Charities criticise Government's 'unrealistic threshold' on who should get help with care under new eligibility criteria

The Government has announced new national eligibility criteria for the first time, setting out a minimum threshold to be introduced in 2015, on who should be offered care and support by local authorities in England.

Care and Support Minister Norman Lamb said the criteria is being introduced to put an end to the ‘postcode lottery’ because “we know people are often confused about what care they can expect from their local authority and far too many end up having to fight for the care that they need because the rules are so complicated”.

He added: “In my view, we need to be clear about the basic minimum entitlements to services so that everyone can be reassured there is some level of support they can expect, regardless of where they live. A national minimum is exactly that – a starting point for local councils to base their care provision on.”

The national threshold being proposed is for people who are judged to have ‘substantial’ needs. Currently, 84 per cent of councils who provide social care in England limit care funding to people with critical or substantial needs. Back in 2005, it was very different with half of local authorities funding care for anyone with moderate or higher needs.

People are deemed to have substantial needs when they only have a partial choice and control over their immediate environment or in cases of abuse or neglect. Also if there is an inability to carry out the majority of personal care or domestic routines or they are unable to work, or undertake any form of education and sustain relationships. Charities have been quick to condemn the new criteria fearing it has been set too high and will exclude millions of vulnerable people.

Michelle Mitchell, charity director general of Age UK said: “We have always said national eligibility criteria are welcome for reasons of consistency, but only if they are set at a fair level. We believe the equivalent of ‘substantial’ sets the bar too high: ‘moderate’ would be much more in tune with the spirit of the Government's new Care legislation, and with what the public has been led to expect.

“Although this may sound like a technicality the final decision about these criteria is crucial: as it stands millions of older people and their families who have assumed they will benefit from the Government's social care reforms will miss out. But there is still time for the Government to change their minds and Age UK will be campaigning to persuade them to do so.”

George McNamara, head of policy at Alzheimer’s Society said: “'The wholly inadequate levels of care available today reflect the extent of the savage cuts that have left hundreds of thousands of people struggling without any support. To suggest that a national criteria, which aims to maintain this status quo is a positive step demonstrates a worrying acceptance of the substandard.”

He added: “Thousands of people with dementia are currently being left to reach crisis point each year before they are offered a helping hand. The government needs to take action now to ensure that people are getting the support they need at the time they need it. Not after it is too late.”

Tim Pethick, strategy director for Saga claims the new criteria makes a mockery of the Care Cap and said: “Whilst the move to standardise the eligibility criteria for care is important, it is masking the big issue here - that it's making a mockery of the cap on care costs. This simply adds another level of complexity to the already widely misunderstood care cap.

“The eligibility criteria is not only about whether you'll receive help to pay for your care, it is also the gateway to the care cap. These regulations will mean that if you have low or moderate needs, the care costs that you do incur will not count towards the overall cap until your needs are assessed as substantial.

“From an individual point of view what this means is that with this system still gives families nothing to plan for, what level or extent your care needs will be assessed at and, more importantly, how much of your estate you will lose before your costs even start to qualify towards the cap.”

The National Autistic Society also said it has “substantial concerns” as the draft criteria proposes that only those identified as having a physical or mental impairment will qualify for support. It fears this may mean that many adults with autism will miss out on the support they need, leaving them vulnerable to falling into crisis.

Sense, the charity for deafblind people has similar concerns. Head of public policy and campaigns, Sue Brown said: “While we welcome the general approach of these regulations, they do not address the gaps in social care nor ensure that more disabled people in need can benefit from support.

“A Sense survey last year revealed that nearly one in five (19 per cent) deafblind people received no social care at all and most people did not receive the care they need. The past few years have also seen many disabled people lose vital social care services as local authorities tighten access to support. The Care Bill provides a golden opportunity for a fairer and more effective care system, however, keeping the bar at such a high level is likely to prevent many disabled people from receiving the care and support they need.”

She added: “We are disappointed that the Government has not recognised the importance of sensory impairment and communication needs in these regulations. Being able to communicate is often a major challenge for deafblind people, who struggle to hear, see or communicate without support. Such communication challenges can also occur due to physical or mental impairments, and the impact is often missed when people are being assessed for support. We would urge the Government to reconsider and include a specific mention of sensory impairment and communication needs in the regulations.”

The Department of Health will publish the regulations on eligibility for formal consultation once the Care Bill has completed its passage through Parliament, in spring 2014.

Following this process, the regulations will be laid before Parliament in autumn 2014. This will provide six months for councils to make practical arrangements, prior to the national eligibility level coming into effect in April 2015.

To see the draft regulations go to www.gov.uk/government/publications/draft-national-eligibility-criteria-for-adult-care-and-support

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