Funding for the long-term care of elderly people should be targeted at the poorest pensioners with few or no assets, according to a report by Iain Duncan Smith‘s thinktank.

In a direct challenge to the Dilnot commission, which called for an increase in support for those with assets, the report, to be published on Tuesday, calls for resources to be concentrated on pensioners solely dependent on state support.

The report by the Centre for Social Justice (CSJ), the thinktank established by the work and pensions secretary while he was in opposition, is likely to have a major impact on ministers as they consider their response to Dilnot.

Ministers are holding cross-party talks before the publication of a white paper in response to the commission into the funding of long-term care for the elderly by the Oxford economist Andrew Dilnot.

His report called for a large increase in the threshold of savings and assets above which the state stops offering help with care costs. The limit should rise from £23,250 to £100,000, the commission said.

The other key recommendation in the Dilnot report was to impose a cap of £35,000 on the amount any individual would have to pay towards their own care costs during their lifetime.

But the CSJ report, Transforming Social Care, sweeps aside these arguments and says the government should first concentrate on the neediest pensioners. It is careful not to define which pensioners fall into this group. But sources at the thinktank say they are thinking of pensioners who are wholly dependent on the weekly state pension of £107.45 and have little or no other assets.

Christian Guy, managing director of the CSJ, says: “Understandably, there is a lot of concern about better-off pensioners being forced to sell their homes and use the proceeds to pay for their care until they drop below the means-tested threshold. But ministers should make the most vulnerable people and the unacceptable conditions they face, their first priority, then phase in the Dilnot recommendations so that help can be extended to all.”

The CSJ says that any extra resources should be focused on the poorest members of the “extraordinary generation” who lived through the second world war, because they suffer most severely from the country’s “broken” care system.

The report says low pay, poor training and lack of oversight has to led to “very poor quality of home care for the most disadvantaged older people“. Many have to put up with “flying visits” from carers carrying out essential tasks.

The report points out that of the 400,000 elderly people living in care homes, nearly two thirds are funded by the state. Many of these, according to the CSJ, suffer poor care because councils use their purchasing power to drive down fees.

The CSJ says the Dilnot commission appears not to focus on the most vulnerable. “The report says little about ameliorating the current system which is in large part failing many … Those proposals do not address the means-tested system for those who have not been fortunate enough to own their own houses but instead find themselves dependent on the state in their old age.”

The CSJ report, which says nearly £1bn has been “stripped out of social care budgets in England” in the last year, warns that a failure to target resources on the neediest will have a major impact on the NHS.

“Older people, we know, account for two-thirds of overnight stays in hospitals … Free at the point of use, and always open, accident and emergency departments have in many of the most deprived areas become ‘catch-alls’ for suffering.”

Sarah Pickup, chair of the Association of Directors of Adult Social Services, said the CSJ report was a welcome reminder that implementing the Dilnot proposals on their own would not solve the current crisis in adult social care.

“The CSJ is right to say that the commission has provided a good answer to the question about how to provide people with more certainty about the costs of care and to reduce the risk of catastrophic costs, but also to point out that solving this problem will not address the wider issue of the need for a level of funding which is sufficient to fund quality support and services to meet needs.”

http://www.guardian.co.uk/society/2012/may/07/elderly-care-funding-duncan-smith?newsfeed=true