RCVS Network Meeting - Health & Social Care 3 rd June 2014 Richmond Council Update

1. RCVS Network Meeting - Health & Social Care3rd June 2014 Richmond Council Update Cathy Kerr, Director Adult & Community Services

2. What I Will Cover • Overview of policy direction for adult social care • Local elections • Health partnerships • Care Act 2014 • What all this means for Voluntary & Community Sector (VCS)

3. Direction of Travel for Adult Social Care • Focus on prevention • Promoting independence • Choice & control • Inclusion • ‘Joined up’ care & support

4. Local Elections • May 2014, Conservative party retain council control • Seats - Conservative - 39, Lib Dem -15 • Cross party support for health & social care policy direction • Administration priorities include: • Caring for vulnerable people, prevention, an age friendly borough, tenants champion, role of voluntary sector, commissioning council, sharing with others. • National elections by May 2015 • Public sector financial position

5. Health & Social Care Integration • Why? • People want joined up support • It makes best use of our collective resources • New local authority powers arising from H&SC Act 2012 • Health & Wellbeing Board & HWB Strategy • Public Health in local authority • Integration • Work with our health partners to integrate • Commissioning – JCC • Delivery – joint teams – RRRT • Local joint strategies eg Better Care Closer to Home

6. The Care Act 2014 - What is it? • Biggest change in adult social care legislation for 60 years • Based on principle of wellbeing • Encompasses whole population • A new policy framework (from April 2015) and • A new funding framework (most from April 2016) • Local implementation arrangements including co production group. Newsletter imminent

7. The Care Act – key changes • Personal budgets on a legislative footing and right to a direct payment. Direct payments for residential care • Carers rights on the same footing as the people they care for. • Changing eligibility criteria for services. • New assessment framework • Preventing and delaying needs for care and support & providing these services for the whole community • Provide comprehensive information and advice including independent financial advice. A web based resource directory

8. The Care Act – key changes • Self funder rights to assessment, support plan and care management (councils could charge) • Adult safeguarding on a statutory footing. • Duty to shape the market (wider than just the services we commission directly) • Ensure no one goes without care if providers fail, regardless of who pays • Transition from children to adults – right to assessment before age 18 • Portability – for service users transferring from one LA to another to ensure continuity of care • Duty to promote integration running through all

9. The Care Act - Funding Reforms • To give more certainty and peace of mind over the costs of old age or living with a disability • Everyone receives the care and support they need and more support to those in greatest need • End to limitless care costs • People protected from having to sell their home in their lifetime to pay for care • Improved options for those who pay for their care • Consistency between different areas and for non-residential and residential care

10. What is changing? Funding Cap • Capped Lifetime Care Costs - £72,000 – currently no limit for people with assets • Lower cap to be set for people with care needs before old age • No costs for people with on-going care needs from childhood

11. What is changing? Extended Means Test • More people to receive state-funded support with changes to the means test • Capital limit increased from £23,250 to £118,000 (for care homes) • Capital limit increased from £23,250 to £27,000 for non-residential care (Richmond’s current limit is £35,000) • Assets below are £14,250 are not included in the means test - this will be £17,000

12. What is Changing? Care Homes • Deferred Payments from 2015 • no one will have to sell their home in their lifetime • Councils will be able to charge interest during the period of the agreement – currently no interest applies during care home stay • Care Homes from 2016 • Contribution to Daily Living Costs (around £12,000 pa) separate from care costs • Daily living costs not subject to the cap • Direct Payments for Residential Care from 2016

13. Case study – Mrs B • Has capital of £20k, property of 200k and weekly income of £260 a week • Has homecare of £100pw & contributes £64. After 3 years moves to care home @ £630 pw. • Current system: in care home pays full cost of £630 until capital falls below £23,250 • New system: Reaches funding cap of £72k after 5years 8 months, after which she pays £230 pw. Care costs of £400 met by the council.

14. The Care Act – Local Implications • We expect substantial increase in demand from self funders but impossible to accurately predict the financial impact • Self funders – occupy 51% of care home beds & only 13.5% of people 80+ currently receive care from the council. • Substantial growth in older population, high proportion of people age 85+; many age 75+ living alone

15. What Does This Mean for the VCS? • A Key Partner for the Council (and CCG) • As commissioned provider of services: • Particularly supporting independence and prevention • Learning from work to date – CILS • Future opportunities • As voice of the sector and bringing service user / carer voice • Engagement routes: • Health & Wellbeing Board • Contribution to strategy development and key programme of work • Care and Support Partnership