The Care Act 2014 was implemented yesterday and will introduce some radical changes to the adult care system in the UK.
The legislation will guarantee rights for those being cared for and their families, including standards for access to services, greater responsibility on councils and a cap on care costs.
However, funding to the sector has suffered under austerity and going forward no commitment to protect it has been made, which is prompting concerns that the new measures may be compromised.
“We really worry that the Care Act is going to fall at the first hurdle,” says Andy Kaye, Head of Policy and Campaigns at Independent Age.
The charity, which provides free information and advice to older people, is warning that new rules without adequate financial support may have a negative effect.
According to Mr Kaye there is a danger it could “raise people’s expectations for the care and support they might receive when in fact we are worried that there will be real crushing disappointment in some cases. That people are going to be rationed out of care services and won’t get the vital help - whether it’s bathing, dressing, help with cooking - that they really so badly deserve and need.”
The sector has undoubtedly taken a hit in recent years and unlike the NHS budget it is not ring-fenced.
In this parliament £3.5bn has been removed from care budgets by councils and recent estimates suggest that the system faces a £4.3bn ‘black hole’ by 2020.
Mr Kaye is baffled by the lack of cohesion between NHS and care funding and calls for a more unified approach.
“It’s a nonsense we think to, on the one hand, protect the NHS budget but not the care budget because social care is effectively the life support that people need to stay healthy and independent for longer in their own home...
“It seems a real nonsense to treat those budgets differently to the health budget. To cut that stuff back, the very stuff that is going to keep people out of hospital, keep them out of the costly A&E services and yet protect and ring fence NHS services.
“What we are saying is let’s not treat these things as somehow different. We have never understood why social care is quite the Cinderella service that it is. We suspect it is treated like that because people don’t really tend to think about it until they need to whereas the NHS, we are all brought up in this country to think the NHS is our national institution.”
This approach, he suggests, is distorting political thinking on the issue and putting unnecessary focus and pressure on health services.
“Our worry is that politicians are still too trapped into thinking that when you are talking about dignity and security in old age you need to talk to it through the prism of what the health service delivers for people and not what the health service and local authorities through their social services need to deliver. So we are seeing there is reasonably good levels of awareness to meet the needs of an aging population, but perhaps politicians tend to think a little bit too often about that being the responsibility of the NHS alone.
“We are hearing just in the last few days about the £30bn adjustment required in terms of deficit reduction. Social care is going to be under even greater pressure unless MPs put those sentiments in terms of protecting adult care into action post-election and face the financial crisis facing this chronically underfunded care system.”
Further funding cuts are worrying for the sector given the strain it is currently under and the adverse effects this has had.
Independent Age has heard from some families who are being put under financial pressure through extra charges that they pay for relatives’ care, which in some cases may be the responsibility of the council.
These top-up fees can be paid on a voluntary basis in cases where families would like to access services over and above what the local authority will provide, however, Mr Kaye describes a different scenario.
“What we hear is that families feel that they have got no choice whatsoever and the council doesn’t back down, it just sticks to its position and says: ‘no, come what may the fee that we are going to provide is £550 and we are not going to renegotiate it.’
“The point about top-ups is they are often hidden, the rules feel a bit opaque, people don’t know what their rights are, they don’t know what they are entitled to. So, you get people paying top-ups when really it was unnecessary and it was really the council’s responsibility to cover someone’s total care home fees.”
Independent Age would like to see these problems addressed and are optimistic about what can be achieved thought the new legislation, but insist that cuts will put this at risk.
As the Care Act takes effect, they are urging the treasury to get its act together on care, to make the new measures a success.