04/12/06 - Elderly face an end to home care

Hundreds of thousands of elderly people will no longer get home care services because of a funding shortfall and the widening impact of NHS cuts, CSCI says.

The Commission for Social Care Inspection reports today that nearly two thirds of the 150 councils that provide social services changed their criteria last year to provide social care only for the most dependent people.

In more than 100 councils, elderly and disabled people who used to get regular help with cleaning, bathing, dressing and shopping will no longer be entitled to care unless they fall into the top two categories of “critical” or “substantial” risk.

Only the very frail, immobile or those at risk of abuse will be entitled to these services, forcing other vulnerable people to rely on families or friends or to go without help.

The commission says that the situation is already getting worse in at least three authorities — North Yorkshire, Northumberland and West Berkshire — which are restricting home care to critical or life-threatening situations. It predicts that this situation will apply in many more authorities next year.

The number of households receiving home care has fallen by 174,000 since 1992 to 354,000 last year, a drop of 30 per cent. The commission says this is mainly because councils are concentrating scarce resources on the very needy. “People entitled to social care are getting better care,” a commission official said. “But that leaves thousands of others with no care at all.”

Mervyn Kohler, of Help the Aged, said that withdrawing preventive services from less critical groups could affect their quality of life crucially. People who no longer had help with cleaning, shopping or dressing would stop inviting people round, lose their self esteem and stay in bed all day. “Councils will end up paying the price for restricting the criteria with more people becoming dependent. This is a foolish, short-term economy.”

Councils are being forced to change their eligibility criteria because government grants for social services have failed to keep up with growing numbers of very elderly people, local authorities say. Many also complain that they are bearing the brunt of NHS cutbacks.

In some cases they are treating people who would have been cared for in hospital, while in others primary care trusts are refusing to pay for services provided by local authorities where they would have done so in the past.

The commission’s annual performance rating of adult social services for 2006 shows that three quarters of the 150 councils gained either two or three stars. Although no council was zero-rated, 33 got only one star; 24 of these had been given one star for the past three years.

Ten councils went up to the highest three-star category, but nine dropped in the rankings to two stars. In total 25 councils improved their services, while 16 fell back.

Ivan Lewis, the Care Services Minister, said that a number of councils need to “up their game” as he announced plans to intervene in 21 councils which had failed to improve their ratings since 2002.

“Adults and their carers who use services in this area deserve better, therefore I am asking (the commission) to work with these councils to develop improvement action plans by March next year,” he said.

Social care leaders broadly welcomed the latest league tables. John Coughlan, president of the Association of Directors of Social Services, said: “We cannot ignore the fact that these improvements have been made in the teeth of one of the most severe financial squeezes social care has experienced for a long while.”

The losers

Councils use four criteria to assess risk for the elderly, disabled, or mentally ill living at home

Critical the very frail with life-threatening conditions or at high risk of abuse

Substantial those unable to manage the “majority” of tasks, such as washing, getting dressed, getting up, cooking or cleaning

Moderate those unable to manage “several” care tasks, such as washing, dressing, cleaning, shopping and similar tasks

Low those needing help once or twice a week for a few hours a day

In 2005, 100 councils restricted their eligibility criteria for providing care for those living at home to the two top categories — critical and substantial

The number of households receiving home care from social services fell from 528,000 in 1992 to 354,000 in 2005

Source : The Times