Councils tighten care criteriaMore needs to go unmet as authorities cut costs

23 December 2011

Support for low or moderate needs allows older people to remain in their own homes. 

Latest Which? research has found that councils are continuing to tighten care needs criteria, with over two thirds now meeting only 'critical' and 'substantial' needs. 

Moderate needs left unmet

A Which? investigation using information gathered through Freedom of Information requests from 163 authorities in England and Wales, shows that councils have further tightened their eligibility criteria for providing elderly residents with care in their own home. 

National guidelines define four levels of need - low, moderate, substantial and critical. Councils can choose which of these they are prepared to meet. In 2009, we found that 69% met only critical and substantial needs. In 2010, this increased to 70%. For 2011-12 the upward trend has continued, with 73% of councils now excluding those with low or moderate needs.

A few hardline authorities, such as Northumberland Care Trust, West Berkshire and Wokingham go further and assist only those with critical needs. Others, such as East Riding of Yorkshire and Northamptonshire, won’t meet all substantial needs but choose to distinguish between ‘higher’ and ‘lower’ substantial needs. The Isle of Wight now meets substantial needs only ‘if there is a risk of these becoming critical’. 

Early intervention an exception

Against this background, it’s good to see a few authorities bucking the trend. Sunderland and Rhondda Cyon Taff meet moderate and low needs - taking the view that early intervention pays off in the long run. 

Sunderland continues the policy outlined by Neil Revely, director of health, housing and adult services: 'The approach is working and demonstrating that not only is prevention better than cure in terms of quality of life, but also in relation to the economics of the situation. The approach over the post two years has seen the admission rates of people to specialist care steeply declining.' 

Caps on costs removed  

Another trend revealed by the latest research is that more councils in England and Northern Ireland have removed the weekly cap on how much an individual can be asked to pay. 62% now have no cap, compared to 54% in 2010. Brighton’s cap is still highest at £900, but all Welsh authorities have now dropped theirs to just £50.

Commenting on the latest findings, Which? researcher, Ian Robinson said: 'With the government considering recommendations from the Dilnot Commission and a White Paper due early next year, this survey is a timely reminder of the postcode lottery that currently prevails. Let’s hope future findings show a more equitable pattern.'                 

More on this...

  • Long term care - how the long-term care system works
  • Choosing a care home - key considerations when choosing a care home
  • The Dilnot Report - main features of the Dilnot Report looking into long-term care