Government delays giving all self-funders access to council care home rates
The Department of Health and Social Care (DHSC) has delayed giving all self-funders the right to take advantage of, typically lower, council care home rates after concerns around the reduced workforce.
Minister for care and mental health Gillian Keegan announced the initial plan by the government to extend the right, under section 18(3) of the Care Act 2014, for your council to arrange your residential care to all self-funders had been dropped from October 2023.
It will only currently apply to new entrants to care homes, becoming eligible to those already in residential care from April 2025 at the latest.
Following a consultation on statutory guidance to implement the government’s flagship funding reforms, councils and providers raised concerns about how feasible section 18(3) would be to implement.
The introduction of an £86,000 cap on personal care and a means-test for accessing council-funded social care will also come into force in October 2023.
These changes would likely give self-funders an incentive to approach their council to have their needs assessed, whether to benefit from council-funded care through the extended means-test, to start a care account metering their progress towards the cap or to benefit from lower fee rates through section 18(3).
With councils already facing significant backlogs of assessments, reviews and care packages, combined with growing vacancies and turnover in social work, council leaders are concerned that there won’t be enough practitioners to implement the reforms.
Concerns were also raised, given providers’ longstanding reliance on the much higher fees paid by self-funders than councils in their business models, about the impact of the change on the care market. A 2017 report estimated that self-funders on average pay an extra 41% compared to councils for a place in the same home.
The government had plans to close the fee gap by making councils pay providers a “fair cost of care” as part of its care funding reforms – with £1.4bn backing from 2022-25. However, respondents have raised concerns that this would not be sufficient to ensure sustainability and pay providers a fair rate.
Keegan raised concerns in a statement that people may be left waiting for care and support “should a large number of people with existing care arrangements already in place approach their local authority to arrange their care at this point”.
The DHSC responded that it was “right that these users, who are at the vulnerable moment of transitioning into residential care, benefit from the support of local authority care arrangement first”.
Keegan said it would “allow individuals funding their own care to benefit from local authorities’ expertise in commissioning as quickly as possible while allowing local authorities and social care providers to plan for this change and avoid unnecessary disruption to service provision”.
King’s Fund director of policy Sally Warren said on Twitter: “The public aren’t getting what they were promised last Sept when Johnson, Sunak and Javid announced reforms – and a tax rise to pay for it, so the public will reasonably feel aggrieved that they aren’t getting what they were told they would be.
“This is the second major change to the reforms since it was announced barely 10 months ago – along with the regressive change to remove support from the LA means test from the cap. What the public was told in Sept and what is happening now are very different.
“Govt could have avoided this backtracking by (1) talking to experts who work in and use social care while they created the policy, not doing it in secret (2) being clear and careful with how they described the policy last September and (3) having enough money to support reforms as announced.”
