1. Review and Development of Adult Social Care Relative Needs Formulae Jude Ranasinghe, Director 17 September 2013

2. Presentation Overview  Current adult social care spending/funding  Care Bill and future funding implications  Remit of our research/timescales  Impact assessment  Activities to date  Local authority funded clients  Self-funders  Modelling local financial implications

3. Planned Expenditure 2013/14  Total planned expenditure in 2013/14 of £14.650bn

4. Current Adult Social Care Funding  Funding received through council tax; fees and charges; specific grants; and general grant  Significant funding received through general grant via Relative Needs Formulae (RNF) – part of Business Rates Retention system  RNF are a set of formulae accounting for relative differences in costs of delivering services – younger adults and older people  But formulae currently ‘frozen’ and not expected to be updated until next reset (at least 2020/21)  Specific grants – NHS funding for social care (£859m) Local Reform and Community Voices (£42m), Community Capacity (capital £129m) – all use the current RNF

5. Current Adult Social Care RNF  Current formulae developed in 2005, implemented in 2006/07  Younger adults (18-64):  Basic amount for all resident adults aged 18-64  Deprivation top-up (DLA, never worked/l-t unemployed, routine occupations, no family)  Area Cost Adjustment  Older people (65+):  Basic amount for those aged over 65  Age top-up aged 90+  Deprivation top-up (AA, Income Support/Pension Credit, rented accomm, living alone)  Low income top-up (LA charges)  Sparsity top-up (domiciliary care)  Area Cost Adjustment

6. Care Bill and Implications for Future Funding Reform currently taking place in relation to ASC funding May 2013 - Care Bill incorporating clauses to implement Dilnot proposals placed before Parliament July 2013 - DH consultation paper, “Caring for our future: Consultation on reforming what and how people pay for their care and support” Essentially, affects eligibility for social care support in terms of: Care need Means test Particular issue is that people currently self-funding their care will need to be assessed and will become eligible for LA support

7. Care Bill and Implications for Future Funding 1.Care plan/account: to assess and monitor needs/outcomes/spending 2.Cap on lifetime costs of care, with full state support after the cap: older adult cap £72k from 2016/17, younger adult cap TBC 3.Free support for those transitioning into adult social care: zero cap for clients turning 18 with eligible care/support needs i.e. no means test 4.Extend the means test: upper limit changing from current £23,250 to £118,000 in 2016/17 for home owners receiving residential care

8. Care Bill and Implications for Future Funding 4. Standardise general living “hotel” costs: from 2016/17, contribution of £12,000 p.a. for residential care living costs 5.Standardise national eligibility criteria: national minimum eligibility threshold in Care Bill from 2015/16 (level TBC) 6.Deferred payment scheme should be extended to a universal entitlement: will be nationally available from 2015/16

9. Remit of our Research - Formulae 1.Local authority funded clients, although not currently planned to update until next reset of system (2020/21). However, is currently used for DH specific grants and NHS funding for social care 2.Introduction of the universal deferred payments scheme from 2015/16 3.Assessment/metering costs from 2015/16 (£335m in total for 2. and 3.) 4.Introduction of the cap on eligible care costs from 2016/17 5.Changing the capital limits for people in residential care from 2016/17  We are not looking at quantum of funding  Impact assessment by DH on costs of social care funding reform

10. Impact Assessment of Funding Reform 2010/11 prices (£m)2016/172019/202025/26 Older people – cap and means test extension3601,1501,940 Older people – assessment, case mgt, review210230290 Working age – all costs100210420 Total costs6601,5902,640 Reduction in AA/DLA benefit costs(130)(250)(340) Net costs5301,3402,300 Source: DH Social Care Funding Reform Impact Assessment, April 2013

11. Impact Assessment Source: DH Social Care Funding Reform Impact Assessment, April 2013

12. Impact Assessment Source: DH Social Care Funding Reform Impact Assessment, April 2013

13. Project Timetable Project initiation/ engagement Autumn 2012 LA contact, feasibility work and data collection piloting Spring 2013 LA and care home data collection – Summer/ Autumn 2013 Analysis and modelling Spring 2014 Peer review/ consultation/ formula outputs Summer 2014 National data collection, local data verification, analysis Winter 2013

14. Activities to Date – General and LA Funded  Engagement with ASC stakeholders – Steering Group (monthly) and Project Advisory Panel (quarterly)  Approval from National Research Ethics and local Research & Governance Committees  Pilot process for LA data collection with c.10 LAs  Development of data guidance/definitions/templates  Now working with 65 LAs to actually collect data

15. Activities to Date – Self-funders  Feasibility study on availability of self-funder data  Asked LAs about information held on self-funders  Investigating potential data sources on domiciliary care  Draft survey for distribution to private sector residential care homes on self-funders

16. Local Authority Data Collection – Volunteers by Type/Deprivation Authority TypeNumberDeprivation Level: LowDeprivation Level: MediumDeprivation Level: High County Council14 Buckinghamshire Cambridgeshire Hampshire Oxfordshire Surrey Essex Gloucestershire Suffolk Derbyshire East Sussex Kent Lancashire Lincolnshire Nottinghamshire Inner London9 Camden Kensington and Chelsea Westminster Hammersmith and Fulham Hackney Haringey Islington Newham Tower Hamlets Outer London9 Merton Sutton Bexley Hillingdon Hounslow Croydon Ealing Enfield Waltham Forest Metropolitan Borough13 Kirklees Leeds Sefton Solihull Stockport Coventry St. Helens Birmingham Manchester Oldham Rochdale Sandwell Wolverhampton Unitary Authority20 Bracknell Forest Cheshire East Cornwall Isle of Wight Isles of Scilly Shropshire Wiltshire York Bedford Milton Keynes North Somerset Northumberland Reading Swindon Torbay Blackpool Durham Hartlepool Leicester Peterborough Total 65 231626

17. Local Authority Data Collection – Volunteers by Region Region County Council Inner London Outer London Met. Borough Unitary Authority Regional Total % of All Auth. EAST 3 2545% EAST MIDS 3 1444% LONDON 99 1855% NORTH EAST 3325% NORTH WEST 1 62939% SOUTH EAST 6 41053% SOUTH WEST 1 6744% WEST MIDS 51643% YORKS & HUMBER 21320% Auth. Type Total 149913206543% % of All Auth. 52%64%47%36% 43%

18. Data Collection from LAs  Collecting data at small area level (Lower Layer Super Output Area)  Using activity data from national returns for consistency/control totals by client group and care type  Residential care – ASC Combined Activity Return (admissions in 2012/13, care home address and pre-care address)  Non-residential care – Referrals, Assessments and Packages of Care Return (clients as at 31 March 2013)  Separated requirements into ‘core’ and ‘supplementary’  Team of 10 researchers, range of on- and off-site support to LAs  Secure data transfer portal managed by University of Kent

19. Data Collection from Care Homes  Also seeking data at LSOA level from private sector care homes  Interested in numbers of self-funders and publically supported  Numbers from outside the LA area  Room price data  Length of time self-funders have been resident  Will combine this information with other data e.g. wealth characteristics, to identify nature of self-funder population and likely implications for future LA support

20. Modelling Local Financial Implications of the Care Bill  Also offering separate support to LAs looking to undertake more detailed local modelling  Reviewing range of national and local data sources  Advising LAs on key local data  Building a bespoke local long-term model, with guidance  Will allow for ‘what-if’ scenarios  Reporting summary implications

21. Next Steps  Continue work with 65 LAs on LA-funded clients  Run self-funder survey with care homes  Verify and analyse data  Analyse/collate national datasets e.g. Census, benefits  PSSRU will develop formulae

22. Further Information  Dedicated project website at www.adultsocialcarernf.co.uk/ Contains a range of information/documentation/latest newswww.adultsocialcarernf.co.uk/  Contact directly at jude.ranasinghe@lgfutures.co.ukjude.ranasinghe@lgfutures.co.uk or on 01908 424387 This research has been commissioned and funded by the Policy Research Programme in the Department of Health. The views expressed in this presentation are not necessarily those of the department.