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Somerset consultation on the review of eligibility for adult care

Name of consultation: "Consultation on the review of eligibility for adult care"
What's it about? Changing the criteria for which social services will provide care for adults in Somerset.
Who's running it? Somerset County Council
Closing date for comments: 1 December 2010 (for comments that will be presented as a response from the LINk)


Some info on this consultation from Somerset County Council

"We pay for a wide range of care for older people and adults with disabilities. This includes care that helps people carry on living in their own homes, placements in care homes, or support that helps carers.

We charge for the care that Somerset County Council provides or arranges depending on the person’s income and savings, but many people only pay a small proportion of the full cost. Some people meet the full cost themselves.

Eligibility criteria are a set of national rules about levels of need. We are required to use them, alongside the assessment of income and savings, to decide which adult social care services the Council pays for. The level of need at which a person has care paid for by the Council is called the “Eligibility Threshold”.

The Government sets four eligibility thresholds for care needs and each Council has to decide which threshold it can afford to pay for. The four levels are: low, moderate, substantial and critical.

  • Critical– this includes adults who need help from social care services or their life would be at risk, they would be at risk of serious abuse or neglect, or their vital personal care and support needs would not be met.
  • Substantial– this includes adults who need help from social care services or they would be at risk of abuse or neglect, or the majority of their personal care and support needs would not be met.
  • Moderate– this includes adults who need help from social care services or they would be at risk of some social isolation and some of their less vital personal care and support needs would not be met.
  • Low– this includes adults who need help from social care services or one or two non-vital personal care or support needs would not be met.

We carry out a Community Care Assessment to find out which level of care need (low, moderate, critical or substantial) a person’s needs fall into.  We can do this for both the person and their carer.

What happens in Somerset now?

We currently pay for care for adults with moderate, substantial and critical care needs.

Although we do not normally pay for services to people with low levels of need, we do offer advice and information to everyone, regardless of the level of need.

What are we proposing to change?

The Council is proposing to raise the eligibility threshold so it only pays for services to meet substantial and critical needs. This means the Council would no longer pay for some services to meet people’s moderate needs.

Please note: No-one would have their care services reduced or stopped until their needs had been reassessed by a social worker. If services are to be reduced, this would be done gradually where possible and appropriate. The Council would help people make alternative arrangements.

Around three quarters of councils in England already restrict the help they offer to people with substantial and critical needs only, including Devon, Cornwall, Dorset, Wiltshire and Gloucestershire councils.

Who would be affected?

This could affect anyone aged 18 or over with needs assessed as moderate who is getting care paid for by the Council, or anyone who may need these kinds of services in the future.

This would include older people, adults with learning or physical disabilities, mental health needs and people with hearing and/or visual impairments.

It would also affect any unpaid carers whose needs are assessed as moderate.

Please note: Only a limited number of people who currently get support from the Council are likely to be affected by this change if it does take place.

How might it affect people?

Existing service users and carers would be reassessed and the new threshold applied. This would result in some service users and their carers no longer having some or all of the services that they are currently receiving paid for by the Council. People may be able to pay for these services themselves, or we could help them make alternative arrangements such as taking part in suitable activities in their local community.

However, services would not be immediately withdrawn. Service users, carers and family members would be fully involved in the process, advised about alternative services available and given reasonable time to make arrangements.Please remember, current services would not change for anyone until their social care needs had been reassessed.

What services would be affected?

At this stage we cannot say what services would be affected because services are not categorised as critical, substantial or moderate. It is a person's needs that are assessed and categorised in this way.

Assessments look at individual circumstances, and the effect any change in service would have on them, as part of the decision-making about whether a need is moderate, substantial or critical.

Because everyone's circumstances are different, the services that meet their moderate needs are different too and we won’t know what those services are until a reassessment has been done.

Services that prevent abuse or neglect or meet important needs such as personal care, or keeping people safe and comfortable in their own home would not be affected if a change to the threshold takes place.

Why are we thinking about making this change?

  • We have less money: The Government has announced big reductions in the amount of money it gives Councils to provide services to local people, so we have to make what we have go further. That means making difficult decisions about how we can do some things at less cost and what things we can no longer do. Raising the eligibility threshold for adult social care is one of several ways of making savings being looked at by the Council.
  • Growing demand: We are facing a growth in demand for adult social care services because: more people are living longer, more people need help with long term health conditions such as dementia, and more disabled children with very complex care needs are surviving into adulthood.

What happens next?

When the consultation period ends in January 2011, the results will be reported to County Councillors to consider before they decide if this change should happen. The decision is due to be made by the Council’s Cabinet on 2 February, 2011.

If it is agreed that the eligibility threshold should be raised, this change would be implemented from April 2011. That means we would use the new threshold when assessing the needs of any new people who have not received care before.

For the limited number of people with moderate needs already receiving care, we would contact them and organise assessments during the year.

As part of the consultation the Council will comply with its duties under the Equality Act 2010 and disability discrimination legislation, to identify what impact this proposal will have on diverse communities. This will help make sure that our services are meeting people’s needs fairly and that all people who are eligible are able to access those services.

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