Paying for long-term care

There is growing consensus that the time has come to rethink how we fund care and support.

In July 2011, the independent Commission on the Funding of Care and Support will report its conclusions. By then, Andrew Dilnot (Chair), Dame Jo Williams and Lord Norman Warner, will have spent a year reviewing existing evidence, gathering fresh evidence, consulting and deliberating with a wide range of key players and members of the public.

For over fifteen years, JRF has been gathering evidence on how to build a sustainable funding system for long-term care. This has included: learning from other countries, including from Scotland's approach; seeking service user views; considering different models (for example: social insurance (1996 inquiry report); private insurance; a care levy where each generations pays its own care costs). Over the same period, Joseph Rowntree Housing Trust (JRHT) has demonstrated different funding models in practice in care schemes in Yorkshire and the North East (most recently a mixed-tenure extra-care housing scheme in Hartlepool).

Drawing on this knowledge and experience, JRF believes any new model needs to be fair, simple to understand, and sustainable – both financially sustainable and also socially sustainable. We believe that any funding system needs to be capable of supporting delivery against outcomes defined by people who require care and support to lead an 'ordinary life', including older people. We also believe that the current levels of funding for social care are inadequate to deliver person-centred support, and that a reformed funding system must help incentivise more investment into low-level support – 'that bit of help' that people value, want and choose to enjoy a better life in their own homes and communities.

Key work

Contributing to the future of care and support in England

JRF is keen that any new system supports different ways of framing social care in relation to human rights, citizenship, voice, choice and control, fairness (including across generations) and sustainability (financial sustainability, social sustainability). Over the past three years, we have:

• Submitted responses to consultations – most recently a response to the Law Commission consultation on adult social care and a response to the Dilnot Commission consultation on funding social care.
• Published a report by Centre for Policy on Ageing which builds on a previous JRF Older People's Inquiry into That Bit of Help. It pulls together evaluated examples from England, Scotland and Wales of low-level support services for older people.
• Published a series of Viewpoints to stimulate debate:
  - Funding care: how can each generation pay its fair share?
  - Funding social care: what service users say
  - Identifying a fairer system for funding adult social care;
  - Reducing gender inequalities to create a sustainable care system;
  - Duty and obligation – the invisible glue in services and support;
  - Care and support – a community responsibility?;
  - Does anyone care about fairness in adult social care?;
  - What future for care?; and
  - Rethinking social care and support: what can England learn from other countries?
• Invested in the development of equity release as a potential solution for asset-rich, income-poor older home-owners. In January 2010 we published a report on Can equity release help older home owners improve their quality of life? We are now supporting further work to distil the learning from three local authority pilots in Kensington & Chelsea, Islington and Maidstone. The pilots are run by the local authorities in partnership with Just Retirement, Just Retirement Solutions, and Safe Home Income Plans.

Housing with care funding models for older people

Joseph Rowntree Housing Trust (JRHT, JRF's sister charity) operates different funding models that are understood by all and benefit those on lower incomes. These create flexible pots of money that can be used to achieve what older people actually want and need. See www.jrht.org.uk.

Intergenerational issues

JRF held two local events in York and Bradford to encourage cross-generational thinking on care and support in the future.

In Scotland

JRF sponsored the Holyrood Conference on Personal and Social Care Provision (17 June 2010), presenting from our evidence base on long-term care funding.

In Wales

JRF responded to the Welsh Assembly consultation on Adult Social care in 2009.

In Northern Ireland

JRF held an 'Older people: choice and independence' event in Belfast in February 2009.