We welcome the Scottish Government plans to extend Free Personal Care to all adults who require social care.  However, we have concerns that the intention and ambition of this policy may be undermined by the mechanisms used to implement it.

In announcing this policy, the Health Secretary, Shona Robison said

We will now take forward the work of extending free personal care to everyone who requires it, regardless of age. At least 9000 people will benefit from this change and we will work closely with local government and others to implement these changes so that all those who require personal care are able to access it.”

We understand that the government is likely to implement this policy by amending existing legislation, producing new guidance, then transferring additional funding to local councils, with the expectation they will use this additional resource to reduce care charging for disabled people.

If this is the mechanism used to deliver the extension of free personal care to under 65s, then we have evidence that it will only benefit a small proportion of the 9,000 people who access personal care and will fall far short of the government’s ambition for this policy that ‘all those who require personal care are able to access it.’

We believe that if this proposal is to deliver the change that is expected by the Scottish Government and disabled people, then a fairer method of implementation is needed.   In order to deliver the Extension of Free Personal Care, each adult under 65 receiving care would still be assessed and the balance between personal care and other support in their care package would be identified.  

 The current charging regimes would still be applied with all the income thresholds, allowable expenses, taper rates and service rates.  However, at the end, after the current calculation has been made, a Personal Care Rebate is applied to the charges deducting the individual cost of personal care hours.

The Cost of Personal Care is a simple calculation of number of hours times the local hourly rate.   This establishes the maximum possible level of rebate.  The value of the rebate can never be greater than the “original contribution/charge”. 

  • Where the cost of personal care was higher or equal to the “original contribution/charge” a null charge would be set.
  • Where the cost of personal care was lower than the “original contribution/charge” a reduced charge would be set.

The Scottish Government would still set the amount it was going to transfer to each local authority in lieu of personal care charges in its normal budget setting process

We have published a more detailed paper that goes into more detail and looks at the equality issues about treating older people and younger adults differently.   Download the full paper

The new Scotland Against the Care Tax Care Charge Calculator.  This online tool will help you see what difference the Scottish Government's proposed extension of Free Personal Care will make to you and others.   Enter a few simple details in the calculator to get a personal result or just change the council area to see how things vary around the country.  

The Personal Care Calculator  or click the Our Calculators link on the right of the page.

 

No one knows how Local Authorities will estimate future personal care needs for people under 65. For new social care users it will be part of the assessment process but for existing social care users there may need to be a new assessment for everyone who gets social care. We can't do that here. So we suggest 3 methods of working out your future social care needs

You can use our "what type of care" calculator where you break down current support into the type of support that is listed in local authorities' current personal care definitions.  There are over 40 different categories of care included (see the table below) so it is comprehensive but we also know it is quite time consuming to complete.  If you want to use this calculator it is the second calculator on "Our Calculator" page - the orange and green one!

There are two quicker alternatives

You could assume that the average level of personal care hours that over 65s get (8.6 hours) will apply to you but that would make no sense for those who got less that 8 hours of support.

You can try different percentages of your support in the future care boxes - so much in the personal care box and so much in the other care box. 50:50 - 60:40 -  70:30. That way is easiest and will let you see the results different breakdowns make very quickly.

 

What is Personal Care?  
The following definitions used by one Scottish Council provide a model to be used to
 classify the tasks required to meet Service User needs into personal or non personal care.
This is a broader and more general definition than that which is used by many other councils
The Scottish Government has said that they expect the extension of FPC to be on the same basis as Personal Care definitions are currently for the over 65s.   This list is probably the best that can be expected.  It may be more restricted in some areas.  
Personal Care Tasks   
Personal Hygiene  Bathing/Showering
  Continence Management
  Toileting
  Incontinence Laundry
  Bed changing
  Hair washing
  Shaving
  Oral Hygiene
  Nail Care
  Skin Care
Health/Wellbeing  Medication administration – including eye drops
  Medication prompts – including eye drops
  Medication remind devices
  Application of creams or lotions
  Catheter care
  Stoma care
  Simple dressings
  Oxygen therapy
  Going to and getting up from bed
  Dressing and undressing
  Behaviour management
  Psychological support
Meal preparation  Preparation of food
  Fulfilment of special dietary needs
  Prompt/assist with feeding
Mobility  Transfers including use of a hoist
   
Non Personal Care Tasks  
Meals  Plating and/or serving of meals and drinks
  Housework Domestic laundry/ironing service
  Firelighting/dishwashing/hovering/polishing
  Use of domestic equipment/repairs
Shopping  Domestic shopping/pension service/bill paying
Assistance with daily living  General counselling and support
  Maintain security of home & possessions
  Maintain security of their finances
  Maintain their personal safety
  Lifeskills
  Engaging with professionals
  Advice on aids & adaptations
  Advice on budgeting & debt, welfare benefits/official
  correspondence
  Managing relationship with neighbours/disputes

If you like the video that Kiana has produced, then we would ask you to write to your MSP to tell them about the Care Tax. You can download a word document here that will serve as a starting point.  Don't forget to put your own address and the name of your MSP in as well.   

Thanks for your help

Responding to the Care Charges Consultation

When responding to a consultation, using your own words and experiences helps to make your contribution stand out.  We have chosen not to produce a single standard response in order to encourage more individual replies. 

But we would like to make it as easy as possible for you to reply to the consultation and have put together some bullet points for you to consider before answering each of the questions.   Feel free to base your responses around these points or as a spark to write your own comments based on your personal experiences and views. 

            Bullets Points for each Consultation Question

 1.       Do you support the principle that non-residential social care services should be available free at the point of delivery to those who have been assessed by a relevant professional as requiring them (as is the case within health care)?

Yes

·       Human rights should not be affected by which organisation, NHS or local authority social care, gives you help or support.

·       Having to pay to exercise basic rights like to get out of bed discriminates against disabled people.

·       Care charging is an unnecessary barrier for proper Health and Social Care Integration

·       Any distinction between “health” and “social” care is false. Poor social care will lead to poor health.  Poor health care will make good social care very hard.   The distinction is based on outmoded values and approaches.

·       Some people worry that more people will ask for social care if it is free but already not everyone who asks for help gets it.    Local authorities and health services already have elaborate systems established to ensure that only people who need help get it.  These include assessment systems and eligibility criteria which are likely to stop lots more people getting social care, even if it is free. 

·       Care charging financially disadvantages disabled people and can push them into poverty