councils reporting last year's NHS deficit of more than £500m is affecting partnerships between local authorities and the NHS, the report says.
Charities including Mencap and the Age Concern have also raised concerns.
Many people rely on joint packages of care, organised by councils and the NHS.
There is evidence of the NHS withdrawing from care in the treatment of people with long-term care needs, such as those with heart problems or people who have suffered strokes.
Social care has then had to pick up the responsibility, the commission's report says.
Who are the carers who step in to help?
They are not paid and they look after a spouse, relative or friend who needs support because of the disability or ill health.
There are 4.7m people over 18 who are carers in England.
The report says that most people will be carers during their lifetime, although many do not want to be defined as such. Over a lifetime, seven in 10 women and nearly six in 10 men will become carers.
In the 2001 census, 471,000 carers reported they were in ill health, the report says.
A total of 70% of those looked after by unpaid carers are over 65.
What does the future hold?
The problem is expected to continue as the number of councils who currently provide low or moderate levels of social care is predicted to fall steadily.
The Local Government Association says that in 2005/6 just over 43% of councils provided such care. In 2007/08, it says this figure will be nearly 20%, dropping to 10% in 2008/09 and none the following year.
The Commission for Social Care's report says there are "positive examples" of services designed to support carers, but it points out progress so far is "limited".
For example, the report says the number of respite breaks for carers increased to 2.76m in 2004/5, but it says their availability "varies considerably" across England.
Story from BBC NEWS:
http://news.bbc.co.u...lth/6248339.stm
As inspectors warn that elderly and disabled people are increasingly relying on family and friends to care for them, we look at why councils in England are restricting access to social services.
How are councils restricting care?
The Commission for Social Care Inspection (CSI) says access to care is being tightened to include only those deemed to be in the most serious need.
In its report, The State of Social Care in England 2005-6, the commission warns of the "ever-rising eligibility criteria for access to services".
In response to an increase in the number of older and disabled people, many councils have raised the threshold people have to pass before they are entitled to council-funded services, the report says.
Two-thirds of councils set the threshold for care in 2005/6 to those whose needs were deemed "substantial" in 2005/6. Other councils are expected to raise their eligibility threshold in 2006/7.
This means fewer people are receiving services, and those who do qualify have a higher level of need.
"Substantial" includes people needing round-the-clock or other very high levels care, such as people unable to feed themselves or get out of bed.
Who is missing out on council-funded care?
People deemed as needing "moderate" or "low" levels of care, where the council's qualifiying level is set at "substantial".
They will then miss out, have to rely on family or friends, or pay for private care. This includes people who need help with getting out and about outside the house and help with housework.
The definition for those needing "low" levels of care includes when "there is an inability to carry out one or two personal care or domestic routines".
Why is demand for care increasing?
Expenditure by councils in England on social care rose to more than £19 billion in 2004/5, with the upward trend continuing in 2005/6.
A range of factors have resulted in a demand for council care which includes home care, day services and respite care.
The proportion of people over 65 has grown, and projections suggest it will rise by 53% over the next 20 years.
Meanwhile, the number of admissions to nursing and care homes has continued to decline, reflecting government policy to support more people to live independently in their own homes.
The number of young, disabled people has also increased - between 1975 and 2002 it rose by 62%.
Are National Health Service finances having an impact?
Yes, there is increasing tension with councils reporting last year's NHS deficit of more than £500m is affecting partnerships between local authorities and the NHS, the report says.
Charities including Mencap and the Age Concern have also raised concerns.
Many people rely on joint packages of care, organised by councils and the NHS.
There is evidence of the NHS withdrawing from care in the treatment of people with long-term care needs, such as those with heart problems or people who have suffered strokes.
Social care has then had to pick up the responsibility, the commission's report says.
Who are the carers who step in to help?
They are not paid and they look after a spouse, relative or friend who needs support because of the disability or ill health.
There are 4.7m people over 18 who are carers in England.
The report says that most people will be carers during their lifetime, although many do not want to be defined as such. Over a lifetime, seven in 10 women and nearly six in 10 men will become carers.
In the 2001 census, 471,000 carers reported they were in ill health, the report says.
A total of 70% of those looked after by unpaid carers are over 65.
What does the future hold?
The problem is expected to continue as the number of councils who currently provide low or moderate levels of social care is predicted to fall steadily.
The Local Government Association says that in 2005/6 just over 43% of councils provided such care. In 2007/08, it says this figure will be nearly 20%, dropping to 10% in 2008/09 and none the following year.
The Commission for Social Care's report says there are "positive examples" of services designed to support carers, but it points out progress so far is "limited".
For example, the report says the number of respite breaks for carers increased to 2.76m in 2004/5, but it says their availability "varies considerably" across England.
Story from BBC NEWS:
http://news.bbc.co.u...lth/6248339.stm
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