To ask Her Majesty's Government what is the margin for error in their estimate in the impact assessment on the Personal Care at Home Bill of about 110,000 younger adults being eligible for free personal home care. [HL412]

To ask Her Majesty's Government what is the margin for error in their estimate in the impact assessment on the Personal Care at Home Bill of the cost of re-ablement services being £130 million a year. [HL413]

The estimate of 110,000 younger adults eligible for free personal care at home is based principally on the referrals, assessments and packages of care (RAP) data from councils for 2007-08¹.

Fair Access to Care Services (FACS) guidance on eligibility for local authorities, a copy of which has already been placed in the Library, establishes four levels of eligibility for services. These are critical, substantial, moderate and low, with critical representing the highest level of social care need.

The RAP data shows 82,000 younger users of local authority home care and 35,000 younger users of direct payments on 31 March 2008—out of 395,000 younger recipients of community-based services. It is not known what proportion of the 117,000 who receive personal care are in the critical need group, but it is expected that they would be the majority.

Therefore, for the purposes of the impact assessment, it is assumed that there could be some 100,000 younger adult local authority-funded users receiving personal care in the critical category. It is likely that most of them receive their care free, as their incomes are generally low. It has therefore been assumed that 90 per cent already receive free personal care at home and that 10 per cent make a means-tested contribution towards the cost.

Little is known about the number of younger adults who currently fund their own care at home. It has been assumed that approximately a further 10,000 younger adults may be brought under state funding following the introduction of the Personal Care at Home Bill.

No specific estimate of a margin of error has been made. However, the figures have been rounded to the nearest 10,000 to reflect the uncertainty. The figure of 110,000 should therefore be treated as an estimate.

The estimated cost of extending reablement services is based on an assumed cost per person of £1,000. This is an average cost and acknowledges that the actual cost of individually tailored packages will lie within a range depending on the length of time and specialist services required.

The anticipated benefits of reablement—ie, helping individuals to live independently at home for longer, thus delaying the need for formal care and/or admission to residential care—have not been specifically included in the impact assessment, so if benefits do arise this will free up resources which can be spent on offering more people reablement services. Neither the number of individuals who already benefit from reablement, nor the precise scale of the benefits, is known for certain. For this reason, no attempt has been made to quantify the net cost/benefit of reablement services.

Note:

1 The RAP data for 2007-08 can be found at: www.ic.nhs.uk/statistics-and-data-collections/social-care/adult-social-care-information/community-care-statistics-2007-2008:-referrals-assessments-and-packages-of-care-for-adults-england-provisional-council-data.

To ask Her Majesty's Government what is their basis for the forecast in paragraph 5.10 of their assessment on the Personal Care at Home Bill that volumes of service demands would increase by 1.5 per cent per annum and prices by 2 per cent per annum; and whether they had regard in making those forecasts to the increase in the demand for and cost of free personal home care in Scotland between 2003-04 and 2007-08. [HL414]

To ask Her Majesty's Government what proportion of the 933,000 elderly people in 2010 estimated by the Personal Social Sciences Research Unit to be in the highest critical needs category will receive free personal home care under the Personal Care at Home Bill who (a) receive no such free care now, and (b) pay for a proportion of such care now. [HL415]

The assumptions about the annual growth in volumes and unit costs are taken directly from Personal Social Services Research Unit (PSSRU)'s micro-simulation model for older people. The figure of 1.5 per cent per year increase relates to the estimated impact of demographic pressure. It is separate from the estimated impact on demand of the introduction of free personal care. The figure of 2 per cent increase in real terms per year is a PSSRU assumption reflecting expected real rises in average earnings.

In Scotland, the experience of extending free personal care differs in respect of coverage, in that it is provided not just to those in highest need and includes those in residential care. For this reason, it was not considered appropriate or relevant to extrapolate changes in demand for personal care to the English context.

Fair Access to Care Services (FACS) guidance on eligibility for local authorities, a copy of which has already been placed in the Library, establishes four levels of eligibility for services. These are critical, substantial, moderate and low, with critical representing the highest level of social care need.

Table 10 of the PSSRU's technical report of its micro-simulation model for older people¹ estimates the number of people aged 65 and over whose needs are assessed as critical according to FACS before informal care considerations. Since the receipt—or not—of informal care forms part of the FACS assessment, it is important to take this into account when estimating the volume of individuals whose needs are likely to be assessed as critical according to FACS criteria, which the PSSRU does in table 12 of its report.

In addition, when estimating the volume of individuals likely to benefit from the proposals in the Personal Care at Home Bill, it is important to exclude those living at home who are not considered to be in highest need—that is, those requiring help with fewer than four activities of daily living—and those in residential care.

As a result—and including estimates of two specific demand effects—the estimated number of older people who will receive free personal care at home under the Personal Care at Home Bill is approximately 55,000 and the number estimated to be making a means-tested contribution towards the cost is 35,000 in 2011-12. These figures, which are shown in greater detail in table 2 of the impact assessment on the Personal Care at Home Bill, should be treated as estimates.

Note:

1 Analysing the Costs and Benefits of Social Care Funding Arrangements in England: Technical Report; Forder and Fernandez; PSSRU discussion paper 2644; July 2009.

To ask Her Majesty's Government whether, under the Personal Care at Home Bill, local authorities will continue to have discretion over (a) setting local service eligibility criteria, and (b) charging for adult social care, so that they can recover costs or reduce services to other users. [HL416]

The Personal Care At Home Bill itself will not directly impact on the Fair Access to Care Services (FACS) guidance on eligibility, a copy of which has already been placed in the Library. FACS guidance to local authorities establishes four levels of eligibility for services; these are critical, substantial, moderate and low, with critical representing the highest level of social care need.

A separate consultation on the revision of the existing FACS guidance ended on 6 October. The intention is to bring forward revised guidance in the new year.

The department is consulting separately on the detailed regulations and guidance under the Bill and the proposal that the offer of free personal care should be restricted to people in the FACS critical category who also need significant help with four or more activities of daily living.

Any alteration to councils' ability to charge for aspects of care would need to be reflected in the department's Fairer Charging guidance, a copy of which has already been placed in the Library.

To ask Her Majesty's Government which items costing more than £10 million a year they plan to cut from the Department of Health budget to pay for their share of the costs of the Personal Care at Home Bill; and in which areas, and what amounts of, departmental research and development will be reduced. [HL417]

Changes to planned expenditure in 2010-11 include nearly £50 million from indicative advertising and communications spending, over £60 million from management consultancy spending and over £20 million in reduced administration costs.

In addition, a saving of £62 million will be achieved by transferring responsibility for research activity from other departmental budgets to the department's ring-fenced research and development budget. That budget will rise to over £1 billion in 2010-11. The research it currently funds will continue as planned.