What will the government’s proposals mean for the social care system?

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The government’s adult social care proposals, announced in September 2021, are a good step towards reform, if not the giant stride that was needed to genuinely ‘fix’ the system, as the Prime Minister promised. This is a quick guide to how the social care system works now – and how the government’s new plan would change it.

How the social care system currently works

The current system is needs and means tested

Social care is not like the NHS, which is free at the point of need. Instead, before an individual can receive publicly funded adult social care they will be assessed to make sure their needs are high enough and their assets – for example, their savings or home – are low enough.

Many people have to pay for their care from their assets – their home and savings

The rules and regulations covering who is charged and how much they are charged are really complicated and have lots of caveats and exceptions so what follows is a basic summary.

If an individual is assessed as needing care in a care home, they will have to pay for it themselves if they have assets worth more than £23,250. If they are assessed as needing care in their own home, the £23,250 threshold still applies but the value of their home is no longer taken in to account.

If they have assets below £23,250 but above £14,250 they will be charged a proportion of the costs of their care.

People may also have to contribute to their care from any income they have

Even if an individual does not have to contribute to the costs of their care from their assets, they may still have to contribute from any income they might have. For example, if someone is in a care home they may contribute all their income (until the costs of the care are covered), apart from £24.90 a week for expenses. If someone receives care at home, they may contribute all their income (until the costs of their care are covered), apart from a sum no higher than the Minimum Income Guarantee, which varies according to age and other circumstances. This figure has not been rising in line with inflation.

If people are not eligible for publicly funded care, there is no limit on how much they might have to pay privately

If an individual has assets above the £23,250 threshold, they have to pay for their care, rely on family or friends, or go without care. If people do pay for themselves, there is no limit to how much they might have to pay over their remaining lifetime. The average cost of a care home in England is around £35,000 a year and some people spend many years in care. So, it is quite possible to end up paying ‘catastrophic costs’ of £100,000 or more. In 2011, the Dilnot Commission estimated that 1 in 10 people might pay more than £100,000.

How the government’s proposals would change the social care system

The government’s proposals would make the means test more generous

Instead of having to pay for all their care if their assets are above £23,250, from October 2023 an individual would only pay for all their care if their assets were more than £100,000. And people would only start to contribute towards their care if their assets were more than £20,000, not £14,250. People with assets of between £100,000 and £20,000 would contribute towards the costs of their care on a sliding scale.

The levels of the Minimum Income Guarantee and the Personal Expenses Allowance in care homes will also start to rise with inflation from April 2022.

The proposals would also set a ‘cap’ on the amount an individual would pay for care in their lifetime

If someone has to contribute towards the costs of their care, there would now be a limit – a cap – on how much they are expected to pay over their lifetime. This cap will be set at £86,000. Once an individual has spent that amount, the government would take over paying their care costs. And in practice many people with medium to low levels of assets would spend less than that before they reached the cap. This is because the means test is more generous, and people who have assets of less than £100,000 would only be a contributing a proportion of their full care costs, with the government making up the difference.

There are some caveats

The cap would only cover the cost of a care home that an individual’s local authority was willing to pay for (not, for example, a more expensive one, even if it would be more convenient). Or if an individual receives home care, it would only cover the number of hours their local authority thinks they need at the price it is willing to pay. And it would not cover the cost-of-living expenses in a care home (meals, etc). And all these figures will change over time with inflation.

What else is in the reform package?

There are other measures in the reform package, including one to ensure that people who pay for their own care get the best deal by letting them ask their local authority to arrange their care.

There are also promises to boost career progression in the adult social care workforce, support unpaid carers, invest in housing, improve information and oversee the social care performance of local authorities.

Comments

Ann glenton

Position
Retired CBT therapist,
Comment date
18 September 2021

Dad currently lives in a care home and due to him working paying national insurance and towards a pension and saving all his life . He has to pay all his care home fees.
He has vascular and mixed dementia. COPD probably due to working many years down mines. Also has atrial fibrillation. And stage 3 kidney disease. He has macular degeneration in both eyes ( poor eye site) and has had 2 knee replacement and has stenosis iOS the spine he can hardly walk. Without help he is doubly incontinent . High risk of falls, cannot dress or independently feed himself. He constantly gets chest and urine infection leading to delirium and when this happens he becomes more disoriented and irritated and sometimes aggressive. Yet under the long term care assessment he is not deemed disabled enough to qualify for help with long term care.it Beggars belief.
He gets nursing funding paid directly to the nursing home as he had 2 falls hitting his head and 2 brain bleeds and had to be taken off blood thinners so is high risk of stroke and heart attack.
This is about £150 pounds per week.
But he still has to pay £750 per week or £120 per day approximately for residential fees these include carers looking after him to see to and help with all the above needs.
Now what I want to know is in the proposed changes will he still have to pay these residential fees baring in mind if he was healthy and did not have as many disabilities he would not be in a care home in the first place
How will the break fees down to cost of care and food etc

Vicky Hutchings

Position
voluntary job,
Comment date
18 September 2021

Could you confirm the point in the article which says those with assets of under £100,000 will have paid out less that £86,000 when they reach the £86,000 cap? I read the printed social care changes as saying everyone will have paid out £86,000 when they reach the cap...but some will reach it more quickly than others, as they will have been paying less for their care and it will have taken longer to reach £86,000. Thanks for the help.

Roger Peeks

Position
Retired,
Comment date
13 September 2021

In the Daily Mail 8/9/2021 It is suggested that the new £100,000 asset floor below which people will get help with their care costs will begin straight away. The words in the Daily Mail were, “ But the £100,000 floor will begin straight away”.

I can not find this reported anywhere else. I would understand this since it might reduce social care costs to Local government substantially, but cost recipients of social care funding.

Currently if you have less than £23,250 in savings and own your home you can receive home care provided by the local authority, your home remains protected. Similarly if your spouse lives in your joint home and you have less than £23,250 in savings you can have residential/nursing care funding by the local authority. Your home remains protected for your spouse.

The new £100,000 asset floor does not appear to protect the family home in these situations. Suddenly local authorities might not have to fund many people who have their own home and Local authority charges on property to pay for social care will become more common.

The people who might gain are those , down to their last £100,000 in assets who will pay up to 20% of the value of their assets a year towards their care.

The reality is many families have less chance of holding onto the home when someone needs care.
If the £100,000 asset floor is immediate Local Authorities have got a busy time ahead and many people a big bill.

Sally Harper

Comment date
13 September 2021

Hi, you're right regarding the current situation. I'm not sure what happens under the new system?!

Stuart Ebsworth

Position
retired,
Comment date
11 September 2021

I thought I read that if your home is jointly owned by a husband and wife and one of he two has to receive care, the home would not have to be sold to cover care costs. Can anyone explain whether this is true within the new rules from October 2023 or is it just another bit of Boris bluster.

Maddy (Madhavi…

Position
Senior Research Fellow,
Organisation
UCL
Comment date
10 September 2021

Very well explained - thank you. The governments 33-page document accompanying the announcement cites numbers ('1 in 7' people aged 65+ will face lifetime costs of over 100k, on average it'll take 3.5 years to hit the 86k cap etc) and case studies which are meaningless as the assumptions/calculations are not provided. You are right to point out that the biggest, and most easily manipulatable, bottleneck to receive any publicly funded social care, even if you have very low assets, rests on determining eligibility via a needs assessment. Do you know if there are national care needs-assessment guidelines and if these are uniformly applied or depend on interpretation by each local council, depending on their (lack of) fund allocation?

Jennifer Griffiths

Position
Retired (Social Care),
Organisation
N.E.Lincs. Social Services
Comment date
09 September 2021

I am writing this as for the first time in my 74 years I feel I have no voice and that my government is actively working in a unilateral manner giving less than 24 hours for people in parliament to have an open and democratic discussion on such an important issue that will effect so many people. Just because three men tell us this is the right thing to do does not mean it is.

These are appox. details of real people in my close contacts. Couple No 3 refers to us.
The position we find ourselves in:
Couple No.1. Having downsize now live very well in a property of say £250.00 have holidays at home and aboard and inheritance from parents etc. increasing their bank balance by let’s say £100.00 they also have State and husbands Works Pension. One member of the partnership has not worked since1969 and paid no National Insurance and Income tax contributions. Couple have never claimed any state benefits.

Couple No 2. Live well in a house valued at appox. £150.000 both have a state and works pension (which they always topped up when they had an increase in pay) that gives them a comfortable lifestyle and holidays at home and abroad. They have savings just under £60.000. Both worked and paid National Insurance and Income Tax. The wife had part time jobs while the children were young. Like Couple No. 1 never claimed any state benefits.

Couple No 3 Worked on and off (through choice not illness) separated from original partners been on full benefits since at least 2000. Owned properties in the past with their separate partners and as a couple, some lovely holidays abroad. No assets happy in the knowledge the state (Tax Payers) will provide care when needed.

Couple No. 4 Separated late on in life after retirement, splitting assets and money. Money spent on rents, bills and holidays etc. Now recieving some benefits.

None of the above are what I would judge wealthy, and all have the choice to live life as they wish, however now all are at an age when they may well need some care support.

Only Couples No. 1 & 2 will contribute to their care, and of cause, contribute to the care of Couples No. 3 & 4

However as far as I understand only Couple No.2 are financially vunerable to losing everything they worked hard for when it comes needing care support.
Their home (or as government coldly sees as an, asset) will not cover the £86.000 limit if both need care so they will lose the family home.
As far as I can understand Boris and his pal’s minds, the balance of couple’s savings will be needed to top up their care meaning their commitment to topping up their pensions to ensure they remain self surficant will more than likely work against them when means testing kicks in. That is unless an 80 year old person can find an affordable Insurance Policy to cover to short fall.
We could see from the news that Boris and is two chancellors had no idea of the difference in house prices between North and South. At least I hope that is the case because if they did still set the threshold at £86.000 knowing that many people in northern constituency such as ours would have to continue to sell their homes to pay for theirs and others care just beggars belief.
I believe the same will be true for the younger generation of today paying higher NI as well as other financial stresses will reduce their ability to save for the future. I cannot see this solving anything due to the lack of honest consultations and is just kicking the problem further down the line.
Thank you for this opportunity to have a say. It has been a difficult and very stressful 2 days for me which has not been help by my inability to share with anyone who allegedly represents me.
NB. There are more Income Tax payers than those who pay NI including me, so why not spread a wider net, plus not let us forget the £350.000.00 wkly.income from the Big Red Bus Fairy-tail

Jean harding

Position
Carer,
Organisation
-
Comment date
09 September 2021

I am bitterly disappointed to read the above accounts.

Why didn’t Boris make it clear that the ‘cap) did not include accommodation, food etc etc?

The wool has been pulled over our eyes and I don’t like it!

Jean harding

Position
Carer,
Organisation
None
Comment date
09 September 2021

My husband has Dementia. I am his Carer. We get Attendance Allowance which helps pay for a gardener etc.

I was excited to think that we won’t have to sell our home which we struggled to buy and went without any luxuries early on.

But reading that accommodation, food and heating etc will has to be paid for has has shocked me! I am bitterly disappointed.

Mike Fordham

Position
Retired,
Comment date
09 September 2021

Jeremy, you echo my thoughts exactly. I can't believe that the media aren't all over this for the con that it is.

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