The Care Act puts a responsibility on Councils to help self funders micro-commission care. Ray Hart from Valuing Care explains more read more The Care Act puts a responsibility on Councils to help self funders micro-commission care. Ray Hart from Valuing Care explains…
With the Care Act coming into force in April, it is time for social care departments to examine the additional support required for self-funders. A number of issues remain despite councils taking steps to improve their offering; many departments are unaware of the numbers of self-funders that will pass through the doors, or the level of professional support required.
There is a statutory responsibility for departments to help self-funders “micro-commission” care, and ensure a supporting infrastructure is available. In response to the government’s Putting People First agenda many local authorities have introduced web-based systems; e-marketplaces for people to search, and buy care and support services online, which also offer information to support safeguarding and advice on costs and quality of services.
Self-funders are making huge financial decisions which require expert purchasing advice and support. The right guidance at this point prevents people spending their assets too quickly and falling back on to local authority funding, something that often happens. It is crucial to fill these gaps in support with tried and tested approaches before the Care Act requirements are needed.
After those who will be funding their own care have qualified for assistance, the most critical factor is determining what services are needed. This can range from simple signposting and guidance through to financial and legal support services.
At Valuing Care, our experience of negotiating cases for self-funders has provided insight into this area. Residential or nursing care is the default option, particularly arranged during a crisis or hospital stay. The professional support provided at this time usually consists of information and advice, not the commercial elements of purchasing care, such as securing a good price on the placement. People often believe high costs mean high quality. And once the placement is made, self-funders and their relatives often feel trapped financially with little or no commercial leverage. It is common to see contracts signed enabling the provider to increase fees between 7 and 9 per cent a year.
Most departments split the assessment and support plan functions from the buying of care; a separation between social worker and purchaser. Those responsible for buying care will work on setting and maintaining contracts with care suppliers, and the prices paid to providers, as well as on wider market management.
This common split in council departments is not how self-funders are arranging care. Relatives are commonly undertaking their own needs assessment, arranging care and making the purchasing decisions, while having little or no understanding of the care market. Given their lack of experience in care commissioning they are probably not the right people to do this, particularly at a time of crisis.
Despite this being known, so far councils are focusing on increasing the amount of advice available, or outsourcing the self-funding support service to one professional support supplier.
Councils that are considering outsourcing to professional support suppliers are basing the requirements for support on existing arrangements they have with advice agencies, or through their contracts for personal budget support, which are primarily aimed at long-term complex cases. In our experience, the needs of self-funders tend to be completely different to long-term cases. They need an intensive six-week period of support, with a good proportion of this being commercial.
This is very similar to the support given to older people financially supported by the council. There is a need to mirror the current set up within councils, which has emerged through years of dealing with transactional support of care home and domiciliary placements. If these arrangements are good enough for public money, then why not the same for self-funders?
It’s time to look at existing arrangements for supporting self-funders and examine whether a central commercial self-funder purchasing team needs to be created, either within the council or outsourced to a third party. These teams could work at an individual council level or across a wider geographical area. This will enable the councils to give commercial power back to the self-funders in arranging their care.