Caremark Thanet Are Holding a Care Advice Afternoon

Who Are We?
Caremark Thanet is a domiciliary care company serving the Isle of Thanet. We have been providing care in this area for about five years. We now deliver close on 1800 hours of care every week. We provide care to around 120 customers and employ almost 90 people.

The World of Domiciliary Care
There is little doubt that the world of health and social care is a complicated one. For those of you who might be considering domiciliary care for yourself or someone you know, one of the most challenging things is finding information. Sometimes you cannot find information; sometimes you find too much.

Our Advice Afternoon
On Saturday 10 February 2018, between 2.00 - 4.00 pm we will be holding an advice afternoon. This event will be held at Smith's Court Hotel, Eastern Esplanade, Margate, CT9 2HL. The principal aim of the afternoon is to answer any questions that you might have, or at least point you in the right direction.

Some of the issues that we can advise you about are:

1. The main types of funding available.
2. The assessment processes that are involved to qualify for funding.
3. Obtaining direct payments from social services.
4. Your right to choose your home care provider.
5. how to find a home care provider.
6. What are some of the questions you should consider when looking for home care.

If you would like to book a place at our advice afternoon, call us now on 01843 235910 and ask for Jemma Clayton or Garry Costain. We look forward to seeing you.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Government Shelves Plans to Cap Care Costs from 2020

Introduction

The government has shelved plans to introduced a £72 000 cap on social care costs. The cap was due to come into effect from 2020. The Care Act 2014 provided the legislative base for the cap. The article below was written in 2014 when there was quite a bit of media attention about the cap on care fees.

At the time the article was published, The Care Act 2014 had not long received the Royal Assent. In the article I argued that there was no guarantee that the cap would, in fact, come into force. The relevant section providing for the introduction of the cap had not yet been implemented and the Act itself did not set any figure at which a cap, should one be implemented, should be set. The government's original intention was to introduce the cap from 2016 - hence the reason that my article refers to 2016 not 2020. This was later revised to 2020.

Given the debacle over social care funding following the Conservatives' manifesto launch during the election this year, and the announcement that there will be green paper on social care next year, it is probably not surprising that the cap has been shelved. It is equally unsurprising that the announcement was made during some tricky brexit negotiations. Perhaps the brexit spotlight has cast a shadow on the social care situation, at least in the short term. I have been saying for some time now that history will judge this government not just by brexit but also on how it deals with social care funding, and social care more generally.

What follows is a slightly modified version of an article first published on 2 October 2014.

The Care Act 2014 and Caps on Individual Care Costs

You may have read in, or heard on, the news that The Care Bill became the Care Act 2014 when it received the Royal assent recently, on the 14 May 2014, to be exact. Potentially, the Care Act 2014 contains some major reforms that will have important consequences for people receiving care in their homes.  A reform of huge significance for everyone involves an upper limit, a cap, being placed on the amount that you as an individual will have to pay for your domiciliary care.

The Legislative Process

The Care Act 2014 (from now on referred to simply as the Act) is an Act of Parliament. An Act of Parliament – or a statute as it is often called - is law made by Parliament. Parliament consists of one elected body - the House of Commons – and two unelected bodies, the House of Lords and the Monarch. A statute begins its life as a Bill. To become law it must be passed by all three of the bodies that make up Parliament. In the Houses of commons and the Lords this is achieved by the members voting in favour of the Bill. The Monarch – ie the Queen – grants her assent, which, it might be suggested, is a type of vote. The final stage in a Bill’s progression through Parliament is reached when it is granted Royal Assent, at which point a Bill becomes an Act.

However, just because a Bill has become an Act does not mean that its provisions have come into force; indeed, far from it. Today, it is fairly typical for a statute to be granted Royal Assent and only over a period of time – often a period of years - for its provisions to come into force. There are some Acts of Parliament various parts of which have never come into force.

The different parts of a statute are generally brought into force by a cabinet minister. Section 127 of the Care Act 2014 says “The provisions of Parts 1 to 4 come into force on such day as the Secretary of State may by order appoint.” Section 127 is known as a commencement section. Parts 1 to 4 are the main parts of the Act. Therefore, even though we now have a Care Act that is law in England and Wales, all the important reforms that it contains await implementation by the Secretary of State over time.

The Care Act 2014

The Act is long – 129 sections contained in 167 pages - and wide ranging. Norman Lamb, the care minister has described the Act as “[representing] the most significant reform of care and support in more than 60 years”.  Speaking more generally about care and the new Act, Norman Lamb has commented that:

"Care and support is something that nearly everyone in this country will experience at some point in their lives….Even if you don’t need care yourself, you will probably know a family member or friend who does, or you may care for someone. And many more of us will need care in the future, so it is important for us to have a modern system that can keep up with the demands of a growing ageing population….Until now it’s been almost impossible for people who need care, carers, and even those who manage the care system, to understand how the previous law affecting them worked.”

Amongst other things, the Act deals with personal budgets, duties on local authorities, minimum eligibility thresholds and, of course, caps on the amount that you as an individual will have to pay for your care.

The Cap on Your Individual Care Costs

Under the current system, to qualify for your care costs to be paid by social services you need to have less than £23 250 in savings (known as your capital) and be on a low income. For more information on this, go to this page.

The new Act provides the legislative framework to place a cap on the total amount that you will have to pay in your lifetime.  There will be a needs assessment – currently known as a community care assessment. The care and support that you are assessed as requiring will be care and support for what will be known as your “eligible needs”. The cap on your care costs is the maximum amount that you will have to pay in your lifetime to meet your eligible needs.

It is important to note two points. First, at this moment in time the relevant part of the Act dealing with the cap has not been brought into force. The intention expressed by the government is that the cap will operate from April 2016. However, there will be a general election in 2015 and we may have a different government. As explained above, it is for the Secretary of State (who is Jeremy Hunt at the moment) to bring into force the relevant part of the Act.

The second thing to note is that there are no figures contained in the Act. Once again, the government has expressed an intention, this time to the effect that the cap should be set at £72 000. Just as with the implementation of the relevant part of the Act dealing with the cap itself, the actual figure at which the cap is set will be set and implemented by the Secretary of State.

The cap will not cover what are called “living costs”. This is highly relevant if you were looking to move into residential accommodation. The cap will not cover such costs as utility bills and food. The aim behind this is to try not to disadvantage those receiving domiciliary care. If you have home care; you still have to pay for things like heating and food. Therefore, excluding living costs from the cap attempts to gain some consistency between those in residential care and those receiving home care.

The cap will only cover the cost of meeting your eligible needs. You may want something extra. In such a case you will be expected to pay for that yourself. For example, if your eligible needs require a home care visit of 30 minutes each morning, only the cost of those visits are covered by the cap. If you wish to have a 45 minute call each day, you will have to pay for the extra 15 minutes.

 

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website atwww.caremark.co.uk/thanet.

An Outline of the Main Sources of Health and Social Care Funding

Introduction

Finding information about health social care funding can be likened with searching for the source of the Nile: Everyone knows it must exist somewhere. My aim in this article is to explain the principal sources of funding (primarily I address funding for domiciliary care) and provide links that you can follow for more detailed information. Just a word of caution here. I provide links to some of my own articles, which in some cases may contain figures that were accurate at the time. It is always worth bearing in mind that any figures cited may now differ.

Social Services Funding

Funding from social services is means tested. Therefore you may qualify and have to make no contribution; you may qualify and have to make a contribution, or you may not qualify. Prior to any means test being conducted, you will have to have a care needs assessment. This article explains about the care needs assessment. Although it refers specifically to Kent County Council, the principles stated apply wherever you are in England. This article explains about means tests. Again, it refers to Kent County Council but the principles are general.

If you qualify for social services funding you now have a choice. Social services can set up everything for you and that will suit many people. However, you will have been awarded what is called a personal budget. You can take this budget in the form of a direct payment. You can then use this money to purchase your own home care. If you have care from a private provider, you may well have to make a contribution from your own funds. Many people are happy to do this.

With a small number of exceptions, you have a right to a direct payment. A right that is enshrined in law - in the Care Act 2014. You do not have to have your home care through social services. You do not have to have your home care arranged by social services. You do not have to have your home care from a company recommended by social services. You have a right to choose; this right cannot be denied to you.

Social care funding is a controversial topic. You may recall that during the 2017 election the Conservative Party's manifesto proposals for funding social care were met with the most hostile criticism. The proposals were so badly received that is arguable that they contributed significantly to the Conservatives poor showing at the polls. I have been saying since then that history will not judge this government on brexit alone. It will judge it to a large degree on what - if anything - it does about funding social care.

Self Funding

If you do not qualify for social care funding you will have to fund your care yourself. This article offers you some advice about choosing home care. Essentially your choices are: use a private domiciliary care provider; employ you own carers directly; use self-employed carers. Option one is likely to be the most expensive. Options two and three clearly provide you with a financial incentive. There are, though, a few things to bear in mind. 

I go into a little detail about the things to bear in mind in this article. Although this article was written expressly about live-in care, the challenges of employing carers or using self-employed carers are identical whether you are talking about live-in care or other types of domiciliary care. In brief, if you employ a carer, you are an employer and have all the responsibilities that employers have. If you engage a self-employed carer who works exclusively for you, as far as HMRC is concerned you are an employer.

Continuing Health Care Funding

If you are assessed as having primary health need, You may qualify for financial support through NHS Continuing Health Care Funding. The NHS Choices website provides a very unhelpful circular definition of primary health need. Assessments are carried out by a multidisciplinary NHS team. There is no right to an assessment, but if it seems that you might need NHSCHC then the Clinical Commissioning Group (CCG) for your area must carry out an assessment. 

There is no means test for Continuing Health Care funding. As with social care funding there is a mechanism for you to have a personal budget, called a personal health budget. Once again, this is something to which you have a right, with a few exceptions.

Intermediate Care

There are occasions when you might need  little bit of help to maintain or regain your independence, for example, when you are due to be discharged from hospital. In such circumstances, you may qualify for intermediate care. This article explains about intermediate care. There is no means test for intermediate care.

Enablment or Reablement

The approach underpinning reablement is to help you to live your life independently. Reablement workers are not charged with the responsibility of doing things for you; they are responsible for helping you become confident and competent in doing things for yourself. This article gives more details. Again, there is no means test for those who qualify.

If you would like more information about any of the above, follow the links or telephone me at Caremark Thanet on the number below.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

You Have a Choice: The Care Act 2014 and Your Right to Direct Payments

You Have a Choice

This article offers advice about choosing your domiciliary care provider. It is particularly aimed at people who are, or who are seeking to be, wholly or partly funded by social services. If you fund your own domiciliary care you can choose your provider. The same is also true if you are funded through social services: you have a choice. You may be very happy for someone to sort everything out for you: and there is nothing wrong with that. However, the fact that you are reading this suggests that you might be interested in exploring your options. Let’s look, then, at what having a choice means.

Social Services Assessments

I have written about these in previous articles so I’ll keep this quite brief. To qualify for social services funding there are two assessments required. The first is a needs assessment the second is a means test, an assessment of finances. You can read my articles on needs assessments and financial assessments by clicking the links.

If you qualify for social services support you will be given a personal budget. If you wish to choose your own care provider you can have your budget paid to you as a direct payment. As I said above, you do not have to do this. It is your choice. Whoever does your assessment should advise you that this choice is open to you.

Direct Payments

If you choose not to have a direct payment, social services will sort everything out for you. If you do choose a direct payment, you can look after it yourself or someone can look after it for you. Someone who looks after your direct payment for you is referred to as your nominated person.

You have a right to have a direct payment. It is enshrined in law. Section 31 of the Care Act 2014 says that if you request a direct payment, the Local Authority to which the request is made “must” make the payment to you. In an Act of Parliament, the word “must” used in this context means that a duty is imposed on a body or bodies, in this case Local Authorities. Where there is a duty imposed on a body there is usually a right granted to another allowing enforcement of that duty. In this case you have the right to a direct payment that is enforceable against the Local Authority.

There are certain circumstances where social services can refuse a direct payment request. However, under usual circumstances, so long as you are able to consent to having direct payments you will be entitled to them.

The Benefits of Direct Payments

As this is public money, quite rightly, you cannot spend a direct payment on just anything; and you will be audited by your Local Authority. Direct payments do, though, give you a large element of control over your care package. Direct payments allow you to choose your home care provider rather than having one chosen for you. But it is more than that. There are wider benefits that flow from exercising choice. 

Choice promotes dignity, and brings independence, and self-reliance, and enhances well-being, and satisfaction and peace of mind, and gives a sense of achievement: And these are benefits that should never be underestimated.

Nothing, though, is set in stone. You can change your mind. If you decide to allow Social Services to look after things for you, you can, at a later date, choose to have a direct payment. There is flexibility in the system to work for you. For more information about obtaining a direct payment and changing home care providers click on this link.

You have a choice.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Social Care Funding and Political Miscalculation

Health and social care funding is now well and truly a part of the political geography of the UK. As far as England is concerned, it has for years been a blot on the landscape that has undergone several attempts (actual and proposed) to hide it from view. Today, we have now discovered that the blot is built on a fault line and the plates have move. The tremors have been felt in Downing Street: the damage is serious.

During the week beginning 15 May 2917, the Conservatives published their election manifesto. Their plans for social care funding in England proved monumentally - and perhaps - disastrously controversial.  There are very few people who would disagree that something has to be done about social care funding. The question, though: is what should be done?

Social care needs more money; but where is that money to come from. The options are few. First, money can be taken from another area of public spending. That's not going to go down too well with the people in the departments affected.

Second, money can be raised from the public. The thorny point here is who should pay. At the moment, if you require social care you get no financial help if you have savings above £23, 500. Below this figure, you receive some financial help. If more money is to be raised, should it fall upon everyone to contribute even though not everyone will need social care during their lifetime. Alternatively, should those who need social care be required to pay for it.

At this election, the big division between the parties on the question of social care funding saw the Liberal Democrats and Labour in favour of distributing the burden more widely, and the Conservatives placing the burden on those who need social care. With the Tory proposals, if you required domiciliary care, your home would form part of your savings for means test purpose; whereas at the moment it is excluded. I should submit, that the Tory manifesto proposal for funding social care was electorally catastrophic for them. Teresa May's claim a few days later that there would be a cap on the social care fees you would have to pay - a cap not mentioned in the manifesto - just made things worse.

Labour called the Tory proposals a dementia tax. The grey vote was alienated. At the 2015 election, 47% of people aged 65 and over and 46% of property owners voted Tory.  I may be wide of the mark here, but I would not be surprised if the children of property owning parents voted to keep their inheritance. On Monday May 15 2016, a poll of polls but the Tories 17 percentage points ahead of Labour. Today, with the election results all but in, the Conservatives are the largest party in Parliament but have lost their majority.

With a hung Parliament, it is questionable whether social care is going to be high on any coalition government's agenda. On the other hand, perhaps there now exists an opportunity deal with the issue of social care funding: it is not going away, that is certain.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Funding Social Care in England: What the Main Political Parties Propose: UPDATE

At the time of writing this article, political parties have published their manifestos and are actively campaigning throughout the country for our votes. Predictably, there is little agreement amongst the parties on most things. There is one point, however, upon which all parties agree, and with which few people in the country would take issue: that point of agreement is that our social care system needs reforming. There is no agreement, though, about how this reform will be funded. This article very briefly looks at what the main parties propose for funding social care in England.

The week just gone, week beginning Monday 15 May 2017, saw the Conservatives publish their manifesto. The proposals contained in that manifesto for funding social care have received quite an amount of media attention. At the moment, financial help with social care fees is provided to people with savings less than £23,250. With regard to domiciliary care, the equity in your home is not taken into account (it is for residential care fees).

The Conservative's proposal is that help with social care fees will no be available for people with savings up to £100, 000. However, the equity in your home will be included in the calculation for qualifying for help with both residential and domiciliary care fees. You will not have to sell your property during your lifetime nor whilst a surviving partner is living in your home. You will, though, have to take some form of loan to pay for your care fees until your savings drop below £100,000.

The thing that occurs to me is that the long term consequence of this may be to discourage home ownership and saving and in a generation or two's time we will be back to a social care funding crisis. To prevent this occurring there may need to be penalties incurred by those who dispose of assets in their lifetime and/or some kind of social care tax or insurance. Which brings me to the Liberal Democrat's proposals.

The proposals from the Liberal Democrats include an immediate one penny rise in the basic, higher and additional rates of income tax. This will raise, it is claimed, £6 billion that will be used to fund the NHS and social care. At some future point, this one penny increase will be replaced by a health and care tax, which may involve a reform of our national insurance system. Eventually, the aim is for one health and social care budget.

Labour's proposals include developing a National Care Service for England. Social care will receive an extra £8 billion during the first Parliament of a Labour government, with an additional £1 billion in the first year. The National Health Service and the new National Care Service will require £3 billion extra in the "first years". A limit will be placed on an individual's lifetime contribution to care fees. To pay for these proposals the Labour manifesto suggests options including wealth taxes, employer contributions and/or a social care levy.

The inescapable fact is that the money to fund social care has to come from somewhere. To give more money to social care either some other area of Government spending receives less, or more money is raised. And the ways of raising more money are fairly limited.

Update

As you are undoubtedly aware, Teresa May announced last week (week beginning 22 May 2017) that, should the government be re-elected, there would be a cap on the amount that you are expected to pay for your social care; notwithstanding that this commitment was not present in the Conservatives' manifesto.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Thanet’s Changed Home Care Landscape

If you live in Thanet and receive domiciliary care through social services you may be aware of the controversial change that has come into effect this year, 2014.  

Home care in Thanet, like home Care throughout Kent, is provided by a number of private companies under contract with Kent County Council (KCC). Until this year, KCC worked with over 120 providers throughout Kent. From 2 June 2014, this was reduced to 23. In Thanet there will be just 3 home care providers. New contracts were issued in July 2017. You can see the providers for each area in Kent here.

Why Have KCC Reduced the Number of Home Care Providers They Work With?

The reduction in providers was clearly a highly contentious decision by KCC. The UK Home Care Association (UKHCA), a body that represents domiciliary care providers, commented that any loss of support could be catastrophic. Saying that something could be catastrophic is a use of pretty strong language. Bridget Warr from the UKHCA is on record as saying that her concern “…is that what we’ll end up with is vulnerable people not getting the support they need at the time they need it.”

No-one at KCC could have imagined that the move to reduce providers would be met with universal acclaim. So why do it? Well let’s look at things from KCC’s perspective. The social care pot is finite. And as with other local government services; it is a finite pot from which savings had to be made. To add to the Council’s burden, social care needs continue to increase. Working with fewer providers will save the council about £2.7 million per year. The council has stated that the care and length of visits that people receive will remain the same. You can read more on the changes made by KCC here.

What Are The Effects For People in Thanet Receiving Home Care from KCC?

If you live in Thanet and currently receive domiciliary care through social services it may well be the case that you will notice very little difference. You may be in the fortunate position where the care you had before the change continues, following the change, in exactly the same way with exactly the same carers. But it may not. 

If your care does not continue to be delivered to the high standard that you have been used to in the past the major consequence of the change is that the choices open to you to select care from a provider which can meet your needs is significantly reduced.  

Remember that care from social services is provided by private companies on behalf of KCC; not by social services itself. The selection of just 3 providers to provide care to you has excluded a number of Thanet domiciliary care providers from being able to provide care to you: even though these companies, and their excellent care staff, may have been providing you with outstanding care for some considerable time. Reducing your freedom to choose in this way is manifestly unfair.

What Can You Do?

If you are receiving home care through social services, fortunately, there is something that you can do. And it is something that is very simple. All you have to do is ask that KCC provide you with a direct payment so that you can buy your own care from the provider of your choice. There are a small number of cases where you will not be entitled to a direct payment, but these are very rare. In most cases, you have a right to have a direct payment. Have a look here for more information on direct payments from KCC. 

A direct payment allows you to buy care services from a provider of your choice. This will include the provider responsible for your care prior to the change introduced by KCC. Direct payments work in a very straightforward way. KCC pay an amount of money into your bank account or onto a Kent Card. The Kent Card is a Visa debit card and you can find out more details here. 

The changes introduced by KCC start from 2 June 2014. If you want to chat, without obligation, about switching to direct payments contact Jayne Costain, the Care Manager, or Garry Costain, the Managing Director at Caremark Thanet. You can speak with them on 01843 235910 or email them at thanet@caremark .co.uk.

 

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.