1st October 2023 is International Day of Older Persons, so there would be a rich symbolism if the Government were finally to introduce its social care charging reforms on that date.
In practice, we don’t know the exact start date (just ‘October’) and local authorities are already struggling not just with implementation of charging reform but in accommodating the wider changes in social care, including introduction of a CQC inspection framework, a new data strategy and the expectations of involvement in newly formed Integrated Care Systems. Together they add up to unprecedented administrative change for local authorities at a time of intense external pressure, particularly around the social care workforce.
That’s why local authorities are now calling for the reforms to be phased in. A report in May by the County Councils Network found that, while there was general support for the reforms from member councils, 97% thought there was not enough money to implement them, 88% thought there were not enough staff and 77% thought there wasn’t enough time. Overall, barely a third thought they were even ‘quite well prepared’ for the changes. The report suggests that, for the charging reforms alone, an additional 4,300 social work staff would be required and an extra 700 financial assessment staff.
However, the Government is showing no sign of willingness to rethink the timetable. It has staked significant political capital on the charging reforms, which allow it to say it has met its manifesto commitment to fix adult social care (even if such a claim is clearly misplaced). But it is not just the Government that would lose out: delay would mean that the people who are intended to benefit from the reforms will have those benefits postponed and providers would see a move towards a ‘fair cost of care’ take longer to come into effect.
Any delay would also, inevitably, make people recall the last time social care charging reform was due to take place. A reform of the means test and lifetime cap on costs was scheduled for April 2016 but postponed by the Government, with the ill-advised acquiescence of much of the social care sector. They were later, of course, abandoned entirely (it is particularly galling that the 2016 cap was a far more generous and progressive one than what is now due to be implemented). The failure to implement as planned in 2016 has meant many people have lost out on the protection against catastrophic cost that they deserve.
The moves scheduled for October are also critical because they increase the numbers who use – and therefore have some understanding of – publicly funded social care. That in turn may well be a prerequisite for the further funding and reform the sector needs.
Together, these make a strong argument for pressing ahead now, while the opportunity for reform still presents itself. DHSC has set an ambitious timetable and now needs to ensure that local authorities, and the wider sector, have the support they need to meet it. The joint approach established between central and local Government to implement the Care Act would be a good basis to understand the challenge and opportunities of the latest reforms.
Money will be critical. The last decade has seen local authorities attempting to implement the 2014 Care Act without the resources they need to do it properly. The next wave of reform cannot be allowed to falter in the same way.