EXPANDED SERVICES AND INCREASED CHOICES FOR OLDER PEOPLE
Investment and reform for older people's social services
Health Secretary Alan Milburn today unveils a wide-ranging package of measures to radically reform services for older people backed up by increased investment. By 2006, compared with the resources available today an extra £1 billion a year will be spent on social services for older people.
The programme of reform will help to ensure that the best use is made of the extra resources. The reforms must guarantee not more of the same for older people but faster access to a wider range of services, offering them greater choice
The package has six key features:
Faster assessment - by the end of 2004 first contact by social services will be made within 48 hours and the assessment completed within one month. All equipment needed will be in place within a week.
Stabilising care home sector - local authorities will be able to pay higher fees to care homes, £70 million to pay for better training for social care staff, and amended environmental standards.
Expanded range of services - double the amount of intensive home care packages by 2005 compared to 1995, 70,000 more rehabilitation packages and a 50% increase in the number of extra care housing places.
Easier access to community equipment - half a million more pieces of free community equipment benefitting an estimated 250,000 people. This will include handrails, hoists and ramps.
Increased choices for older people - following assessment of care needs all councils will be obliged to offer direct payments to all older people allowing them to make their own decisions about the care they need.
More support for carers - doubling of carers grant to £185 million by 2006. This will provide respite care and breaks to a further 136,000 carers.
On faster assessment Mr Milburn said:
"By the end of 2004, all assessments will begin within 48 hours and will be complete within one month. Following assessment the services to older people in need will be in place within one month. All equipment needed to help people live independently in their own homes will be provided within just one week.
"And these shorter waiting times will be accompanied by major reforms to ensure older people are able to leave hospital when they are ready to do so. To accompany these extra financial resources - which will increase capacity in all aspects of older people's care - local authorities will gain the financial responsibility for older people once they are ready to leave hospital. We intend, subject to legislation, to introduce this reform by April next year."
On stabilising the care home sector Mr Milburn said:
"There will be more support to help more people who need care in residential and nursing homes. For many frail or disabled older people care homes - thanks to the efforts of care home staff - offer the best security and support. The size of the care home market peaked in the mid-1990s. Since then the boom in the property market - especially in the South of England - combined with low increases in fee levels paid by local authorities, has seen the number of care homes beds fall. Laing and Buisson, perhaps the foremost analysts of the care home market, say that ideally occupancy levels in care homes should be at about 90%. They estimate that today occupancy levels are running at around 91%, suggesting that a modest increase in bed numbers from current levels is needed. We will now plan to increase the number of care home places supported by local councils.
"Since last November, when we made available an extra £300 million to social services, fee levels have risen - by up to 10% in some parts of the country. The resources we are providing from April next year will allow local councils to pay higher fees still further is that is what is needed to stabilise their local care home market.
"Greater stability must be accompanied by higher standards. This is what care home providers called for and the Care Standards Act enshrines. For the first time, clear national standards are in place but we always said we would keep the new standards under review.
"The size of rooms and doors, availability of single rooms and the number of lifts and baths are important but they should not mean good local care homes having to close. We will therefore shortly issue for consultation an amended set of environmental standards to remove them as a requirement on existing homes instead making clear that they are good practice to which all care homes should aspire. We will require care homes to spell out whether they do or do not meet these standards and let those who are choosing homes make an informed decision for themselves.
"Other standards - for example, those covering qualified staff - make a greater contribution to the quality of care provided for older people. We will make £70 million available by 2006 ring-fenced to support training for social care staff - most of whom currently do not have a qualification - and many of whom are employed in the care home sector."
On the expanded range of services Mr Milburn said:
"We will guarantee greater choice for older people over the services they receive. Care homes are a good option for some older people but not for all. They are not - and must not become - the be all and end all of elderly care services in our country. Our objective is to broaden the spectrum of services available for older people in order to widen choice and promote independence.
"To enable local councils to provide more rehabilitation services we will earmark resources to ensure an extra 70,000 older people a year get these services to avoid them going into hospital unnecessarily or to help them leave hospital speedily when it is safe to do so. I intend to legislate to ensure that these and all intermediate care services will be free whether they are provided by the health service or by social services.
"We will also invest in new models of supported care for older people. We will therefore resource a 50% increase over the 1997 total in the number of extra-care housing places - very sheltered accommodation - available for older people. And we will work with local authorities, housing associations and others to do so."
On easier access to community equipment services Mr Milburn said:
"More older people, who choose it, will get the support they need to continue to live in their own homes. For too many older people the choice they have faced in the past is between going into a care home or struggling on in their own homes. Just like anyone else, older people want to remain as independent as possible for as long as possible. As a result of the investment I am announcing today, by 2005 there will be twice as many older people receiving the intensive help they need to live at home than there were in 1995.
"Charges are currently made for community equipment such as hand rails, ramps or hoists which can make the difference between an older person becoming dependent or remaining independent in their own home. Subject to legislation, from April next year I plan to remove these charges altogether. Through ring-fenced funding up to half a million extra pieces of community equipment will be provided free of charge to an estimated quarter of a million more older people."
On increased choices for older people Mr Milburn said:
"Older people will be given a direct choice over their own care. Direct payments have given younger disabled people the chance to spend for themselves the resources they are assessed as needing. Now, in line with our manifesto commitment, we will make it an obligation on every local authority, for the first time, to offer older people access to direct payments. Every older person assessed as being in need of care - whether for rehabilitation after a hip operation or for a bit of help with household chores - will be given the choice of receiving a service or receiving a cash payment to purchase care for themselves that better suits their individual needs.
"We will work with older people's organisations to make this choice a reality for tens of thousands of older people. I believe this reform will empower older people, their families and their carers in a way that has never been possible before. Direct payments will give older people direct choices over the services they receive."
On more support for carers Mr Milburn said:
"Many older people rely on more informal care from their family, friends and neighbours. Without the millions of carers in our country the services provided by the NHS or local councils simply could not do their job. The whole country owes our community of carers an enormous debt of gratitude. They are living proof that there is such a thing as society.
"In recent years we have provided more help to carers. Now we can build on that and I intend to more than double the Carers Grant to £185 million by 2006. As a result 130,000 additional carers will get help not just with short breaks through respite care, but with the extended care they themselves need so they can continue caring. Carers put so much into the community, it is right they should get something back.
To ensure that councils do offer older people more choices and better care, as announced in Delivering the NHS Plan, a new independent Commission for Social Care Inspection will be set up. The new body will begin operating in shadow form by the end of this year and will play a key role in driving forward with reforms to older people's services.
Mr Milburn concluded:
"These reforms and these resources will increase capacity to make choice a reality for hundreds of thousands of older people. There will be more places in care homes and sheltered housing. There will be more intermediate care services. And crucially there will be more support to live at home for older people and for their carers. More older people will be able to access more services and exercise more choice.
"The emphasis must now be on helping more older people to live more independently for more of the time. When these reforms are fully implemented, there will be a greater proportion of older people being cared for at home.
"After all that is the choice most older people say they would prefer. That is what older people have every right to expect. It is what we intend to deliver."
Notes to Editors:
1. In April's Budget the Government announced that from next April social services funding would increase by on average 6% per year over and above inflation. This package announced today outlines how this increase in funding will be spent. This equates to £1billion extra a year by 2006.
2. Guidance on the single assessment process for older people was issued in January 2002 and will be fully implemented by 2004. It will minimise duplication of assessments by agencies, and save older people from having to repeat their personal details and needs to a range of professionals.
3. £300m was made available over last year and this year, £100m in 2001/2 and £200m in 2002/3 to provide for a continued reduction in the number of delayed discharges from hospitals and build greater confidence and stability in the care sector. This money is already delivering results. In March 2001 there were 5,938 delayed discharges among the over 75s and at the end of March this year 4,691.
4. For media enquiries please contact Lisa Ward or Shima Islam at the Dept of Health media centre Tel: 020 7210 5315/5375.
