How many people need social care?
Nearly 1.4 million people aged 65 and over requested support from councils in England in 2019-20. Add to that 560,000 working-age adults and a steady rate of increase and the demand will soon exceed 2 million people.
How many receive it?
About 1.4 million people, according to estimates of long-term and short-term care use. However, there is a backlog of people awaiting needs assessment by councils which is likely to increase considerably when the new policy of allowing self-payers to use councils to buy their care in order to get a lower price.
Who pays?
Until the latest changes, anyone with assets above £23,250 has to pay all their social care costs, until their assets have dwindled to this level. At that point councils start to contribute, but will only pay 100% of costs if assets are below £14,250, and any income from sources such as pensions or dividends can also affect council contributions. The new upper and lower asset thresholds will be £100,000 and £20,000. Roughly 70% of social care recipients in England have all or part of their costs covered by the state, with about 30% paying all their own costs.
What is the cost to the taxpayer?
Local authorities spent £23bn on adult social care in 2019-20, up more than £1bn from the previous year, according to the King’s Fund. Despite rising demand, in real terms, it is only £100m higher than in 2010-11. The NHS England budget is £136bn this year. The average council-funded old age care home place costs £679 a week and almost double that for a working-age adult.
What is the cost to the private buyer?
The government estimates that one in seven people aged 65 will face care costs over £100,000. People who pay their own fees have to pay on average 41% more than councils pay, at least according to a 2017 report by the Competition and Markets Authority (CMA). That implies an average of more than £950 a week, but places costing well over £1,000 are not unusual.
Why the difference?
Because care homes have been “propping up their finances” by charging private payers more while “councils are paying fee rates for the residents they fund which are below the costs care homes incur”. Those were the conclusions of the CMA four years ago when it said the shortfall was £1bn a year. Care industry analysts believe it is considerably higher.
What is to be done?
The government wants private buyers to stop subsidising the public sector, but many believe that to level the prices charged requires more cash in than it announced this week. The spending review this autumn is a chance to do that, but expectations are not high that the playing field will be levelled immediately. Not-for-profit care operators argue that the sector should become entirely not-for-profit, as the dividend demands of investors backing private firms are distorting the picture.
