Social care for the elderly – it’s up to us

Last week I attended a seminar organised by the influential think-tank, the International Longevity Centre, about “Creating a market for innovation in care”. Having just watched the BBC1 Panorama exposé about abuse in adult care homes, the cost and quality of social care was very much at the forefront of everyone’s minds.

As anyone who is struggling to look after an elderly parent knows, social care as opposed to healthcare is not centrally funded by Government and is not free at the point of delivery.  As the population ages, the social care bill is getting bigger and at the moment there is no agreed consensus as to how it should be paid.

The funding of social care has been a political football for some time now. So potentially toxic an issue is it, that both the Labour Government and now the Coalition have encouraged cross–party talks so any unpalatable decisions are seen to be made collectively.

To their credit, the Coalition has been pretty quick off the mark with the launching of the Dilnot Commission which is due to report later in the summer.

Whilst we will have to wait for the Commission’s findings, it is inconceivable that Dilnot will conclude that social care will be fully funded. The most likely outcome is a cap on individual contributions which the media has suggested will be in the region of £50,000. This will open the way for insurance companies to design products to fund this shortfall but will also mean for many people downsizing or selling family homes to fund care.

As was evident at the ILC seminar, very many people are focussed on how to reduce social care costs and the burden to families of caring whilst at the same time ensuring quality. And there are some interesting projects underway. 

CareBank, which is being piloted by the Royal Borough of Windsor and Maidenhead, aims to encourage volunteers of all ages to help older and more vulnerable people live independently. Volunteers who register with CareBank and help out with things like, for example shopping, driving, housework and gardening can earn credits for their time which could then be saved for the volunteers’ own or their family’s support in the future or used for a range of different services and activities, e.g. free swims.

There is much to commend this sort of approach but as with all “Big Society” projects it raises some fundamental questions about funding, quality and whether people will be willing to give up their time in this way. It is interesting that CareBank uses a carrot approach so that volunteers can be rewarded with credits.

NAAPS on the other hand aims to increase the choice of low cost care services which are available  to individuals by supporting micro-enterprises. These are very small community services, set up by front-line workers or people with support needs and their families offering activities, transport, hot meals, advocacy or home help.

In reality much social care will be provided by families and friends. Dilnot has warned that over the next 20 years, grown up children are expected to spend 13 per cent more time caring informally for relatives, while demand for such care will soar by 55 per cent. Key to the effective delivery of this care will be the attitude of employers. Not only can employers help by offering flexible working, they could also offer social care insurance as an employee benefit (similar to health insurance) or provide signposting to carers to help them juggle work with their caring responsibilities. Employers could also encourage employers to take part in volunteering as part of their corporate social responsibility programmes.

Certainly there is much to think about. And the shift from State to individual means that social care is going to remain an individual problem. Are we all ready for that much responsibility?