Coalition criticised for "lack of detail" on plans to cap individual care costs

Despite positive reports and rumours regarding the Government’s intention to see through a cap on individual care costs, several leading sector voices have announced their disappointment that the Coalition’s Mid Term Review was lacking in firm commitment or detail.

The words ‘cap on social care’ did cross the Prime Minister’s lips during his Review speech yesterday, a reference – to those following the care financing issue – that would seem to corroborate last week’s comments by Norman Lamb, the Minister for Care and Older People. Mr Lamb had claimed that the Government was poised to support a cap of £75,000, after months of growing uncertainty that the Treasury might not be prepared to support this key recommendation of the Dilnot Commission.

Sifting through the nitty-gritty of the Mid Term Review document itself, however, and care professionals are left disappointed that the same sense of doubt remains – at least for now. Key policy announcements are planned for the next few months and so the cap may still materialise, but it is clear the sector is in no mood for suspense.

Executive director of the , Des Kelly OBE, is among those to criticise the Review for offering ‘limited details’, while also highlighting the funding crisis as an unanswered issue, despite being supportive of many aspects of the Review document.

Mr Kelly comments: “It is encouraging that issues of care and health were highlighted as key priorities in the Mid Term Review. The report highlights achievements and aspirations; to improve quality; support a strong regulator; encourage greater integration; and protect people from provider failure. It also restates commitments around dementia and to establishing a culture of ‘compassionate care’ across health and care services. There was also a general statement of support for the principles of the Dilnot Commission.

“However, once again, there was no detail on addressing the twin approach recommended by Dilnot – both capping care costs and raising the means-tested threshold. Most people still perceive the social care system to be complex, unfair and inequitable.

“The limited details in this announcement make it look disappointing. The introduction of a cap on residential care costs addresses only a part of the problem. The growing funding crisis in the care sector remains unresolved and given demographic pressures will continue to create pressures on the system.”

director of external affairs, Andrew Chidgey, spoke up for adults with dementia and other complex conditions, saying “They deserve to know an end to this injustice is in sight.”

He continues, “Despite the rhetoric on the need to reform the rules on charging for social care we have yet again been left without any detail of how this will be done. People with dementia and other conditions are being hit with huge bills for inadequate care or care that arrives too late.

“Our political parties must provide clarity on how the financial burden on people who need care will be reduced both now and in the future. We also need to hear how the gaping and expanding funding hole in social care is to be plugged. Only then can we guarantee that people will receive the care they need, at the right time and at the right price.”

chief executive, Janet Morrison, also criticised the ‘lack of detail’ and questioned how much of an impact a cap of £75,000 will have, saying: “Whilst Independent Age is pleased that the coalition is committing to the introduction of a cap on the amount that older people have to pay towards the costs of their care, we were left disappointed by the lack of detail on the level of the proposed cap.

“We are also concerned at reports that the cap might be as high as £75,000. The cap is only one of two key reforms recommended by the Dilnot report and the Coalition now also needs to commit to the second – the raising of the means test threshold from the current £23,250 to the Dilnot Report’s recommended £100,000. To be considered fair, reform must include both a realistic cap and a substantial rise in the level of the means test threshold.”

An Age UK statement concurred: “We were for hoping for clarity and certainty about the Government’s plans for helping with the costs of care and are deeply disappointed that we got neither today. “Meanwhile the social care system is careering towards breaking point, starved of funds, with investment failing to keep pace with the growing needs of an ageing population.

“There is a urgent need to know for all those working in and cared for by the system when and how the Government plans to put the Dilnot reforms into action and ensure that all older people receive the care support that they need.”

Aside from the care cap, those measures welcomed from the Review include a series of commitments to improving care standards and treatment for long-term issues like dementia, with the aim of putting mental health conditions on a level par with physical health – within the NHS – in order to impact on access and waiting times.

Commitment is also announced for the service user’s entitlement to a personal budget; for the introduction of a national minimum eligibility threshold, holding local councils to specific care commitments that, it is hoped, will end the postcode lottery; and for the introduction of a Universal Deferred Payments scheme that will prevent homeowners having to sell their property in order to finance care.

Attempts to prevent another Winterbourne View scandal also feature, focusing upon care for adults with learning disabilities. This includes an investment of £56m to help transform the future of children and young people with mental health complications; a strategy focused on building a ‘culture of compassionate care’ amongst nursing, midwifery and care staff; as well as new measures in place to protect service users where their care provider’s business happens to fail.

A further £100m will be targeted at innovating NHS services to help bring about a ‘technology revolution’ in the practice and delivery of patient care, with hospitals receiving loans having the incentive of ‘Friends and Family Tests’ which, if able to prove their quality through positive feedback, will not be asked to repay any amount.

*edit* This afternoon Deputy Prime Minister Nick Clegg responded in the House of Commons to a question from former Care Services Minister Paul Burstow, confirming that Government is prepared to legislate for a cap on care costs by 2015.