Does the draft Bill clarify individual rights to care and support in a way that is helpful?
This question relates to clause 17 and 19
Answer questions by topic
Does the draft Bill clarify individual rights to care and support in a way that is helpful?
This question relates to clause 17 and 19
I have secondry progressive ms and my husband has heart failure. I have small early retirement pension net £155 a week which deducted so I receive supported cESA £65 a week, I now after a long battle get full mobility and care component of DLA ( because of abolishment for pension income regarding wealfare reform bill cESA is still deducted and will be for PIP too).Because of supported cESA and early retirement pension is means tested every which way I look for rock solid secure assistance and help is not there and/or is unaffordable.. My husband will not cope with my ever increasing care needs he has wrongly been placed in limited cWRAG so he has problems too. My question is Who will look after me when I cannot move a limb or feed myself, this is the way my ms is progressing. My husband can not do it and I have to pay for adaptations to home and pay a hefty amount towards my care as well as pay small mortgage £57 a week and council tax etc…in all I pay £20 council tax, £15 tax, and £40 deduction from supported cESA My hubby gets £99 a week WRAG cESA. I live in a small accessable bungalow. I have done all the right things with finances etc and adapted bungalow best I can. I live every day in worry as how care funding will be worked out and who will pay the bills as my hubby only gets £99 a week. I,m late 40 and hubby late 50 both have had to give up work in past 7.Please have you got a secure answer for me about the financial implication of my future? It is far easier not knowing exactly how my ms will pan out than the worry of my care?
Mmmmm that’s a head ache if you can understand it but it is only one small part of the complicated system.
Ensuring that the family home is not sold is not the main worry for many people. The main worry is what happens when the money runs out? Will an elderly relative in a good but expensive care home be obliged to move to a cheaper home, where they know no-one, at a very advanced age?
Why is there nothing about a minimum standard of care that someone can expect? With allowing a market based system there is the very real prospect of standards in some areas being higher than others so the postcode lottery will continue. Will the government insist that minimum standards are laid down within care homes whether they are privately owned or owned by a local authority?
I understood that all care homes had minimum standards to adhere to.
The Olympic security staff fiasco should warn us of the dangers of out sourcing what used to be provided by the state. I am all too well aware of the battle of local authorities to transform services on a third less and of the subsequent appeal of ‘cheaper’ services, but when the needs of an older person equate to approximately £2.72 an hour of a residential care budget, one can see that the devide between those who can afford to ‘top up. their care and those who can’t is becoming ever wider.
Can we really be hypocritical enough to talk about ‘quality’ care when clearly our resource allocation’s limit spending on provision is set at such low levels.
Care from the cradle to the grave should mean just that, and nobody, in life or after death, should be expected to sell their him to meet care costs.
This approach is a good example of why you should never work, those on benefits from the cradle to the grave always come off best!
How true, having left school at 14 years old and work from that age. Attending night school at my own expense to further my education. paying my taxes and buying my our home to bring up a family. Was it all worth it when if I had done nothing I would have been looked after in my old age !! Not Fair is it ?
Reading the care and support draft bill i wish to propose that all care homes be obliged to deliver a uniform care service where ever in england you live bybthisvi mean a standard of care laid down for all care providers to deliver. The quality of care must be laid down and care homes and other providers should be assesed on these standards. Secondly care must be based around the individual and there requirements taking into account the views of family members and where need be carers and other individuals such as doctors or social workers. Thirdly we have to set out care plans involving the payment of the care provided,how much this will cost and what level of care this will cover. All of this will need to be done with the individual or there family.
The above has been in existence for some time, the CQC has historically issued multiple care standards which homes need to meet in order to adhere to their registration requirements.
However there is a shortage of homes which can provide care at the prices which local authorities contract to, most homes choose to charge a top up fee to increase their funding. Thus the potential crisis of an already shortage of affordable residential care needs to be recognised. The carrot rather than the stick approach needs to be adopted and a realistic view of what as society we believe is a fair funded price. Many members of the public would be surprised to learn that in some local authorities such funding means that residential care is being provided at a cost of £2.72 per resident, is this a realistic price for ‘quality’ care?
THE CQC is a box ticking toothless body as the Winterbourne scandal highlighted. Having spoken to one of their inspectors I found their approach to investigations rather weak- based mainly on whether organisations have the correct paperwork and can give the impression of being good.
What is in the paperwork can be a lie- but the CQC do not care- it is all too simplistic, the star ratings were the example of how organisations who the public, if the organisation’s background was known, would not touch them with a bargepole- given 3 star ratings by the CQC. .
I experienced the very significant and burdensome issues relating to social and nursing care when my father had to go into residential care due to dementia in 2004. This Bill is long on consideration for the individual, but fails to address the single central source of constraint, lack of choice and worry for both those needing care and their carers, which is the financial basis of care provision.
The argument is well enough known not to need repeating. Those faced with having to sink their life savings or their home into residential care costs (and those with power of attorney having to make decisions on their behalf) have a huge additional burden placed on them at a time of great stress. This arises not only from the actual financial cost and the disappointment of not being able to pass on that which they have worked hard for, but also the concern that the particular financial solution they adopt might not be the most effective. I have recently been informed by HSBC that as my father’s attorney I was mis-sold a funding package by their subsidiary, NHFA.
Families across the country are desperate to see this uncertainty removed because the task of trying to make the right funding decision involving banks and insurance companies is itself a major burden. We should remember that for most working homeowners, the relatively small inheritance that might be available is potentially an important part of the family’s financial resilience, particularly when there are very often low-income working or even unemployed children to help towards independent living.
The Government must at minimum introduce a limit on contributions to residential care costs. However, for a great many people a cap of, say, £30,000 would never apply as they will never have amassed this much capital in any form. So for them, care is free. On the other hand, many ordinary working people who have worked hard for modest savings and a home, will be heavily penalised, while the truly wealthy will not feel the loss to anything like the same extent. In principle, therefore, a financial cap is indiscriminate and operates unfairly. We should go further and make care free at the point of need, consistent with the principles of the NHS. This might need some brave and radical thinking about our budgeting priorities as a nation, but the absence of a clause to this effect in the Bill is simply not acceptable given the impact this issue has on increasingly large numbers of UK citizens. The Bill should not be passed without a financial settlement that addresses these points.
I am not confident that references to ‘ information and advice” are sufficient. I believe it is essential that advocacy is enshrined as a statutory service.only in this way can we ensure those most disadvantaged in our society have the professional support they need to navigate through the systems, understand available choices, make informed decisions and get the services they want to enhance life , rather than the ones someone else believes they need. It could be a really effective tool to help protect the most vulnerable from the horrors of another winterbourne green. For that reason it is not sufficient to assume that adequate support and safeguards can be provided by information and advice services staffed by people who don’t have specialised knowledge for example to be able to support people with multiple and/or complex issues, such as those without speech, those with severe MH conditions interpreted as ‘challenging’ or those in prison or other secure settings.
It fails yet again to address the legal rights and pathways to redress if care is not provided and yet again leaves the family members to pick up the slack of non provision. No framework to force resolution of complaints and sort problems out quickly. No personal accountability of LA workforce to do their jobs properly .
Where is the advocacy provision that will support vulnerable people to challenge and complain or even just access services?
Even statutory advocacy does not seem to be mentioned in this draft which is very worrying.
I am a carer of of a severely disabled child and even though I work as an advocate I was unable to challenge the lack of services for my child (due to the emotive issue of being a parent who felt overwhelmed at the time), without the help of Contact A Family advocate who was brilliant (unfortunately they lost their funding shortly after this)
We know from the reports on Winterbourne that the abuse that took place with impunity, would have had much less likelihood of occuring if advocacy services had been present.
Advocacy acts like a torch shining a light into the dark places which might otherwise be ignored.
Advocacy services which are independent are essential to protect the most vulnerable, and ensure that carers, and their relatives get what they are entitled to and challenge bad practice. Please reconsider your draft bill and include at least a section devoted to advocacy provision.
Two Questions…. As a Disabled Driver with a Motability vehicle I applied for a Disabled Facilities Grant for a hard standing for my vehicle to the frontage of my home. The O/T that came from the Housing Trust, said the Trust would not consider paying for a hardstanding and mentioned nothing about the DFG. However I have applied for a DFG before and was turned down because I did not meet the criteria of the Grant. The fact I had a Mobility vehicle and the work would be for a hardstanding was not even considered!
I have heart problems and angina and my wife has just been diagnosed with Fibromyalgia and finds walking on uneven surfaces painful. The DFG should be changed to incorporate the fact of someone having a mobility car for adaptions to take place.
The other issue I have is my wife cannot get Carers allowance for me because she is on contribution based ESA. Something to do with National Insurance credits. This should be changed. The Carers Allowance should be classed as an Independant non Income based Allowance. People should not have to care for disabled people for nothing regardless if they are getting ESA themselves.
Are the founding principles of Welfare provision in this country so out dated?
I’m no communist or left wing activist but surely “each according to his needs,each according to his means” is a sound foundation. A market in Social Care is not a philanthropic – not for profit environment it exists to make a profit and as costs escalate standards and quality keep pace, but in the opposite direction.
I don’t have an answer, if I did I would probably be drafting this bill. Unfortunately it is clear that the people actually drafting the Bill don’t have and answer either. Perhaps a return to getting control of costs, direct control and provison of services by staff commited to the task and not to maximising profit for a business enterprise could help put the “Social” back into Care.
There a numerous charities large and small across the country working in a variety of health related areas, regulated and quality assurred. Research has proven that £1 invested in supporting these gives a return to the funder and the wider community of 11:1
My mum is a kinship carer for my niece who is 10 years old. Although my mum is over 60 she is doing an execnlelt job, but would not cope if she had to do it on her pention alone! She would not be able to go back to work and provide a good quality level of care. My niece is at the top of her class for all subjects and is a very well adjusted girl, this is all thanks to my mum, giving up her retirement to take on my sisters job! We need to support these carers, who knows where we would be without them. I dred to think.
I went to a public consultation meeting about these proposals months ago. I was left in no doubt of the government’s intentions when told that the most vulnerable frail and elderly could organise their care with outsourced providers online! The whole concept is a cruel hoax and I sincerely believe that the government intend to reduce costs by allowing people to die instead of providing proper care.
The government are hittnig us that need it most I look after my gran child and have donr since she was 6 weeks old she is now 7 and I find myself having to look for work both her parents let her down on a regular basis which messes with her emotionally and now I feel that I will be doing the same when I go back to work shouldn;t the childrens needs come first.
I agree with Adrian Hall. Care should be delivered free at the point of need. The money wasted on all these ancillary bodies required by this bill would be saved if the care was delivered by one centrally funded body, with one set of eligibility criteria. The care should be funded by higher taxes. I know of no one who would object to paying the extra tax required to make this system fair and run smoothly. Given that it is estimated that only one in four of us will need such care at, say, an average cost of £60,000, that would require less than £400 per head per year to be paid over a 40 year working life. Not a huge burden. Even better, re-impose a higher level of tax on the highest earners. We always seem to have money available for meddling in foreign affairs and getting involved in warfare as a result. Far better to spend that money on providing support and dignity to our most vulnerable citizens.
This bill only increases the burden on hard working people who have, in your words, ‘done the right thing’. Work hard and, once you’ve paid off your student depts (mid 40s) you may be able to scrape enough to buy your own home, but only to lose it to the local authority when you need care. And what of your latest idea to use the home as a guarantee for your children to buy a home – will they lose that guarantee when the council steals your home because you have dementia and cannot look after yourself? What of your son or daughter who has given up their life to move in to care for you – will you throw them out to pay for your care? Or just wait until you are dead to throw them out – and charge them interest?
You have ignored the recommendations of your own enquiry – Dilnot recommended a cap of £35,000 and the £100,000 threshold, which together would have allowed parents to have a chance to have something left of their hard earned assets to pass on to their children – why make every generation start again, you are in so many ways with this and other bills condeming people to a life in dept?
If you want to provide a disincentive to people to ‘do the right thing’ then this bill does the job. The message of this bill is – we’re not all in it together – you’re on your own, the very rich will be fine as always, the very poor will be OK, but the majority of hard working ordinary people will lose out again.
P.S. the financial sections on your main comments page are broken links – makes it more difficult to find what the bill has to say on this and to submit a comment on this area – you should take this into account when finding seemingly few comments on sections 14, 15 and 16!
Personalisation – the bill continues the promotion of ‘Choice and control’ to the individual and the roll out of personal and individual budgets. There are opportunities for RECHG as the local authority has to ensure that there are diverse and quality providers of services for whom individuals can chose their support from.
We believe that clauses 17 and 19 provide clear direction on the individual rights to care and support. However, we would comment that clause 23 which refers to the steps for local authorities to take to meet the need under section 17 or 19 makes no reference to providing a ‘person centred’ care and support plan. This is essential to ensuring the needs of the adult are met and the focus is always on the individual.
I find it hard to see this bill as anything other than a cynical and calculated attempt by an extreme right-wing governent to remove those rights to care that were won by the creation of the NHS. There is no social justice in this bill and little humanity. I call upon the government to withdraw it immediately.
It is recognised that there are insufficient funds to fulfil the populations desire for health care. There are however, sufficient funds to fulfil the populations health needs.
Private enterprise is more costly to the nation than state funding (see USA), let alone the moral questions over making a profit from others illness.
The population can decide how much it wishes to spend on healthcare through the taxation system – ask them.
The government is not competent to decide on the distribution of these funds, as political motivation clouds their judgement.
Individuals are also not qualified to decide on this distribution as personal experience guides them, not the nations needs.
Epidemiologists are qualified to decide on the distribution of funds using an open and transparent calculation for the impact of any disease process on society.
The Governments only role in health care is to ensure the funds are spent efficiently.
Education for clinicians should be led by clinicians.
Manpower and education must be linked due to the long lead in times.
distribution of manpower should be decided by epidemiological needs.
The system must be nationally organised, regionally (and geographically) distributed and locally delivered as an integrated whole.
Boundaries between “Health” and “Social” care must be clearly defined, with clear pathways for the transition between them to produce a seamless system to return people from the healthcare system to society when support is required in an ongoing fashion.
It must be recognised that no system is foolproof, and accidents and errors will occur. As a consequence no fault compensation must be implemented, which would remove the delays in obtaining support for those who require it, and reduce costs. Obviously all errors must be investigated in order to acertain intent if the problem is criminal, or a system error that must be rectified.
Competition has no place in healthcare, collaboration and cooperation is required. Best practice comes from the desire to do better for ones patients, rather than the desire for better wages and working conditions. This only comes about if healthcare workers are themselves valued by those they treat.
This bill destroys the NHS and creates a system which will produce a two tier healthcare privision. Private with a nubbin of state funded care which will always struggle. The country will lose something, that when compared to other countries healthcare systems by those that use them, rather than those that proselytize about them is envied by all.
It is right that there is a single consolidating peice of legislation and in broad terms BASW welcomes the proposals. The right to care and support has been very difficult to define because of the complexities of 32 different statutes and this legislation should simplify that. There are of course concerns about what that means to an individual in terms of resources, but it is an improvement on the present complexities
I have a number of comments to make an they are listed below:
1. Current legislation for the provision of care states that the Local Authority provides the care under current guidelines. Care should be provided where there is a proven need. Unfortunately under the current financial circumstances this is not happening. In order for the Local Authorities to manage their budgets they are only providing care where the need is “critical” across all Service Users. This is not acceptable, it should be quite clear that if care is needed it should be provided and not influenced by financial concerns.
2. Under the National Strategy for Carers, they have a right to a life of their own. Given the current financial constraints that Local Authorities face and the reduction in services that has arisen, this is placing further pressures on Carers to the extent that they have to make unpalatable decisions about whether they can continue in their caring role, this is not acceptable. Carers save the Local Authorities a lot of money and provide a vast amount of care at no additional cost to this country. It needs to be very clear in any new regime that this is not acceptable practice.
3. Duplication in the provision of some services which assist Service Users such as Welfare Rights or Advocacy is not best use of financial resources, This appears to arise because of the split of service provision between Health and the Local Authority. This is not best use of the finite resources available, so it would be much better if all placed together under the one Authority so that a Service Users needs are dealt with in the round.
Derbyshire County Council believes that the duties to meet needs for care and support are clearly defined in the Bill. The fundamental concern with the proposed legislation is that it will amplify and exacerbate the funding crisis which is already engulfing local authorities with adult care responsibilities in the period until 2015/16. It is the Council view that an immediate injection of money is required into the adult care system which will give stability over the coming period until a long term solution is put in place. Without that, people who need services and their carers could face a further 5 years of uncertainty and hardship rather than having the clear rights envisaged in this Bill. The Council would suggest that consideration is given to transferring resources from the NHS to local government as part of the prevention and integrated care agenda.
What nobody has yet spoken about is the true innovative way to plan the future care of our elderly [and other vulnerable groups]. We could offer many thousands of users and carers the opportunity to have their care provided in their country of origin [or where they have assets]. This would offer them a fantastic opportunity to enjoy their own wealth/savings and inheritance; spend time with loved ones and we could save £billions as it could be done at a reduced rate- a lot less than what we pay in the UK. I know many of our blood sucker agencies will oppose to this proposal as they milk the system, but this is the way forward for the aging expatriate communities- affordable care- better choice- saving the UK £billions!