Four out of 10 elderly needing care shut out of system as rules toughened up unofficially

Almost 40 per cent of elderly people who would have qualified for care in recent years now excluded after social workers ordered to apply tougher eligibility tests unofficially, report concludes


Four out of 10 elderly needing care shut out of system

More than 450,000 frail elderly and disabled people who would until recently have received state-funded care have been shut of the system because of pressure to cut numbers, a stark new report concludes.

The academic study, published as MPs prepare to debate the Government’s long-awaited overhaul of care, found that almost 40 per cent of those who would have had some help with basic tasks such as washing and dressing less than a decade ago are now left to fend for themselves.

It comes as an alliance of 75 charities warned that the Government’s good intentions in overhauling the system risk being completely undermined by a “black hole” in funding for social care.

The report, by researchers at the London School of Economics, describes cuts in the last two years alone as “without precedent in the history of adult social care”.

It warns that the care system is now caught in a “vicious circle” with fewer and fewer people receiving help at home but more and more likely to have to turn to the NHS – something which could ultimately cost the taxpayer more.

Significantly, it found that the sheer speed at which people have been excluded from the social care system outstrips the rate at which rules about who qualifies for care have been tightened up.

The only explanation for that, the report suggests, is that social workers who assess people to decide whether they are frail enough to need care are under pressure to operate an extra “implicit criteria” – meaning that they are being told to apply an even more strict interpretation than the rules might suggest on paper.

Richard Hawkes, chairman of the Care and Support Alliance which commissioned the study, said: “Social care is on its knees and the system is in desperate need of reform.”

Official NHS figures published earlier this year show that the number of people in England receiving some form of social care, either in their own home or a care home dipped below one million this year for the first time in recent memory.

Overall the numbers have dropped from almost 1.3 million five years ago to 928,000 now.

But that decline has come despite a rapid growth in the population of older people.

When demographic and social changes are factored in, the LSE concludes that there are 453,000 people currently not receiving any help with their care who would have done if test applied in 2006 were applied now – a drop of 36 per cent.

Among elderly people the decline is as much as 39 per cent – with the equivalent of 333,000 fewer older people receiving care than would have been the case.

The report points out that the cuts are most noticeable among those receiving care at home, those deemed to be at the lower end of the scale of need.

It says that this could be because councils have decided to target their efforts at those in the greatest need.

But Dr José-Luis Fernández, the lead author, remarked: “Even so … questions would then arise about the extent to which councils have been able to invest in prevention or remain embedded in a vicious circle of restricted interventions and crisis response.”

He added: The scale of reductions in spending and provision which we have

revealed here are almost certainly without precedent in the history of adult social care.”

The report then warns that by the time the overhaul, which will introduce a notional £72,000 cap on the cost of care, comes into effect in 2016, it will be imposed on a system “whose foundations have already been seriously eroded”.

It notes that while almost all councils have narrowed their eligibility criteria for care in recent years this could not in itself account for the scale of the mass exclusion of elderly and disabled people.

“It seems therefore that ‘implicit’ eligibility policies (the interpretation on

the ground of the stated local definitions of eligibility thresholds) might have shifted significantly through time without an equivalent reflection in terms of changes in the ‘explicit’ local eligibility thresholds,” the report remarks.

Mr Hawkes said: “The Government deserves credit for its bold, ambitious plans to reform the system.

“The Government proposals for a care cap are a positive step.

“But it is becoming clear that a huge number of older and disabled people and their families that need support will not see any of the benefits of the new system – because eligibility will be set too high.

“Getting the health and care systems working better together is a positive step but councils say this won’t address chronic underfunding.

“Ultimately the plans need to go hand-in-hand with a commitment to properly fund the social care system.”