Care Support Independence

What is care and support?

Care and support helps people to be independent, active and healthy throughout their lives. It is about helping people to do day-to-day things like:

• Living in their home
•  Working
•  Cooking
•  Shopping
•  Caring for their family

The care and support system includes a wide range of services. Below are some examples:

• Meals on wheels
• Home adaptations
• Housing support services
• Support to help disabled people live independently
• Benefits for disabled people
• Occupational therapy
• Day care
• Care homes
• Support for carers

Who needs care and support?

Any of us might need care and support at some time in our lives. The main users of care and support services are:

• People who have had an accident
•  People who have a long term illness
•  Disabled people
•  Older people

 Who provides care and support?

There are a number of ways that care and support is provided:

• Local authorities pay for and provide services
•  Central government provides financial help through benefits and grants
•  Families pay for care services and provide care themselves
•  Voluntary and community organisations provide care services and schemes
•  Private companies

 What is the role of families in providing care and support?

There are 5.2 million carers in England and Wales who care for a family member or friend. This can be rewarding but it can affect a carer’s health and career as well as impact on the wider family. Families often pay towards the care and support of their loved ones as well. For example, some older people who get local authority funding to pay for a care home also receive extra top up payments from their families.

Families mean different things to different people. In the care and support debate, we are using the word family to talk about family members, friends and neighbours who help individuals with care and support needs.
How is the care and support system funded today?

There are three sources of funding for the care and support system:

• Individuals pay for some or all of the charges for the services that they receive
•  Families provide care or pay towards the cost of services
•  Everyone in society pays through local and general taxation. The money that is raised is used to provide services or financial help.

The government believes that the costs of care and support will always be shared, but that there are different ways in which we can look at balancing this responsibility in the future.

Why do we need a new care and support system?

"People want, and have a right to expect, services with dignity and respect at their heart. Older people, disabled people and people with mental health problems demand equality of citizenship in every aspect of their lives, from housing to employment to leisure. The vast majority of people want to live in their own homes for as long as possible."
‘Putting People First’
Dec 2007

There are two main reasons:

• We are living much longer than we used to. There are more older people and disabled people are also living longer, healthier lives. This good news means that more people need care and support and they need it for a longer period of time.
•  Our expectations have changed. People have told us they want more choice and services that are flexible and personalised to their individual needs.

These two factors mean that the cost of care and support will increase and the current system will not be able to meet the demands of the future. You can read a report on the "funding gap" here. The Government will continue to spend money as efficiently as possible but this alone will not be enough. Changing the system is an opportunity to make the system fairer, to make sure that peoples’ demands are met and to help people to plan for their future care and support needs.

 What is the Government already doing?

The Government has developed an extensive transformation programme to improve the care and support system. This includes Putting People First, which is:

• Personalising services so that individuals have more choice and control over the care and support they receive
• Creating more preventative services that help people before they need care and support
• Improving the quality of care and support services
• Improving information so that people can make informed decisions about care and support services.

Other current initiatives include:

• The Independent Living Strategy which will enable disabled people to have the same choice, freedom, dignity and control over their lives as non-disabled people
•  The Dignity in Care campaign, which aims to ensure that all health and social care services respect the dignity of the people who use them
•  The Carers Strategy, which is improving the package of support given to carers
•  The Dementia Strategy to improve quality of life and quality of care for people with dementia, in particular through early diagnosis and allowing people to stay independent for longer.

What is the Government’s vision for society?

The Government wants a society where:

• Everyone is respected and included as equal members
• Everyone has the opportunity to fulfill their potential
• Public services empower people and help them to meet their aspirations
• Everyone can understand their role in terms of what they contribute to society and what they are entitled to from government

What does the Government’s vision for care and support mean for society?

For care and support, the Government’s vision means that people are supported to:

• Live independently
• Stay healthy and recover quickly from illness
•  Have as much control over their own lives as possible
•  Llive with or look after their family
•  Participate as active and equal citizens
•  Have the best possible quality of life

 What should a new care and support system do?

By listening to what people want from care and support, the Government has created some key principles that will underpin a new care and support system. People have said that a new system must:

• Give people independence, choice and control
• Make sure that everyone can get the care and support they need but that funding is targeted at those most in need
• Be affordable for the Government, individuals and families in the long term

 How is care and support provided in other countries?

• In Japan, the Government encourages people who need care and support to use formal, organised services so that carers, particularly daughters and daughters-in-law, do not need to take on too much. This system is funded half by general taxation, and half by premiums taken from the wages of people over 40 as well as private pensions.
•  In Germany, the Government encourages more informal care and support. German people pay into a specific care fund throughout their working lives and people who have no children have to pay more. If care is needed in later life, people can choose between formal services or a lower cash payment which can be used to support the members of their family who care for them

Why does the Government want to have a debate about care and support?

The Government believes everybody should be able to have their say about how a new system should work as every adult in England will be affected by these changes. Many of us will need care and support when we get older or we will have family members or friends who will need it.

Between May and November 2008, the Government engaged with service users, carers, members of the public and shareholders to get their views on how care and support services should be delivered in future.

These views will feed directly into a Green Paper which will be published in 2009. The paper will suggest various ways in which the system could work in the future. Publication will be followed by a period of consultatuion, when the Government will go back to those it engaged with and test its ideas.

This website will have regular updates on the consultation progress, and provide visitors with the chance to share their opinions. You can read more about the engagement process in the Stakeholder, Media and What’s New sections of this website.

What are the key issues?

You can read about the key issues on the pages listed below and register for updates on how the debate is progressing.

• Achieving our vision
•  Sharing the responsibility
•  Setting clear, fair rules

If  you or a member of your family need care and support or health services, go to the Directgov website where you can find information about public services that can help you.