The Care Bill and Disabled People

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2013 National Disabled Members' Conference
5 July 2013
Carried as Amended

Conference is concerned that the Care Bill will have a detrimental impact on disabled people who use care services. We condemn the failure of this government to find a long-term sustainable solution to the funding deficit in social care. The Coalition government is introducing a £72,000 cap on the amount individuals will need to pay for social care in England and Wales from 2016. Although this may help individuals with costs it will not solve the underfunding of social care.

The Bill does not mention rehabilitation or re-ablement that helps disabled people maintain their independence. Local authorities face nearly £3 billion of cuts to social care budgets. The cap will increase the burden on the budget particularly in the most deprived areas.

The level of care disabled people receive varies depending where they live. Budget cuts mean that many councils have tightened their funding criteria. Care Assessments fall into four categories: low; moderate; substantial and critical. In 2011 only 32 of 148 councils funded care for needs assessed as less than substantial.

Eligibility: The Bill introduces national criteria. The level of need that qualifies for care will be the same in all areas. The level, to be set by George Osborne in the Spending Review, is likely to be ‘substantial’. This means the end to the help for an estimated 150,000 people with moderate needs, including everyday tasks such as washing and dressing, who live in an area where that rating qualifies.

Assessments: Social care assessments often fail to take account of all a disabled person’s needs. The risk based model used to access care services has led to inadequate, standardised assessments that fail to consider multiple or complex needs meaning many disabled people are left without the care they need. Little has been done to improve assessments even though the issue was highlighted five years ago in the Commission for Social Care Inspection report ‘Cutting the Cake Fairly’.

In response to the Draft Care Bill 2013 UNISON has set out concerns about the proposed privatisation of assessment work, highlighting potential conflicts of interest if the same providers start winning contracts to do assessments alongside other contracts they have for the provision of services.

UNISON also has concerns about legislation to widen the role of care workers, who are not qualified and properly trained to make care assessments in private practices. To accompany any health and care worker role shift there needs to be a national standard on care assessments and qualifications and training of staff. This needs to be integral to career skilling and remuneration of care skills.

Resource allocation: Councils can miscalculate or underestimate the true cost of meeting care packages for disabled people meaning they do not receive a care package or personal budget to help them live independently.

Calculating costs: UNISON is seeking more clarity on how Independent Personal Budgets (IPBs) and “care accounts” will be used to assist everyone eligible for care. The Bill states that the new IPBs and care accounts will accrue costs based on only what the local authority would have paid not the actual cost that a private provider will charge and that a person has actually incurred. This has implications on how local authorities in future will calculate people’s individual care accounts in a local social care market.

Given that the UK care commissioning regime is currently weak and without robust regulation of commissioning and enforcement of good pay, terms and conditions to drive up quality care, how will commissioning authorities be able to (i) regulate the costs of care charged to reflect quality skilled staff through paying for training and providing good pay and employment terms and conditions? (ii) ensure that private providers charge in line with the local authority so that there are no differences in care costs for those able to access local authority provision and those only able to access private provision.

Conference this Bill needs major changes if disabled people are to receive the care they need to manage at home, at work and have a good quality of life.

Conference calls on National Disabled Members Committee to work with appropriate bodies to:

1)continue to promote UNISONs policy to support a national social care service that is free at the point of need; and

2) campaign for

• the national minimum threshold to be set at moderate;

• assessments to be carried out by specialists when a disabled person has complex or multiple needs; and

• local authorities’ responsibilities to fund intermediate care to maximise an individual’s independence to be included in the Care Bill

3) Request clarity on how Independent Personal Budgets (IPBs) and “care accounts” proposed in the Draft Care Bill will be used to assist everyone eligible for care