Westminster council underspends adult care budget by £4.4m - guardian

Westminster council underspends adult care budget by £4.4m

Labour leader says 'significant' surplus is result of rapid pace of cuts

• Gill Hitchcock
• Guardian Professional, Friday 30 March 2012 16.09 BST
• Article history

Westminster has reduced home care hours for disabled residents.

Westminster city council has underspent its adult social care budget by £4.4m so far this financial year, according to a report on the council's financial performance. The figure is part of a total underspend of £10.4m, which also includes a £0.8m underspend on children's services and £2.3m on housing.

Paul Dimoldenberg, leader of the Labour group on Westminster council, told the Guardian's social care network that the "significant underspend" was a result of the Conservative-controlled council introducing cuts, which should have been phased in over two years, more quickly.

"The council is speeding up the cuts and that is having an impact on the quality of care that the council is offering," he said.

The Labour group has highlighted the case of 49-year old Mary Garland, as reported by the Ham and High newspaper. Garland's home care hours were reduced from 19 per week to 10.5 hours after Westminster council changed its eligibility criteria.

According to the paper, Garland, who suffers from rheumatoid arthritis and Crohn's disease, said she asked her social care manager how there would be time for her home carer to help her properly. She said the manager recommended she would be "better off cutting her hair", as this would save the carer time.

Dimoldenberg said: "Westminster Conservatives are acting in the most hard-hearted and mean-spirited way by making even bigger cuts than agreed by the council and piling on the price increases on items that the poorest residents cannot do without."

The Conservative-controlled council's executive director of adult social care, Andrew Webster, said: "Westminster has overachieved in its saving targets this year to compensate for the tough savings of £16m that we need to attain by 2013-14.

"The council is working hard to make improvements to adults services to ensure we meet the needs of our most vulnerable residents whilst providing taxpayers the best possible value for money."

Webster also said that Westminster has created four new "community hubs" for older people and will be opening a new dementia centre to provide care facilities for residents and family carers.

According to Dimoldenberg, the Labour group has been successful in reversing a council decision, taken in August 2011, to cut the Taxicard service - which provides subsidised transport for people with serious mobility or visual impairments - by making it available only to people in receipt of benefits.

The group found that 50 blind residents had been refused a Taxicard because they did not claim benefits, and Westminster has now reviewed its policies and agreed to give Taxicards to all registered blind residents.

Rachael Robathan, Westminster cabinet member for adults, said: "We recognise that this is an important service for our residents. The changes we are making will ensure that all of those in greatest need of the Taxicard scheme will continue to get the benefits that it offers."

http://www.guardian.co.uk/social-care-network/2012/mar/30/westminster-council-unspend-adult-care-budget

Social care reforms must put the needs of the user first - Guardian

Social care reforms must put the needs of the user first

The forthcoming white paper offers the best chance in a generation to overhaul an outdated system, says David Rogers

• Comments (6)

• David Rogers
• Guardian Professional, Thursday 29 March 2012 08.59 BST
• Article history

Reforming adult social care is one of the country's biggest challenges.

The Local Government Association has long campaigned for reform of our care and support system, and there is a growing belief across the sector that we are edging closer to seeing real, tangible change for the better.
For decades, central government has struggled to address the issue of adult social care and, while different governments have made attempts to put forward a workable reform programme, only minor tangible changes have actually been made to the system – and many have stalled completely.
As such, the importance of the imminent publication of the government white paper on care and support cannot be underestimated. The reform of adult social care is potentially one of the biggest challenges this country is facing; for councils, fundamental change is vital.
The cost of social care, which already takes up more than 40% of the budgets of those councils responsible for it, is projected to grow further as our population ages. Putting this into context, we know councils are facing an estimated £1bn reduction in social care budgets as well as the pressures of growing demand and escalating costs in a system that is already underfunded, and it's clear that even the very best efforts of councils mean we will not be able to deliver all that we used to.
Ensuring reform is done right will mean we can continue to deliver the services our older and disabled people deserve and rightly expect, while easing a lot of other pressures on local government.
There is wide-ranging consensus that we need fundamental change, and right now we have the best opportunity for reform of our outdated social care system in a generation. All parts of government must now come together – and transcend political point scoring – to ensure future generations of older and vulnerable people can live full, happy lives and receive quality care when they need it.
Care and support reform is an issue that is on the radar of other sectors than our own. Crucially, it is becoming more of a recognised issue for the public as well. Indeed, our research shows that more than half (56%) of people in England believe they will need care or support as they get older.
However, this backdrop of a consensus for the need for change will be quickly dashed if the white paper does not harness the cross-sector momentum for reform and offer an outlook of real, practical change. It is, therefore, crucial that the white paper clearly sets out how the government intends to build a better care and support system.
In Ripe for reform: the sector agrees, now the public expects, the new guide from the Local Government Association, we set out a checklist of measures that should be included in the government's plans and the criteria that the sector will use to judge it.
First, it's important the government introduces a care and support bill by summer 2013 that will set out a real commitment to make the system fairer, simpler and fit for purpose.
It is also of utmost importance that it improves people's experience of care and support. The needs of the individual must come first; people should be given more control over the care they receive. This includes implementing a cap on the amount of risk people will be exposed to when planning for their care costs and making the means-testing system fairer on those who have some assets.
The white paper must set out proposals for a reformed system that will provide stability, predictability and transparency, as well as encouraging a long-term view. It is essential that it uses the totality of an area's resource base and provides sufficient funding that is appropriately directed.
From the perspective of local authorities, it is essential that the white paper recognises the role and value of local political leadership and decision making. It needs to balance national inputs with local flexibility, to support local decisions about the services that are delivered to meet the local needs and the amount that should be paid for them. It needs to makes appropriate links with health and wellbeing boards, with councils taking a lead role in single commissioning with pooled budgets for appropriate client groups. Finally, it must set out clearly defined relationships between councils and other key partners.

David Rogers is chair of the Local Government Association's community wellbeing board
http://www.guardian.co.uk/social-care-network/2012/mar/29/social-care-reforms-control-users

Kinship carers let down by councils, study finds - Community Care Magazine

Kinship carers let down by councils, study finds

Tristan Donovan

Tuesday 27 March 2012 00:01

Kinship carers in England are being failed by their local authorities, according to "shocking" research by the Family Rights Group and Oxford University.

The study, published today, surveyed 493 kinship carers from across the UK and found 70% rated the support they get from their local council as poor or very poor.

Nearly half (45%) of England’s councils have yet to publish a family and friends care policy, despite the government telling them to have done so by 30 September 2011.

One in five children now looked after by family or friends were initially placed in unrelated foster care, causing more disruption to their lives, the research revealed.

Cathy Ashley, chief executive of the Family Rights Group, said the lack of support offered to the country’s kinship carers and the 250,000 children who live with them was “absolutely shocking”.

“Our research shows many local authorities are not fully exploring and supporting opportunities to place children with family and friends, who can offer the security, continuity and love they so desperately need,” she said.

“These people are relieving a great deal of pressure from the state care system and acting in the best interests of incredibly vulnerable children, benefiting the rest of society. They deserve better.”

Often family and friends carers fall through the gaps in local services because they don’t fit neatly into remit of social services or family support, Ashley said.

“There are far more children living with families or friends than will ever be adopted but they appear to be invisible to local authorities,” she said.

She continued: "We want to see local authorities being audited and properly funded to ensure that guidance is being effectively implemented across the country. At present, that clearly isn’t happening."

More than three quarters (76%) of kinship carers surveyed felt they did not have a sufficient understanding of the legal options and support available to them to make informed decisions about the children they care for.

Massive variations in personal budget take-up across councils - Community care magazine

Massive variations in personal budget take-up across councils

Tristan Donovan

Wednesday 28 March 2012 16:44

Massive variations in personal budget take-up persist between councils and regions, the latest official figures show.

While 29.2% of adult care users or carers receiving community services had a personal budget in 2010-11, up from 13% in 2009-10, rates ranged from 4% in Somerset to 71% in Manchester, according to statistics published by the NHS Information Centre.

The figures suggest progress on moving people on to personal budgets is slowest in the South West, where the average uptake is 18.3%, and fastest in the North West, at 35%.

The government has set a target of 100% uptake of personal budgets by April 2013 but the Association of Directors of Adult Social Services recently warned that the target could be counterproductive and could be driving authorities to implement budgets without ensuring they delivered genuine choice and control.

However, despite today's figures, Adass vice-president Sarah Pickup said that "there is no reason to assume that we cannot meet the target of 100% by 2013 in most places".

"There are indeed significant variations," she said. "Some authorities got off to a slower start than others and some will have had some specific priorities to tackle."

Pickup added: "Personal budgets should always be the way in which we meet people's needs as a matter of course," she added. "If we are anywhere close to the 100% target then the strategic objective is surely achieved. If there are a few authorities that still have some work, that would not be seen as failure."

Progress on personal budgets will be discussed at this year's Community Care Live, the annual free event for social care professionals, which takes place on 16 and 17 May.Register to attend now.

Homecare for elderly disgraceful, repot finds -Guardian

Homecare for elderly 'disgraceful', report finds

Standard of care provided to elderly in their homes has been described as disgraceful in report by consumer group Which?

• Press Association
• guardian.co.uk, Friday 16 March 2012 05.41 GMT
• Article history

A geriatrician holds the hand of an elderly woman with arthritis. Photograph: Corbis

Older people are suffering "disgraceful" home care, including missed medication and confinement to soiled beds, an undercover investigation has revealed.
Researchers for the Which? consumer group reported missed visits, food out out of reach and vulnerable people left without a way of getting to the bathroom.
Which? asked 30 people or their carers to keep diaries over the course of a week in January detailing their experiences of home care, also known as domiciliary care, by paid workers.
One elderly woman was left alone in the dark for hours unable to find food or drink. Another was left without a walking frame, leaving her unable to get to the bathroom, while one man was not given vital diabetes medication, the watchdog said.
Which? declined to name the agencies involved, saying it wants to protect people who gave feedback.
One unnamed daughter reported: "They missed a day just after Christmas. They incorrectly entered into their database the days we didn't need care. I covered but mum didn't contact me until early evening, by which time she needed a lot of cleaning up. You wonder about the elderly with no relatives."
A son said: "There are times when dad, who is diabetic, hasn't had his insulin on time and it's vital medication. When I voiced my concerns to the care agency I was just told to find another agency."
Another daughter told the watchdog: "She can't see her sandwiches to eat them and hasn't touched her drinks as she can't see those either. I can't express how angry I feel at the carers. There is a printed note on the front door about putting a light on at 4pm as well as a note from me in the kitchen beside the care book. It is also in the care plan. What more can I do?"
Others did identify good service, with one son saying: "My mum's carer does things without being asked, such as tidying up, and will do extra things like brushing her shoes. Mum says she's a real carer."
However, a separate Which? survey found one of the most common complaints was missed and rushed visits, with relatives often left to step in.

Almost half of respondents (47%) able to answer a question about visits said at least one had been missed in the past six months, while 62% of those had not been warned in advance.
Which? said "in many cases" diarists reported a good service was provided only after complaining, with some family members being forced to make numerous phone calls and to have a "constant battle" with agencies.
The Which? executive director of Which?, Richard Lloyd, said: "The government can no longer claim to be shocked as report after report highlights the pitiful state of care for older people. If they are serious about ensuring vulnerable people are treated with dignity, then we must see real action because every day they delay is another day older people risk being neglected."
The chief executive of the Care Quality Commission (CQC), Cynthia Bower, said: "Homecare is one of the most difficult areas of care to monitor because it is delivered behind closed doors which is why, starting next month, CQC will be carrying out a themed inspection programme of 250 providers of domiciliary care services.
"We will be focusing on dignity and respect, the safeguarding of people in vulnerable circumstances and how well-supported and trained homecare staff are to undertake these most important care tasks.
"We will use a range of ways of checking up on these services, including going into people's homes, contacting people who use services and their families and talking to local groups who represent the users of homecare services."

The Age UK charity director general, Michelle Mitchell, said: "While many careworkers work hard to provide compassionate care, the underfunding of the social care system is resulting in a serious reduction of domiciliary care, which can put both the health and dignity of older people at risk.
"Good homecare must begin and end with the needs of individuals rather than focusing on a tick box of tasks to be completed within a set time."
A spokesman for the UK Homecare Association, Colin Angel, said the report highlighted "the disturbing consequences of the commissioning of homecare by local councils".
"To meet the current stringent public sector spending cuts councils are making significant attempts to reduce the price they pay for care," he said.
"Homecare agencies repeatedly tell us that councils also allow less time for care to increasingly frail and elderly people. This raises serious questions about the ability of people to receive dignified, effective care, a situation which must be addressed nationally."
David Rogers, chairman of the Local Government Association's wellbeing board, said there was too little money in the system "and without fundamental reform the situation is only going to get worse".
"Local authorities are doing all they can to find solutions that don't impact on the services they can deliver to elderly and vulnerable residents and despite a 28% funding cut from government, spending on adult services this year is expected to fall by just 2.5%, the lowest for any service area."
The minister for care services, Paul Burstow, said: "We are funding work to put in place the first ever training standards for care assistants to raise the bar on quality.

"The best councils are arranging care that concentrates on delivering the outcomes people have a right to expect. Kindness, compassion, dignity and respect must be central to care, whoever provides it and wherever it is provided."

http://www.guardian.co.uk/society/2012/mar/16/home-care-elderly-disgraceful-which-report

Dilnot assessment plans risk bureaucracy for social workers - community care magazine

Dilnot assessment plans risk bureaucracy for social workers

Mithran Samuel

Tuesday 20 March 2012 12:07

Dilnot commission plans to overhaul social care assessments and eligibility risk loading extra bureaucracy on to social workers without delivering on their promise of fairer access to care.
That was the warning from a report today for the Social Care Institute for Excellence by social care consultant Melanie Henwood, which called for further examination of the practical implementation of the proposals and related assessment reforms put forward by the Law Commission.
Last year's commission on funding reform, headed by Andrew Dilnot, proposed creating a national eligibility threshold for adult social care based on a more objective and easily understood assessment system, to ensure that access to care was equitable. Access to assessments would also be extended to many more people under Dilnot's plans to put a cap on individuals' lifetime care costs, which would be implemented by councils' assessing and costing the needs of self-funders to track their progress towards the £35,000 cap.
Interviews with stakeholders for Henwood's report found little appetite for any new assessment tool designed to create a more objective system, with interviewees concerned that it would "generate further bureaucracy and be a costly process" at a time when the current assessment process is already considered bureaucratic.
The pursuit of consistency would also be undermined by the fact that social workers exercised subjectivity and professional judgement in assessments, meaning reforms to assessment would have "major training and workforce implications", she warned.
Henwood also stressed that a national eligibility threshold for formal social care would not ensure consistent access to support because it would not take into account access to lower-level services, information and advice, which are crucial to improving outcomes for individuals.
While she welcomed the opportunity Dilnot's capped costs proposal created to give self-funders access to assessments, information and advice, she raised concerns about councils' capacity to manage the increased numbers of assessments required.
Henwood's report is designed to influence the government's forthcoming White Paper and progress report on care funding reform, which will address the recommendations of the Law Commission and Dilnot respectively and lay the foundations for legislation on care and support.
The government is expected to accept Dilnot's proposals for a national eligibility threshold and believed to be considering implementing a cap on care costs, though at a higher figure than £35,000.
http://www.communitycare.co.uk/Articles/20/03/2012/118085/Dilnot-assessment-plans-risk-bureaucracy-for-social.htm

Safeguarding threshold risks leaving adults unprotected - Community Care Magazine

Safeguarding threshold 'risks leaving adults unprotected'

Mithran Samuel

Thursday 22 March 2012 12:16

Adult protection legislation risks leaving people unprotected by setting too high a threshold for intervention, a safeguarding expert has warned.
Lower-level incidents risk being missed by government plans to provide statutory protection to people who may need care, are unable to safeguard themselves and are at risk of "significant harm", as opposed to "harm", said Shirley Williams.
Williams, a consultant and independent chair of Blackburn with Darwen Safeguarding Adults Board, was speaking at a Community Care adult safeguarding conference yesterday. Earlier, Department of Health official Robert Parsons had revealed that forthcoming legislation was likely to set a significant harm threshold for adult protection proceedings – in line with child protection and the current No Secrets guidance on safeguarding adults.
Parsons, the DH's policy lead on safeguarding legislation, stressed the plan was provisional and subject to further discussions around the government's forthcoming adult social care White Paper, which would itself be subject to consultation before a parliamentary bill is published.
Were it to go with a "significant harm" threshold, it would reject the recommendations of the Law Commission, which proposed a threshold of "harm" in its review of adult social care law, which reported last year and is supposed to form the basis of the government's own legislation.
It would also leave England with a technically higher threshold for adult protection than Scotland, whose 2007 law defines an "adult at risk" as someone at risk of "harm", unable to safeguard themselves and affected by mental disorder, illness or disability. The Welsh government has also proposed a "harm" threshold for adult safeguarding in its consultation on a Social Services (Wales) Bill.
Williams said the evidence suggested that socially excluded people with lower-level disabilities were at particular risk of abuse, but were often screened out of services.
“What concerned me is the use of ‘significant harm’," she said. "If we set the threshold too high we will miss small incidents [that indicate risk].”
The Law Commission initially proposed a "significant harm" threshold in consultation, and while some respondents felt this would help keep safeguarding workloads manageable for councils, others warned that it would undermine preventive work and imply that some levels of abuse were acceptable.
Action on Elder Abuse chief executive Gary FitzGerald reiterated this concern, in the light of Parsons' comments. "What level of harm does a victim have to endure before it is considered significant," he asked. "Or, perhaps more precisely, what level of harm is society willing to ignore before allowing intervention? Are we not in effect authorising perpetrators to commit a certain level of abuse?"
Though the commission removed "significant" from its final proposals, it stressed that the other criteria - that the person was unable to safeguard themselves and had health and social care needs - "would do the main work" of defining who was at risk.
Parsons also said that the government did not plan to bring self-neglect under safeguarding procedures, again contrary to the Law Commission's proposals.
He said the planned Care and Support Bill would be likely to give local authorities powers to make enquiries where abuse was suspected.
Safeguarding adults boards would be put on a statutory footing, convened by councils with mandatory membership from the relevant police force and NHS clinical commissioning groups, said Parsons.
Their role would be to produce a strategic plan setting out outcomes, an annual report setting out progress against the plan and to commission serious case reviews. He said the legislation would set out that the purpose of SCRs was to learn lessons, not apportion blame.
Parsons said the DH wanted to allow boards the flexibility to adapt arrangements to local circumstances, and also to widen their remit to take in self-neglect and other issues if they so wished.
http://www.communitycare.co.uk/Articles/22/03/2012/118091/safeguarding-threshold-risks-leaving-adults-unprotected.htm

Overhall Personal Budgets for Older People, says ADASS - community care magazine

Overhaul personal budgets for older people, says Adass

Tristan Donovan

Monday 19 March 2012 16:39

Personal budgets must be overhauled to ensure older people, particularly those with dementia, can benefit from them, the Association of Directors of Adult Social Services said today.
With councils working to a government target of having all eligible service users on personal budgets by April 2013, Adass warned that the current system was not flexible enough to give older people choice and control over their care and said safeguarding concerns needed to be addressed.
“We’ve done well to get a third of service users using them but those people have tended to be younger adults as there tends to be resistance and anxiety about personal budgets among older people," said Adass president Peter Hay.
"We don’t want to blow all the good work that has been done by pushing this system on them to meet the April 2013 target for 100% uptake of personal budgets.”
"It is self-evident that people with dementia need something else,” he added.
The organisation’s concerns are set out in The Case for Tomorrow, a discussion paper on the future of older people’s services that it released today. Specific issues cited include the transfer of risk from councils to older people receiving direct payments, particularly where they employ staff as personal assistants.
In an accompanying paper on personal budgets, it warned that the challenges "cast doubt not only on the practicality of reaching the April 2013 timetable, but also on the wisdom of it". It warned that the implementation of personal budgets were "being artificially driven by the timetable over and above ensuring that real choice and control is delivered".
Adass called on the government to conduct a review of personal budget systems that would develop a more suitable approach for older service users, including recommended minimum standards for safeguarding.
The paper also sets out a number of other recommendations on how to address the challenges faced by older people’s services.
These include more examination of how to remove the barriers that prevent integrated commissioning by social care and health services, and a call for more government spending on social care.
It also suggests the creation of ring-fenced innovation funds that would encourage a shift away from acute care to more community-based provision. “A similar fund saw an explosion in mixed provision in community care – it was the game changer there and could be the game changer here,” said Hay

http://www.communitycare.co.uk/Articles/19/03/2012/118078/overhaul-personal-budgets-for-older-people-says-adass.htm

Disabled people have come so far – don't undo all the progress

The UK is at risk of breaching international obligations to disabled people, so I'm proud to help safeguard independence

• Jane Campbell
• guardian.co.uk, Thursday 1 March 2012 08.55 GMT
• Article history

The joint select committee on human rights reports today on its 12-month inquiry into disabled people’s right to independent living.

As a severely disabled person, I am reminded every day of the tremendous progress made over the past 30 years in the UK to enable disabled people to become active citizens. Autonomy and freedom would not have been part of my vocabulary half a century ago. I might have been reliant upon my family for support, with the prospect of being put into an institution when they could no longer cope.
Instead, at 52, I am an independent crossbench peer and member of the joint committee on human rights (JCHR), which reports this week on its 12-month inquiry into disabled people's right to independent living.
Since leaving university I have had the privilege of being involved in helping develop the complex weave of legislation and public policy necessary for disabled people to live in, and be part of, their community.
Keeping millions of disabled people inactive and dependent is costly, from a financial and moral point of view. I have witnessed disabled people raise families, work or simply be more cost-effective by keeping healthy and taking greater control over their personal care. It's not been perfect. But by many standards, we were ahead of the game compared with much of Europe.
And now decades of positive progress are at risk of being reversed as economic austerity is used as justification for denying independence.
That is why I am so pleased to be part of the strong and unambiguous stand taken by the JCHR in publishing its report. We listened to a whole range of expert witnesses and took into account extensive research and consultation, looked at the context of the UN convention on the rights of persons with disabilities (UNCRPD), which was ratified by the UK in 2009.
Although I feel I have the right to independent living, the legislative and policy framework simply isn't in place to make it a right; and what there is, is in danger of disappearing fast.
If my local authority cuts my care package or demands I transfer to NHS care (because they regard using a ventilator as the trigger for health services), I lose control of my life. I might have to leave parliament, or give up work altogether (because I need social care direct payments to do everything, from eating a sandwich to delivering a speech). I am only a few bureaucratic decisions away from returning to the inequality I endured at 18. It wouldn't take long to transform all my relationships with my colleagues, partner, family, friends into one which gives little or nothing to anyone. Everyone loses.
The fact that all this could happen without my consent hangs over me and thousands of others. That is why I am so glad the JCHR report recognises and recommends the need for freestanding legislation to protect the right to independent living in UK law.
The report addresses recent government and local authority measures and austerity reforms that impact upon independent living for disabled people; such as reforms to disability living allowance and housing benefit, closure of the Independent Living Fund and restricting eligibility for social care to "critical or substantial" needs only.
The JCHR found no tangible evidence of the government giving due consideration to the UK's obligations under the UNCRPD during this critical reforming time.
This lack of regard to the convention, coupled with the potentially retrogressive impact of these reforms, risks placing the UK in breach of its international obligations. This report is so timely. It sets out the risks to progress on independent living and makes sensible, achievable recommendations.
The UK's international reputation in public policy and legislation which places more power in the hands of disabled people to assume control over their own lives, and to be included in all areas of life, is clearly in jeopardy.
Independent living has never made more sense. The government must heed the JCHR report and act fast. Otherwise history will repeat itself – the next generation of disabled people should not have fewer rights than I've had.

http://www.guardian.co.uk/commentisfree/2012/mar/01/disabled-people-have-come-far

Don't let us down on care funding reform, alliance tells Andrew Lansley

Groups representing millions of elderly and disabled people tell health secretary they will not stand for 'empty promises'

Read the joint letter to the health secretary

• David Brindle
• The Guardian, Monday 5 March 2012
• Article history

An alliance of charities, care homes and housing providers say they will not stand for 'empty promises' on care funding reform.

Pressure is being piled upon the beleaguered health secretary, Andrew Lansley with a blunt warning from groups representing millions of elderly and disabled people that they will not stand for "empty promises" on reform of care funding.
In a joint letter to Lansley, the biggest ever alliance of charities, care home organisations and housing providers says the government must not duck its commitment to deliver reform when it publishes a social care white paper later this year. The warning comes amid reports that Downing Street fears the white paper could turn into a repetition of the government's NHS shake-up, the poor presentation of which is widely blamed on Lansley. Officials at No 10 are said to have stepped in to influence the policy process.
Ministers are believed to have some political cover as a consequence of all-party talks on care funding reform, which have begun behind the scenes in parallel with preparation of the white paper.
The letter to Lansley comes before a planned mass lobby of parliament on Tuesday by elderly and disabled people, organised by the Care and Support Alliance.
The alliance is pressing for implementation of the funding reforms for England proposed last year by a commission led by economist Andrew Dilnot.
Among the 46 organisations that have signed the letter are leading charities such as Age UK, Macmillan Cancer Support and Scope; the English Community Care Association and the National Care Forum, representing the main care home chains; and specialist housing providers such as Anchor Trust and Home Group.
Describing the Dilnot proposals as part of "a roadmap for a sustainable and clear social care system", the letter says: "Years of underfunding, combined with rising demand, have resulted in a social care system that is in crisis: an unfair and confusing postcode lottery … now facing additional cuts.
"This is a challenge which successive governments have failed to overcome – but we cannot wait any longer."
Dilnot has called for a cap on individual liability for care costs, to be set at perhaps £35,000, to stop people facing catastrophic bills and having to use almost all their savings and the value of their homes. But introducing his plan in full would cost an initial £1.7bn a year and rising. Amid clear signs of divisions in Whitehall, ministers have already decoupled the funding question from legal reforms and other issues that will be tackled in the white paper — not now expected before June – and have announced that a "progress report" on the all-party talks and wider thinking will be published alongside it.
The letter warns that decisive action is expected on "both fronts" and that the white paper will fail without a funding solution. "As they meet you and other MPs on Tuesday, to ask you to seize this opportunity to act," it tells Lansley, "older and disabled people and their families want to know that they are not going to be let down again. Without decisions on funding, all they will hear are empty promises."
Simon Gillespie, chief executive of the MS Society and chair of the alliance, said the spring was "crunch time" for Lansley to address the crisis that was engulfing the social care system.
"The health secretary faces the opportunity of a lifetime to ensure that this government's pledges are not just empty promises, and to make his mark on a social care system that will deliver for the next 20 years," Gillespie said.
In a statement, Paul Burstow, care services minister, agreed the care system was in "urgent need" of reform to create a more sustainable system that provided more choice and control to individuals and their carers. "We have to get this right," Burstow said. "That is why we have been engaging with a wide range of stakeholders, people who use services and carers on the priorities for social care reform.
"We will publish our white paper on care and support and a progess report on funding reform in the spring."

Downing Street reins in Andrew Lansley's plans for social care

Health secretary forced to put social care plans on hold amid fears of another political disaster

• Toby Helm, political editor
• The Observer, Sunday 4 March 2012
• Article history

Andrew Lansley has had to stall a major policy announcement on the future of social care for the elderly because Downing Street fears that it could turn into a political disaster on the scale of the health and social care bill.
The Observer has been told that No 10 has "seized the reins" on social care from Lansley, the health secretary, and called in experts to ask their views on what should be in a much-delayed white paper. "No 10 know they have to ensure this is not another disaster like the health bill," said one.
One of the concerns is that plans to give more elderly people their own "personal budgets" – sums of money with which they can buy in social care from private providers – might open up the government to more damaging accusations of the "marketisation" of health services.
The news comes as more than 1,000 older and disabled people from across the country prepare to travel to London on Tuesday to call on their MPs to end the crisis in social care. The lobby of parliament has been organised by the 60 organisations that make up the Care & Support Alliance, including Age UK, Mencap, Scope, the MS Society, Macmillan Cancer Support, Sense, Rethink and Carers UK. The alliance argues that chronic underfunding of social care, combined with rapidly growing demand for care and cuts to local government budgets, has left the system in crisis.
The white paper on the future of social care was originally expected early this year. MPs were then advised that it would be published in March. Now sources at the Department of Health say it will not be produced until "late spring".
The delay caps a miserable two months for Lansley, during which time much of the medical profession has lined up to demand that his health and social care bill – which would devolve power to commission services to GPs and open the way for a greater role for the private sector – be scrapped. Downing Street is dismayed at the political damage inflicted on the coalition by the row and, in large part, blames Lansley for failing to explain the bill's purpose to the public and medical profession. Officials close to David Cameron also accept that No 10 paid insufficient attention to the plans before they were launched in a white paper in 2010. Now, sources say, they are determined to avoid a repeat of the fiasco when a white paper is published, and legislation then framed, on social care.
Last month, the all-party select committee on health, chaired by Stephen Dorrell, the former Tory health secretary, dealt Lansley serious blows when it produced two reports that suggested his NHS reform programme failed to address adequately the most pressing health problem – that of how to deliver affordable and effective social care for the growing elderly population.
The committee suggested that there needed to be far closer integration of the health and social care systems than was currently envisaged, so that more elderly people are treated and cared for at home and are not left until they require expensive and long stays in hospital.
Such views have been registered in Downing Street. Lansley's plan to give every eligible person a "personal budget" through a direct payment by April 2013 has also raised concerns. Under the plan, first introduced by Labour, people's needs are assessed by local social services. They are then allocated a budget, paid as a direct cash payment, with which they can buy care. Currently, personal budgets cover 340,000 people.
Opponents of the system argue that personal budgets will be inappropriate for huge numbers of elderly people who will not be able, or want, to manage their own funds, particularly at times when they are in greatest need of care. Critics also say people's needs will change and the system may not allow them to switch providers quickly enough if contracts have been signed.
With the government also having to address the issue of how to fund social care, MPs believe the social care white paper could even be delayed until after the summer, when Lansley is expected to be replaced as health secretary.
Problems over the health and social care bill now passing through parliament will mount next weekend when Liberal Democrats debate an emergency motion calling for it to be scrapped.
http://www.guardian.co.uk/society/2012/mar/04/social-care-plans-reined-in

Inaccessible public transport - Transport for All

London’s transport system is not a public transport system: much of it remains inaccessible to older and disabled Londoners.

Along with other disability and pensioner’s organisations, Transport for All will be taking our demands for accessible transport direct to City Hall on 20^th March and launching our manifesto. Together, we’ll call for the next mayor to upgrade London’s transport, so that older and disabled people can travel with the same freedom and independence as everyone else.

Our five key demands:

• Implement penalties for bus companies which regularly fail to meet minimum standards in relation to access; broken ramps; pulling into the kerb and giving passengers enough time to sit down.

• Ensure that at least a third of London’s Tube stations are stepfree by 2018, including from platform to train

• Lift the cap placed on TfL’s contribution to the Taxicard service

• Commit to a target of 100% of bus stops to be accessible by 2018

• Restore all staff axed from the Underground and ensure assistance is reliably available at every station, including on London Overground.

This demonstration, following directly after our Mayoral Hustings, will be the official launch of our manifesto for an accessible London transport system.

Meet outside City Hall (nearest station, London Bridge, which is stepfree) at 2:30pm. Bring banners, placards and a thirst for change!

Cheers

Lianna

Lianna Etkind

Campaigns and Outreach Co-ordinator

P.S. There are still some spaces left at the Mayoral Hustings – email libby.oakley@inclusionlondon.co.uk to register.

London Underground’s experiment in minimal staffing on the Tube has failed.

Have you had experience of empty stations or lack of assistance? Let us know:

http://www.transportforall.org.uk/news/disabled-londoners-hard-hit-by-tube-staff-cuts-tube

Transport for All

336 Brixton Road

London

SW9 7AA

Visit our website:

www.transportforall.org.uk

Tel: 0207 737 2339

Fax: 0207 737 2231

Choice and control for all report - In Control

 Choice and Control for all

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'Choice and Control for all' is a new report published by Groundswell which looks at the role of Individual Service Funds (ISFs) in delivering fully personalised care and support.

Groundswell's first report considers the pressing challenge of introducing personal budgets for everyone and the important role that ISFs can play in making choice and control work for people with the most complex needs. Choice and Control for all explores current practice in personalising care and support within commissioned services, describes what Groundswell has tried and learned through its work with providers and sets out a framework for personalisation in residential settings. Groundswell believes that ISFs should be a key part of any local strategy for making personal budgets happen at scale and hopes this report will be an important contribution to the debate.
The report can be downloaded from Groundswell's new website.

http://www.in-control.org.uk/news/in-control-news/new-report-choice-and-control-for-all.aspx

Scotland legislates to enshrine personalisation of care - community care magazine

Scotland legislates to enshrine personalisation of care

Mithran Samuel

Thursday 01 March 2012 17:44

Service users will have the right to a personal budget but will also be able to leave their care management in the hands of their local authority, under legislation issued by the Scottish government today.
The Social Care (Self-Directed Support) (Scotland) Bill would make Scotland the first UK country to enshrine personalisation in law at the heart of the care system.
But it would differ from the approach taken in England, where the government wants to place all eligible service users on personal budgets so they can direct their own support by 2013, whether taken as a direct payment or as a budget administered by the council or as a mixture of the two.
In Scotland, service users would have these three options but would also have a fourth option, under which the council would commission support for the individual, who would not have direct or ongoing involvement in deciding how the resources are used, but would be fully consulted on decisions.
Councils would be under a duty to offer service users all four options and would have to give effect to the user's choice unless it is clear that this would result in needs not being met or where regulations prescribed certain individuals or types of support were ineligible for direct payments.
The bill, which applies to children and adults, would also give service users the right to be fully involved in assessments, to obtain information and advice to help them direct their own support and to collaborate in producing their support plan with professionals.
The legislation was widely welcomed by social care user groups, providers and charities.
The bill was "an important step on the journey to putting every person in control of the support they need to live the life of their choice," said Peter Scott, chief executive of learning disability charity ENABLE Scotland.
http://www.communitycare.co.uk/Articles/01/03/2012/118031/scotland-legislates-to-give-users-right-to-personal-budget.htm

Rights of disabled people may be at risk, says Human Rights Committee

Rights of disabled people may be at risk, says Human Rights Committee

01 March 2012

The Joint Committee on Human Rights (JCHR) today publishes its Report on the implementation of the right of disabled people to independent living in the context of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) which was ratified by the UK in 2009.

• Report: Implementation of the Right of Disabled People to Independent Living
• Report: Implementation of the Right of Disabled People to Independent Living (PDF)
• Inquiry: Implementation of the right of disabled people to independent living
• Joint Committee on Human Rights

The Report draws attention to a number of significant human rights issues, including:

• the need for freestanding legislation to protect the right to independent living in UK law
• the effect of current reforms to benefits and services on the ability of disabled people to enjoy independent living
• the role played by the UNCRPD in policy development and decision making at all levels of government
• the use of equality impact assessments
• the effects of devolution on implementation of the UNCRPD
• hate crime

The right to independent living does not exist as a freestanding right in UK law. Although it is protected and promoted to some extent by a matrix of rights, the Committee believes that this is not enough. It argues that the Government and other interested parties should immediately assess the need for, and feasibility of, legislation to establish independent living as a freestanding right. In addition, the Committee concludes that the UNCRPD is hard law, not soft law, and that the Government should fulfil their obligations under the Convention on that basis, and counter any public perception that it is soft law.
The Committee finds that:

• reforms to benefits and services risk leaving disabled people without the support they need to live independently
• restrictions in local authority eligibility criteria for social care support, the replacement of the Disability Living Allowance with Personal Independence Payment, the closure of the Independent Living Fund and changes to housing benefit risk interacting in a particularly harmful way for disabled people
• some people fear that the cumulative impact of these changes will force them out of their homes and local communities and into residential care

It also finds that:

• the Government had not conducted an assessment of the cumulative impact of current reforms on disabled people. The Report urges them do so, and to report on the extent to which these reforms are enabling them and local authorities to comply with their obligations under the UNCRPD
• the UNCRPD did not appear to have played a significant role in the development of policy and legislation, as is required by the Convention. The Committee therefore argues that the Government should make a commitment to Parliament that they will give due consideration to the articles of the Convention when making legislation

Further, the Committee deprecates changes to the duties of public authorities in England under the Equality Act 2010, which no longer require the production of equality impact assessments of changes in policy, nor the involvement of disabled people in developing policies which will affect them.
The Committee finds variations in the manner in which the devolved administrations have implemented the Convention, and uncertainty as to the role the UK Government should play in ensuring implementation. The Report notes with disappointment the lack of a strategy in Northern Ireland to promote independent living and reminds the UK Government to acknowledge their responsibility to ensure implementation.
The Committee also considers a range of other issues relating to independent living. It recommends that the Government should take further action to ensure that assessments for care needs are portable across the country in order to ensure disabled people’s right to choose their place of residence. It also expresses concern over a growing incidence of hate crime against disabled people and urges the Government take action to foster respect for the rights and dignity of disabled people.

Dr Hywel Francis MP, Chair of the Committee, said:

"We are concerned to learn that the right of disabled people to independent living may be at risk through the cumulative impact of current reforms. Even though the UK ratified the UNCPRD in 2009 with cross-party support, the Government is unable to demonstrate that sufficient regard has been paid to the Convention in the development of policy with direct relevance to the lives of disabled people. The right to independent living in UK law may need to be strengthened further, and we call on the Government and other interested organisations to consider the need for a freestanding right to independent living in UK law."
http://www.parliament.uk/business/committees/committees-a-z/joint-select/human-rights-committee/news/independent-living-report/

Independent living for disabled at risk from cuts, say MPs - community care magazine

Independent living for disabled at risk from cuts, say MPs

Mithran Samuel

Thursday 01 March 2012 07:35

Independent living for disabled people is being put at risk by the combined impact of cuts to social care and benefits, MPs and peers warned today.
Cuts to care and different benefits are interacting in a "particularly harmful" way for disabled people and many service users fear they will be forced into residential care as a result, Parliament's joint committee on human rights said in a report.
It cited increases in eligibility thresholds for social care, the closure of the Independent Living Fund to new claimants, cuts to housing benefit and the replacement of disability living allowance by personal independence payment, which will see 500,000 people lose out on the benefit.
The committee called on the government to assess the cumulative impact of these cuts on disabled people and consider the introduction of a right to independent living.

http://www.communitycare.co.uk/Articles/01/03/2012/118028/independent-living-for-disabled-at-risk-from-cuts-say-mps.htm

Fundamental change needed to improve elderly care, says report - community care magazine

Fundamental change needed to improve elderly care, says report

Tristan Donovan

Wednesday 29 February 2012 10:29

Residents and relatives should be given a direct say in the running of care homes, according to a report examining how care for the elderly could be improved.
The Delivering Dignity report, by a commission set up by Age UK, the NHS Confederation and Local Government Association, sets out a range of recommendations designed to act as “a call to arms to the whole health and social care system”.
As well as greater involvement of residents in decision making, it also urges care homes to stamp out ageist language and calls for the creation of a new rating system for care homes that would inform inspections by the Care Quality Commission.
It also calls on local authority commissioners to set standards for residents’ dignity in care home provider contracts and adopt a person-centric approach to older people’s care.
“Care homes must be more than just aimless places where the only goal is to keep residents clean, dressed and well-fed,” says the report.
“This means turning on its head a task-orientated approach to care giving. For example, the aim must not be to get the person washed and dressed as quickly as possible in order to move on to the next task, but should be to help the resident choose their clothes and prepare for the day ahead.”
Other recommendations included:-

• The creation of a Care Quality Forum to help raise the status and quality of care home staff, as a first step towards creating a College of Care.
• Care homes should ensure residents have sufficient access to medical care.
• Care home managers should be recognised as experts and providers and commissioners should ensure they receive sufficient training.

The organisations behind the report are consulting on their recommendations until 27 March. The joint commission that produced the report was formed in response to the failures in older people’s care exposed by the Health Service Ombudsman in February 2011.

http://www.communitycare.co.uk/Articles/29/02/2012/118021/fundamental-change-needed-to-improve-elderly-care.htm

Benefits test based on medical model of disability, warn MPs - community care magazine

Benefits test based on medical model of disability, warn MPs

Tristan Donovan

Monday 20 February 2012 14:38

Disabled people risk losing out because government benefit reforms are overly based on the medical model of disability, MPs have warned in a report.
Parliament’s work and pensions select committee said that the proposed assessment for personal independence payment (PIP) did not take sufficient account of the social barriers to living faced by disabled people. PIP is due to replace disability living allowance from 2013 for people of working-age.
“The PIP assessment criteria, as drafted, tend towards the medical model of disability,” the report on the proposed reform said. “[The mobility criteria] concentrate heavily on ability to move a fixed distance and do not include barriers to accessing public transport, or the difficulties of some locations for individuals where routes to shops, public transport etc are particularly hilly or stepped," it added.
The government hopes it will save 20% of the amount spent on DLA by 2015-16 through the introduction of PIP, with 500,000 people due to lose out on support as a result of tighter criteria.
But the committee’s report raised a series of concerns, including doubts that the savings would be as large as the Department for Work and Pensions envisages.
The MPs called for a more detailed assessment of the impact of the reform on the health and social care system, on the basis that the loss of DLA income for a claimant could shunt costs on to social services and the NHS, contrary to the government's view. DLA currently helped people manage their conditions and the extra costs of disability, reducing the burden on social care and the NHS, it said.
The committee also raised concerns that PIP claimants would generally undergo face-to-face assessments to determine eligibility. It noted how this may not be suitable for some claimants, including those with autism, and recommended that the advice of medical professionals with expertise in specific conditions is given more attention when making assessments.
It also noted that many claimants, including those eligible, would find the face-to-face assessments stressful and a source of anxiety, as has been the case with the work capability assessment used to determine eligibility for employment and support allowance.
“The assessment for PIP needs to be empathetic and avoid the mechanistic, box-ticking approach initially used in the work capability assessment," said committee chair Anne Begg.
http://www.communitycare.co.uk/Articles/20/02/2012/117991/mps-disabled-people-to-lose-out-from-medical-model-reform.htm

Reablement success leads to social work job cuts - community care magazine

Reablement success leads to social work job cuts

Mithran Samuel

Wednesday 22 February 2012 12:47

A council is cutting social work jobs off the back of its success in helping service users regain independence through reablement.
Seventy three full-time equivalent posts, including 22 registered social workers' jobs, are to go in Hertfordshire Council's locality older people and physical disability teams because of cuts to caseloads attributed to the county's reablement service. The teams employed 526 people as of April 2011.
The changes, agreed at a meeting on Monday, are due to save £1.4m next year, part of a £3.4m package of annual savings delivered through reorganising the council's adult social care functions. A further £1.6m will be saved by transferring initial assessments, brokerage, scheduled reviews and adaptations assessments to outsourcing company Serco, with 12 registered social workers due to transfer to the firm.
The reablement service, delivered by Goldsborough Home Care, has led to a 40% reduction in referrals to locality teams. The short-term service, open to most users who meet eligibility criteria, has supported 1,708 people in the past year, half of whom have needed no ongoing support after the intervention.
"As a result of this, [the council] will be able to reduce the number of locality social work teams and the staff headcount in these teams based on significantly lower caseloads," said a paper to yesterday's meeting of the council's ruling cabinet.
The council said that the savings to older people and physical disability teams were also attributable to more efficient processes, such as allowing team managers more autonomy to agree care packages.
It will also save almost £0.5m by cutting 13.2 posts from its community learning disability teams, delivered though "lean and efficient processes" in relation to assessment, review, care package approvals and safeguarding. One social worker role will be cut as part of the change to the teams, which employed 176 people as of April 2011.
The council said 128 staff (109 full-time equivalent posts) were due to transfer to Serco to establish a "social care access and housing solutions service". As part of the shift, 74 staff have agreed to take voluntary redundancy or retire early and the council hopes there will be no compulsory redundancies.
The Serco service would be responsible for initial assessments, referring people to reablement or locality teams, arranging services for clients based on their support plans, scheduled reviews and occupational therapy assessments for adaptations.
It will be linked to an electronic marketplace to enable self-funders and personal budget holders to directly purchase care services online.
The staff will transfer in April on their council terms and conditions and Serco has agreed to allow them to maintain their local government pensions.
Serco managers with responsibility for signing off community care assessments will retain a contract with Hertfordshire Council to ensure the council fulfils its statutory assessment duties, while the authority pledged to put in place "robust measures" to monitor the Serco service.
"People who currently receive support from the county council should not notice any difference in the care they receive," said cabinet member for health and adult care Colette Wyatt-Lowe. "The same experienced staff will continue undertaking initial assessments as they do now and qualified Hertfordshire County Council social care staff will continue to sign-off these assessments."
“We want to give people more choice and control of their care services and think our e-marketplace will make a big difference, letting people shop online for the health and social services they need."