"As the population ages and more pressure is put on
social care, the Department must ensure that its oversight of the
care market is robust, that people have access to the information
and support that they need and that it has arrangements in place in
the event of large providers getting into financial
difficulty"
Amyas Morse, head of the National Audit Office,
15 September 2011
Shortcomings must be addressed if value for
money is to be secured in the future for users of social care
“personal budgets” once they are extended to all eligible users by
April 2013, according to a report published today by the National
Audit Office. Most people who use personal budgets to pay for their
social care report improved wellbeing. But more needs to be done to
ensure that care markets deliver a genuine choice of services to
all users, that support is available to help them exercise choice,
and that essential services relied on by vulnerable people continue
to be provided in the event of the failure of a major provider.
Today’s report finds that some people are
using their personal budgets in innovative ways, such as pooling
them with others to pay jointly for a personal assistant to help
with their care needs. Most people who use a personal budget report
improved wellbeing although a small minority feel worse off. Some
also reported that they found buying care for themselves
difficult.
Some local authorities report that personal
budgets have led to achieving better value for money in social
care, but the overall impact on cost has not been evaluated. And,
whilst there are examples of good practice in some local
authorities, such as offering help to those with personal budgets
to plan their care, these are very localized.
Local authorities are also responsible for
those that fund their own care, if they run out of money. However,
60 per cent of local authorities do not know how many
“self-funders” there are in their area. Few local authorities offer
formal support to help prevent people falling back on state
funding. The NAO estimates that the total cost to the taxpayer of
the state having to pay for self-funders who run out of money could
rise from £0.5 billion to £1 billion per year by 2035.
The Department of Health is responsible for
overall social care policy, but it has few means of influencing the
way that local authorities deliver care. Local authorities have
powers to assess needs and manage care. The Department should
determine where market oversight is not sufficient, and if more
central oversight is necessary. The recent financial problems faced
by Southern Cross illustrate the need for government to develop a
system to address serious provider failure.
Publication details:
HC: 1458, 2010-2012
ISBN: 9780102969993