“When the money runs out”: capital depletion and transition out of self-funded care

Introduction

Many people pay the full costs of social care themselves. They may not approach the council because they know they are unlikely to get help. Even when the council assesses people as needing social care support, the person will have to pay the full cost of their care if they have savings/assets above £23,250.

Many care services are expensive and over time the person will use up a proportion of their savings. When savings/assets fall below £23,250 people can request a needs and financial assessment from the council. The council may step in at this point to meet some or all of the cost of care. Little is known about people’s experience of asking for support, or what happens when there is a change from self-funding to council support. This research will involve speaking to the different groups involved to fill this knowledge gap. Proposed changes to the law (from 2023) may mean this shift from self-funding to council support affects more people. Councils will need to manage this extra pressure (workload and financial) whilst supporting service users.

The project will focus on care homes, because this form of care has a number of distinctive features. Residents who self-fund care often pay higher fees than those supported by the council; this can be the case even in the same care home. If the council will not pay the level of fees that residents previously paid privately, the resident may be moved to a new home, possibly outside their local area. Alternatively, family members may contribute financially, to top-up what is paid by the council or, care providers may accept lower fees for the resident to stay in their home.

Methods

The project will begin with interviewing around 24 care home managers/owners, and about 10-15 people each from three other groups:
• residents and their family;
• people in councils who buy care services or conduct financial assessments;
• those who provide independent advice.

From initial interviews, a picture will be developed of what has been occurring. Gaps in that initial picture will be identified and where this is the case there will be additional interviews with those groups from whom more information is needed. It is expected that there will be up to 90 interviews in total.

Once understanding of the transition from self-funding to council support has been gained, whether this fits in with economic theory will be explored. It may transpire that as ‘big players’ in the market, councils could push care providers into accepting low prices. There may be other circumstances where providers can charge councils more than the council would ordinarily pay. Economics is a way of understanding the choices that people make and the motivations behind those choices, particularly in the context of financial or time pressures.

Overall understanding from the research will be used to create resources to help councils, providers and independent advisers to support residents, improving their overall experience as they move from self-funding to council support. The motivations of these different groups to change current practices will also be considered.