SCIE media statement

Eligibility and assessment – making the Dilnot and Law Commission reports workable

20 March 2012

A new report is published today providing critical analysis of what needs to happen to make key aspects of the Dilnot and Law Commission recommendations workable. These publications, and much other work, will inform the Social Care White Paper expected shortly.

Today’s report, from the Social Care Institute for Excellence (SCIE), concludes that there are significant issues over the implementation of reform that need to be addressed. It identifies three central issues:

SCIE’s Director of Adult Services, David Walden, says:

This report is a timely reminder that the reform of assessment and eligibility for publicly funded social care cannot be approached simply as a technical matter.  Tools are only part of the process and the central focus has to be on meeting people’s individual needs and aspirations, and delivering better outcomes in ways that are judged to be fair.

Eligibility

Who is eligible for care and support? The Dilnot Commission proposed the introduction of a national eligibility threshold for access to publicly funded social care to provide a “clearer, fairer and more coherent system for the public”, and to address the widely criticised “postcode lottery” of different eligibility thresholds operating in different councils.  The SCIE report, written by Melanie Henwood Associates, concludes that eligibility cannot be looked at in isolation, as much depends on whether or not people can access preventive and community services without meeting the eligibility criteria.

Assessment

The Dilnot Commission also recommended that a new assessment tool should be introduced. The SCIE report concludes that no tool will ever be entirely objective because it necessarily involves interpretation by an assessor. The study finds no appetite among staff for a new tool; it also finds considerable awareness that several attempts have been made in the past to implement new approaches and tools, with mixed results. There are multiple assessment tools in use in social care and the introduction of another would not of itself guarantee greater consistency.  There are particular challenges when ensuring that any tool recognises the complexity of people’s lives and also addresses aspirations and preferences that maximise independence.

Limited liability and the capped contribution

The report also considers the implications of establishing limited liability for individuals for care costs, by the proposed capped lifetime contribution, suggested at £35,000. There would be considerable demands on the assessment system to determine people’s needs and the “virtual spend” (see Note below) to which they are entitled. Reform would have to address what must be done to avoid the process becoming highly bureaucratic and complex to administer.

The SCIE report concludes that changing the model of assessment, and redefining the eligibility threshold, could have unintended consequences.  It is vital that these matters are fully understood and addressed if the much-needed reform of adult social care are to be implemented successfully.

Links

Note on "virtual spend"

Under the capped contribution model, anyone would be able to request an assessment of their needs for care and support.  If a person met the eligibility threshold but had assets above the financial limit (currently £23,250 but Dilnot proposed raising this to £100,000) they would have to pay for their own care.  However, the cost of meeting their needs would be calculated  and this ‘virtual spend’ would then be counted towards their capped contribution.  Once the virtual spend reached the cap (suggested by Dilnot at £35,000) they would then become eligible for publicly funded support.

Media contact

Steve Palmer | Press and Public Affairs Manager | Tel: 020 7766 7419 | Mob: 07739 458 192 | Email: media@scie.org.uk