The Dilnot Commission Report - What we think?

Thursday, 07 July 2011

The Dilnot Commission reported to the Government this week about their suggestions for the future of adult social care funding. The Government will now consider them. The focus of the report is upon the need to fund an aging population which is growing. The main points are listed below: 

• All those who enter adulthood with a care and support need should be eligible for free state support immediately rather than being subjected to a means test. 
• Individuals’ lifetime contributions towards their social care costs – which are currently potentially unlimited – should be capped. After the cap is reached, individuals would be eligible for full state support. This cap should be between £25,000 and £50,000. The Commission considers that £35,000 is the most appropriate and fair figure;
• The means-tested threshold, above which people are liable for their full care costs, should be increased from £23,250 to £100,000;
• National eligibility criteria and portable assessments should be introduced to ensure greater consistency.

The DSA has looked at how the proposals in the report could impact upon people with Down’s syndrome if implemented.

Will people with Down’s syndrome have to pay?

Everybody who receives free support from the state will continue to do so. Those reaching adulthood with eligible care needs would continue to receive support, without charge, for the rest of their lives. The £35,000 cap would not apply as this would be met by 18 if a person was born with a disability and had identified needs. Future living costs would be met through personal income and disability benefits.

Who will be eligible?

A national eligibility threshold is recommended to tackle the problem of ‘postcode lotteries’ making the provision of social care fairer. A minimum eligibility criteria of ‘substantial’ is suggested. This proposal conflicts with the report’s later recognition of the importance of prevention in maintaining people’s independence. The Commission wants the Government to provide new eligibility criteria to replace Fair Access to Care ( FACS). These should be easier for people to understand and measure their needs against.

What about assessments?

There needs to be fewer assessments and closer working between agencies so that budgets can be pooled and assessments simplified. The report supports the Law Commission’s proposal to place a duty upon local authorities and the NHS to work together. National eligibility criteria should mean that assessments are portable across local authorities.

Will my disability benefits be affected?

Universal disability benefits based on need like DLA should remain.

Where will I find out about changes?

People must be given the right information about any new system that is introduced. The Commission would like to see a national website to provide information and signposting. The Government should produce an information strategy in partnership with voluntary and community organisations. Local authorities should have a statutory duty to provide information for everyone regardless of need.

What help will there be for carers?

Carers should have better assessments. There should be a legal right to a carers assessment and a duty for local authorities to carry out carer’s assessments at the same time as the cared for individual. Carers should be consulted regularly (yearly) to ensure their needs are being met. GPs should be mindful of the demands of caring and ensure that the right support is put in place. Carers should be able to take up paid and unpaid work. Support already in place for carers should continue (targeted respite, cash support, carer’s allowance).

Where will the money come from?

If we want long term care for all then more money must be found from those who can pay and the government.

The government has three options:

• General taxation
• Reprioritise existing expenditure
• A specific tax increase to cover social care.

What will be the role of the local authority?

Resources for social care will still be given to local authorities to use flexibly. They must be open about how the money is used and work in partnership with their local communities. Reviews of local government financing should consider how sustainable the resources are to support adult social care. The Commission notes that recent additional resources for social care have not found their way into social care budgets in some areas.

How might the suggested system be introduced for people with Down’s syndrome?

If the scheme proposed by the Commission was introduced, certain groups could already be deemed to have met the cap. These could include all those who have been in residential care for two yearsas well as all those born with a disability, or who have a care and support need and are under the age of 40.