SCC26
Legislation Committee No. 5
Consultation Response to Proposed Social Care Charges (Wales) Measure
Introduction
Scope is a national disability organisation whose focus is people with cerebral palsy. Our aim is that all disabled people achieve equality and enjoy full human rights. Scope has a particular focus on disabled people with high support needs and complex impairments.
Scope provides a range of services to disabled people including information, education, transition, employment and residential accommodation as well as campaigning for disabled people’s human rights and equality across England and Wales. For more information on Scope’s work visit: www.scope.org.uk
Consultation Answers
1. Is there a need for legislation to be made to ensure that local authorities across Wales adopt a more consistent approach to charging service users for non-residential social care services, and if so, why?
Scope Cymru welcomes the intentions of this Measure to establish a simplified and coherent system for dealing with the financial cost to an individual of securing social care services. Although we welcome greater consistency we hope eligibility thresholds will not be set too high because this will still lead to a postcode lottery.
Millions of disabled people and older people rely on social care services every year in order to live independent, dignified lives. For disabled people and older people who need support with day-to-day tasks (such as getting out of bed, going to the toilet, having a shower, getting dressed, cooking a meal, or going shopping) high quality social care services are a condition of equal citizenship.
But the social care system is in crisis. Eligibility and charges for vital services are governed by a postcode lottery - what you get and how much you pay depends on where you live, rather than what you need. Services vary in quality. What’s more, the services frequently do not meet the varied needs of the disabled people and older people who use them.
Disabled people and older people want access to the same opportunities and quality of life as any other citizen. When Scope, Age Concern England and Mencap asked people what they thought were the biggest problems with the current social care system, they identified four key issues:
Lack of information, advice and advocacy to help make informed decisions.
The postcode lottery - which means eligibility and charges for services differ, depending on where disabled people and older people live.
Lack of choice and control over where (and how) disabled people and older people live their lives, to poor quality or inappropriate services.
The inconsistent (and often prohibitive) cost of services.
A recent report by the Coalition on Charging1 found that many disabled people lived in poverty as a result of charging for social care and that the criteria for means testing the savings limit is very low and should be heightened. As families with disabled children are also more likely to be on low incomes charging for care and support services can condemn an entire family to poverty and affect the ability of non-disabled members to save for older age.
2. Are the sections of the proposed Measure appropriate in terms of reforming legislation relating to the social care charging regime? If not, how does the proposed Measure need to change?
Scope Cymru believes the proposed Measure is appropriate to reform the social care charging regime. At present, social care services are means-tested. Disabled people and older people who are eligible for state support are means-tested. Local authorities have the power to charge individuals for the social care services they provide.
Charging policies vary considerably across the country and it is common for people to pay different rates for identical services, depending on where they live. In 2006/07, disabled people and older people paid £2 billion pounds in social care charges2. It is noted that 7 local authorities out of 22 in Wales have no ceiling on charges at all.
Disabled people are already more likely to have fewer qualifications and are less likely to have a job3. Both disabled people and older people are much more likely to live in poverty4.
For those on modest incomes, charging for vital services simply exacerbates these disadvantages. Increasingly, disabled people and older people report having to choose between basic things like eating or having the heating on because they can’t afford both.
"I have cut back on laundry and housework, but cannot do without personal care and help with meals… I very rarely buy new clothes or shoes.” 5
3. How will the proposed Measure change what organisations do currently and what impact will such changes have, if any?
Scope Cymru welcomes the Measure to introduce a more equitable charging arrangement, whereby prescribing a uniform approach to local authority charging without removing authorities’ current discretion as to whether to charge at all or to charge less than would be required. There is a risk that some local authorities may attempt to charge the maximum possible in order to pool finances by taking into account potential loses being made in other social care areas. However it is noted that any implementation costs for local authorities such as loss of income and administrative and IT costs associated with the changes will be assessed accordingly as part of the Regulatory Impact Assessment.
4. What are the potential barriers to implementing the provisions of the proposed Measure (if any) and does the proposed Measure take account of them?
Large sums of money are wasted in administrative and legal costs in seeking to resolve disputes caused by ordinary residence rules. The Voluntary Organisations Disability Group recently estimated that there are at least 500 people at any one time affected by ordinary residence disputes, costing an estimated £3m a year in legal fees and administrative costs6.
5. What are the financial implications of the proposed Measure for organisations, if any?
Most disabled people and older people have told us that the current system of charging for social care services - which often delivers poor quality and inconsistent services - is unfair. This is confirmed by further consultations that Scope (and other disability organisations) had with disabled people, where the majority of disabled people think that charging for social care services is unfair. This is especially the case for disabled people who are more likely to live in poverty and less likely to be in work. Without a social care system that works for the individual a disabled person is denied opportunities for work that non disabled people take for granted
The fundamental issue is the quality of care provided, not the cost. However any increase in public funding must be used to improve quality and ensure that those who cannot afford to pay for their own care receive adequate services. Local authorities may have to work collaboratively with neighboring authorities in order to achieve efficiency and value for money. .
"Why should we have to pay to get out of bed and have a shower? No one else has to pay for this.”
A disabled person responding to a Scope survey
6. Has the appropriate balance been struck between the provisions set out in the Measure and the power delegated to Welsh Ministers to set out the detail of the revised charging arrangements in regulations, orders and statutory guidance? Are the procedures which would apply to these regulations appropriate (negative or affirmative)?
We welcome the principles that underpin this Measure: to set maximum charges, to state the persons and services in respect of which charges must not be imposed, the relationship between the amount of charge and ability to pay, the provision of information about charges and reviews of charging decisions. All of these principles will lead to a fairer and transparent system.
7. Are there any other comments you wish to make about specific sections of the proposed Measure?
Inadequate or unaffordable social care impacts on people’s ability to work, gain new skills and participate in community life - creating dependency, isolation and wasting people’s potential. Poor quality or inadequate social care can have a direct impact on people’s health, and their ability to manage their condition effectively - making them more likely to need access to other services; often crisis, health and mental health services.
Any charges must be calculated in a way that is fair and subject to a fair and transparent means test. Disabled people feel very strongly that benefits should not be counted as income when applying the means test (they are in some local authorities) as these monies were intended to pay for other essential items like food and housing costs, not support.
Rights not write off! What disabled people and older people want from social care reform, published by Scope, Mencap and Age Concern (2008), is attached to this consultation response.
Submitted by Scope Cymru, August 2009
For further details contact Ian Ross, Policy and Campaigns Officer (Wales), on ian.ross@scope.org.uk or 02920 662 406.
Scope Cymru
The Wharf
Schooner Way
Cardiff
CF10 4EU
Notes
1 Charging into Poverty, Coalition on Charging, 2008
2 http://www.csci.org.uk/PDF/20080128_SOSC_2006_07_Appendices.pdf
3http://smf.co.uk/assets/files/publications/Disability,%20skills%20and%20work.pdf
4http://www.ageconcern.org.uk/AgeConcern/Documents/Just_above_the_breadline_report_2006.pdf
5 Charging into Poverty? Charges for care services at home and the national debate on care reform in England (2008), Coalition on Charging, London
6 No Place Like Home, Voluntary Organisations Disability Group, 2007
