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Community care - some questions answered |
More money for community care
Our letter to the Minister asked how he would ensure that the extra money promised by the Chancellor in his annual spending review "especially to improve community care for the elderly" was used for that purpose. The answer we received was:
"The Department of Health does not instruct councils on how to spend the money they receive. It is up to councils to consider their local priorities and decide how they spend their budget to best meet the needs of their local population."
So it's up to us to ensure that Southwark Council gives top priority to community care for the elderly in its spending plans for the next three years.
Extra care housing
We asked about the Government's plans for extra care housing to enable older people to live at home for as long as possible. The Government fund set up for this purpose was expected to provide only 1,532 extra care housing units in 2004-05 over the whole country. We asked how many were planned for future years. In reply, we were told that none of the 1,532 new units were in Southwark; but local authorities were now being encouraged to bid for money for 2005-06, and another £60 million would be provided for the two years 2004-06. The letter continued:
"It is very much the long-term target that extra care housing should become the dominant form of housing, care and support for older people over the next 20 years. It will be the work of a generation to modernise the housing with care options for older people in this country, but I hope you will agree that an excellent start has been made with a significant increase in public funds to promote, prompt and provide more extra care housing."
It sounds encouraging, but we're now trying to find out what the Council is doing to ensure that Southwark gets its share of extra care housing. Watch this space!
Direct payments
We asked about the use of “direct payments” - paying people in need of care to make their own arrangements - in cases where care is provided by family members. We noted that there must be many family members who could be rewarded for their services in this way; but was this a development that the Minister would welcome or that local authorities were encouraging? In reply we were told:
"Councils are able to make conditions about who can be employed in individual circumstances. There may be legitimate reasons for doing so but a decision should be taken according to the merits of each individual case."
This tells us nothing about the Minister's views but does make it clear that, in cases where the regulations allow payments to family members, the Council cannot object unless there are good grounds for doing so in the particular case.
Pressure to accept direct payments
We asked what guidance had been issued to local authorities to prevent pressure being exerted on older people to accept direct payments. The reply was:
"A person must be able and willing to have a direct payment even if they need help to manage one. If a person does not want a direct payment, their social services department must provide or arrange services to meet their assessed needs instead."
This doesn't really answer our question. Local authorities are themselves under pressure to increase the number of direct payments and, while we have no reason to think that undue pressure is being exerted on older people in Southwark, we remain concerned that this could be happening elsewhere.
Separate bank accounts
We pointed out that Southwark Council required people to open a separate bank account for direct payments and asked whether this was really necessary. The reply was that this was a recommendation of the Chartered Institute for Public Finance Accountancy - "not a matter of trust so much as a practical way that councils can account for public funds". We still think it's needless red tape!