Local authorities are pulling out all the stops to get ready for the Care Act. But in the mad rush to get all the relevant training and systems in place, one issue risks getting seriously overlooked. With new eligibility criteria being introduced from April, how can we hope to meet the needs of older people who remain unlikely to get any local authority-funded care?
Worryingly, our recent research with the Strategic Society Centre revealed it is not just adults with so-called moderate needs who are missing out on care and support. By bringing together data from the census and the Health and Social Care Information Centre, we were able to consider how many older people who struggle with even the most essential activities of daily living (ADL’s) get the help they need.
What we found was alarming. There are 70,000 older people in England who struggle with three or more aspects of self-care, who don’t receive any form of paid or unpaid care. These are people who report having difficulties completing three or more of the most basic tasks, whether it is getting in or out of bed or going to the toilet unaided.
“Unmet need” is a contested concept. But whatever definition of unmet need we choose to use, over 360,000 fewer older people received local authority social care services in 2013–14 compared with 2008–09. A grave situation indeed.
The crucial point raised by our Bigger Picture report is that deep pockets of unmet need are emerging across the country. In some areas of England the numbers of pensioners in receipt of publicly funded support don’t appear to correspond with the numbers of older people who experience the biggest difficulties going about their everyday lives.
So what steps can local authorities – and the government – take to reach this core group of 70,000 who need assistance with multiple tasks? Part of the answer is that there are some things only the Treasury can help with. It is not too early to be making the case for more funding to be delivered in the next spending round.
The other part of the answer might see local authorities rethinking how they work with different partners to engage older people with limited day-to-day activities. Since many older people who have difficulties with ADLs appear to have greater contact with primary care than they do adult social services, creative partnerships could be sought in the interests of helping refer older people from the places they typically access the most.
We have heard of promising work in areas like Camden, where funding from the Better Care Fund will be used to pilot projects such as social workers in GP surgeries to better identify risk and prevent delays in assessing the most at-risk groups.
The Bigger Picture research also highlights the large numbers of older people with day-to-day difficulties who have contact with the disability benefits system. There is a strong case for making sure that applications for attendance allowance, regardless of the success of any claim, should be followed by the offer of a range of information, advice and potentially lower-level support, such as telecare.
As a charity advocating for older people concerned about care, we will continue to call for the funds local authorities need to deliver on the promise of the Care Act. In the meantime, there are a number of other practical measures councils can start putting in place, such as through the kinds of joint working arrangements Camden has initiated. With less than a month to go until the act takes effect, there is work to do to make sure older people don’t have to struggle on their own.