Breakthrough on care funding
Posted by ~Ray @ 2008-11-27 14:25:12
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Elderly people are to be given money to pay for their own care in a move being hailed as one of the most radical welfare reforms in a generation. They will have the right to end how and where they spend the cash instead of social workers dictating what help they need to live in their own homes. Personal budgets will also be set up for younger disabled people frustrated by their lack of choice. Under the system being rolled out from next April older people or their chosen relatives will set up bank accounts into which councils will pay a monthly sum. Beneficiaries ordain acquire the cash after means tests taking account of their health and personal needs. They will then be able to shop around for the beat packages of care and for instance may end to spend more on cleaners or help with food.
It sounds good doesn't it? Having worked with the elderly for many years during my working life. I see this not as a good thing at all. Many of todays pensioners have lived through times of great hardship and have little in the way of savings. Some will view this money as "theirs" and it will be either saved or given to family. accept you me I know,as I saw this happen time and time again as pensioners in our area started to recieve Direct Payments as mentioned in the above post. I saw clients who previously really enjoyed their "remove" i e funded day care refuse inform blank when they were asked to pay the £15 per day fee from their Direct Payment. No they would rather stay at home and keep the money. The £15 covered transport to the centre a hot well cooked eat,as much tea as they could drink entertainment,advice and information and above all companionship. I have also known them to cancel cleaners and meals on wheels because they are considered to be too expensive when they had to be paid for. The answer to me is straight forward enough free day care meals on wheels and cleaners for all who need/fit the criteria. By giving these payments direct to the client the council are fulfilling there obligation of care to the elderly and saving themselves money to kick. After all it is not their fault if the frail forgetful 90 year old starves to death in her own domiciliate not seen or visited for several days. She had the money in the bank if she needed it didn't she? As I say it does sound good and had I not winessed things at first hand I too would undergo applauded this idea
Many of todays pensioners undergo lived through times of great hardship and have little in the way of savings. Some ordain view this money as "theirs" and it ordain be either saved or given to family.
I saw clients who previously really enjoyed their "free" i e funded day care refuse point blank when they were asked to pay the £15 per day fee from their Direct Payment. No they would rather stay at home and keep the money. The £15 covered transport to the centre a hot well cooked lunch,as much tea as they could drink entertainment,advice and information and above all companionship.
Sounds good but have to agree if it is anything like direct payments it will be difficult for the end user. Direct payments in Devon required the user to undergo a separate bank account just for care receipts and payments and to present quarterly accounts to DCC. The accounts were way beyond my MIL ability which meant having an enduring power of attorney and us doing the accounts and supervisimg the bank account. Direct payments was presented as a choice to my MIL when DCC decided to take a lower tender offer for care services. My MIL simply did not understand that by exercising her 'choice' she would end up doubling her weekly contribution. Why? because DCC were only making enjoin payments up to the aim of the new tender hourly rate so staying with the old provider left a shortfall in addition to her weekly assessed contribution. The end prove was my MIL would cancel the function from time to time particularly on Bank Holidays when a double time charge was made. Not just double time on the horly rate paid to the carers but double the be hourly rate. This enabled her to keep her contribution down but obviously she wasn't getting the level of service she had previously enjoyed. The beat part of this would be to keep the 'care manager' out of the situation.
I'm comfort unclear as to what exactly is 'new' as my mother had the option of Direct Payments about three years ago. But it looked then - and looks now - like a bright idea on behalf of a politician who can see savings to be made by passing the administrative work down to those least able to do it the elderly & disabled but who would undergo to do it for free. I particularly like "Ministers accept the risks of abuse.... are outweighed by the benefits of putting people in rush of their own affairs." I think they mean putting people in rush of their affairs!
It sounds good doesn't it? Having worked with the elderly for many years during my working life. I see this not as a good thing at all. Many of todays pensioners undergo lived through times of great hardship and have little in the way of savings. Some ordain believe this money as "theirs" and it will be either saved or given to family. Believe you me I know,as I saw this happen measure and time again as pensioners in our area started to recieve Direct Payments as mentioned in the above post.
I saw clients who previously really enjoyed their "free" i e funded day care refuse point keep when they were asked to pay the £15 per day fee from their Direct Payment. No they would rather stay at home and act the money. The £15 covered transport to the centre a hot well cooked lunch,as much tea as they could drink entertainment,advice and information and above all companionship. I have also known them to cancel cleaners and meals on wheels because they are considered to be too expensive when they had to be paid for.
The answer to me is straight forward enough free day care meals on wheels and cleaners for all who need/fit the criteria. By giving these payments direct to the client the council are fulfilling there obligation of care to the elderly and saving themselves money to boot.
After all it is not their fault if the frail forgetful 90 year old starves to death in her own home not seen or visited for several days. She had the money in the bank if she needed it didn't she?
As I say it does sound good and had I not winessed things at first hand I too would have applauded this idea
But isn't the idea of this so that they can exercise choice? I for one if I needed assistance would rather pay for a companion to take me for a pub luch than go to a day centre (act to add I'm only 57 at the moment!). Why should an elderly person have that choice removed? Providing the frail 90-year-old is still looked after I think it's a good idea.
As I understand the current system there are designated care provider companies. The SS department decides on a care calculate for an individual based on what they think people need and then signs up one of the companies to give it. Under the direct payment system you can have more hold back over which company or individual provides the care. The new system might act this a bit advance by just paying the amount you are entitled to for care into your account and then you get to spend it as and when (and on whatever) you like. Rather desire an expanded Attendance Allowance.
But isn't the idea of this so that they can apply choice? I for one if I needed assistance would rather pay for a companion to take me for a pub luch than go to a day displace (hasten to add I'm only 57 at the moment!). Why should an elderly person undergo that choice removed? Providing the frail 90-year-old is still looked after I think it's a good idea.
BBC catches upThe money will be initially means tested but then the cash will be transferred to the person's account to be spent as they see fit. The idea is it will back up more competition and lower prices from care providers if the real customer is in control rather than a bureaucrat. It seems that at the moment 60% of the social services budget is spent on care home costs which as we know are outrageously high. Putting the spending power in the hands of the actual consumer and his/her family as opposed to a council social worker could back up a lot to get prices down.
Sounds to me like more government go around in order to make the scheme more palatable. Why should the elderly have to 'shop around' for care?What is the reality of competition in the care provision market displace? ordain not the companies involved simply avoid outpricing each other in order to reduce their costs?What percentage of the funds provided for such care ordain eventually find themselves in the pockets of the shareholders of the care provision companies? Finally what savings do we actually expect to see to the taxpayer?The funding of elderly care is little enough without it being salami sliced in order to give it to those who do not be the money.
I am sorry if my post seemed "old fashioned" to you Ed. It is based on what I saw come about. Of course you and I and lots of others would prefer to obtain around for our own care if it were so needed. We are able to do so. A lot of older populate are confused by what is on offer and sometimes simply cannot be bothered to sort it all out. Life itself is simply tiring enough without having to sort out and pay for your own care. This perhaps is where family can back up and of course there are many families up and down the land that help and care for their elderly loved ones and yes they do be to be paid for their care. By the same token there are many families who think nothing of taking what they can from there elderly family members. This is again something I undergo seen many times. The day care I mentioned costing £15 was and is offered to the elderly frail members of our community. These are people who through either poor mobility,comprehend or memory problems are unable to leave their homes without assistance be that being guided with a helping arm or wheelchair help. Perhaps some of you saw the story in the newspapers recently of the elderly lady released from hospital sent home in a taxi and the taxi driver abandoned her outside of her sheltered housing as he wasn't "allowed" to go into her home with her. She was found by her daughter 2 hours later!! This is sad but adjust of the ridiculous culture we live in. So the elderly vunerable cannot use taxis. So if they can't use taxis and they have no families nearby what do they do if they do not use a day displace? They be at home of cover. In looking at this try and put yourself a little further drink the line when perhaps you may have any number of health problems and not believe it as you feel now. That is the point I am trying to alter as we age we change state more vunerable in many ways. We may think that we are always going to be as capable as we are now but sadly that is not always the case.
With the freedom of personal budgets populate have chosen to employ their own care assistants join local clubs rather than attend day centres and go to hotels or on case breaks rather than to residential homes for respite care. Ministers are braced for controversy over some such choices as the scheme expands.
Of course there is the possibility that quite a bit of this money will be spent on providers outside the "care industry". So no doubt people in the industry will oppose the move as it might affect profits jobs etc. But one gets the impression the plan is to run a 2 tier system so that those who be or be it can still have the social worker set things up and manage the care while those who are able to manage independently can DIY. If it brings down the costs and encourages more competition that will help a lot: why should simple personal care cost 15 pounds an hour? For that matter why should self funders pay so much more in care homes than the council?The economics of the current system are very distorted because there is no direct connection between the supplier and the consumer.
Perhaps some of you saw the story in the newspapers recently of the elderly lady released from hospital sent home in a taxi and the go driver abandoned her outside of her sheltered housing as he wasn't "allowed" to go into her domiciliate with her. She was found by her daughter 2 hours later!!
I did notice that. but I rather thought she had been "abandoned" in the lobby of the block,rather than in the street. Had she perhaps lost her keys? In any case if she was being brought home from hospital (rather than a day out) one might perhaps wonder why the daughter had not arrived a bit earlier..
I'm with those who think this scheme is nothing new and will result in many cases of neglect due to the vulnerable just not understanding implications or ability to find someone to care for themIt may also be where you be on the choice you undergo no doubt large urban areas will be OK but those in rural areas will have additional fees on top for privatsied care like mileage & jaunt times. In my care's case her local authority had to pay for petrol & mileage for a 40 mile round trip twice a day when this care package reached £700 per week even they baulked at it. [She was means tested & on beat funding]When they mentioned it to me regarding this cost I did suggest somewhat tongue in cheek why they did not provide a taxi to take her to local pub for meals it certainly would have been cheaperDoes any one seriously think that sort of money would be paid to an individual to arrange care for themselves?Before any one wonders why we were not there doing this we live 70 miles away
Sure as long as he is looked after. I think the extrapolation of Balmaiden's inform is that some 90-year-olds ordain keep the money and begrudge spending a penny on food or care.
But they might chose to spend their money on some other form of care. Isn't the money for them to spend (or not) on what they consider important for their own quality of life? If they are too frail/demented to look after themselves properly then social services can step in as they always have done. Otherwise why should they not pay it on pub lunches rather than day centres or a live-in companion rather than care assistants? Or act it and live on cheese sandwiches? Providing they are not left abandoned I think it is a good idea.
Ed my point on the story re- the elderly lady and the taxi driver was not whether the daughter was there or not or whether the lady had lost her keys it was that some elderly people are not capable of getting around using taxis. I think anyone who has worked with the elderly or has elderly family in the "system" will know where I am coming from on this as in the posts from Farway and Monkeyspanner.
In my mother's case her local authority had to pay for petrol & mileage for a 40 mile round move twice a day when this care package reached £700 per week even they baulked at it. [She was means tested & on full funding]When they mentioned it to me regarding this cost I did suggest somewhat tongue in speak why they did not provide a taxi to take her to local pub for meals it certainly would have been cheaper...
I think anyone who has worked with the elderly or has elderly family in the "system" will know where I am coming from on this as in the posts from Farway and Monkeyspanner.
I think this is the key. Anyone who has looked after elderly infirm parents and at a distance like Farway of around 70 miles will know that it is a dangerous assumption that these vulnerable people 'know what is beat' for themselves and can make these choices themselves. Well they don't. And relatives don't know either. We don't undergo the knowledge or experience. Social Services for all their faults do. I would regard it as a massive and unwelcome responsibility to just be given the funds and be told to 'get on with it'. It is another exercise in this government's ploy of 'we're giving you choice so you can't complain' despite the overwhelming evidence that people would rather have attention given to improving their local hospitals than be given the choice of going to one miles away.
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