Author: Anji Mehta

Financial advice around social care costs

Posted on by Anji Mehta

Mistrust and lack of understanding limit access to financial advice around social care costs, research suggests

Adult social care and financial services sectors share aspirations towards better joint working

A lack of understanding between members of the public, adult social care organisations and the financial services sector is preventing people getting advice about paying for care later in life, new research suggests.

The Care Act 2014 made it a requirement for local authorities to provide information on how to access independent financial advice on matters relevant to care and support – but few people in fact do so.

Researchers at the University of York analysed past policy and academic papers, and interviewed members of the public and professionals in order to better understand the barriers people face in this area.

They found mutual desires for joint working from adult social care and financial services organisations were being hampered by poor cross-sector awareness, which fuelled mistrust of one another’s motives.

Members of the public, whose reluctance to plan ahead for care was seen as the single biggest obstacle to seeking advice, also lack knowledge of financial services and are instinctively wary of them, the study found. This caution contrasted with the benefits reported by participants who actually went on to seek assistance from regulated professionals.

Lack of focus

The study’s literature review element found there had been little research focus on financial advice around social care over the last 20 years. An uptick in references within the policy sphere, with the advent of the Care Act, had fallen again because of attention being diverted to the 2015 reforms to pensions.

No academic papers found by the research team took financial advice around later life care as their main focus. Nonetheless, available evidence suggested that barriers to access include poor signposting and suspicion of the financial sector, but that advice from regulated advisors was seen as useful.

Interviews with people involved in giving and receiving advice revealed that, perhaps unsurprisingly, financial-sector experience and personal wealth made accessing advice more likely – with those who had received regulated advice citing a number of benefits.

“Advice could enable people to pay for care not otherwise affordable, through either purchasing a previously unfamiliar product (a care fees annuity) or rearranging finances to maximise assets,” the study report said. “The financial security offered by engaging a regulated financial adviser could engender a sense of agency, even empowerment, and reduce anxiety about the future among individuals with care needs and their families.”

But other interviewees mentioned advisors’ pushy tactics, or poor financial outcomes from following non-specialist advice – both factors likely to worsen perceptions of the sector.

Family and friends, meanwhile, were seen as valuable sources of informal advice and professional recommendations, but could also generate conflicts of interest, for example on the part of adult children with stakes in an inheritance.

Cross-sector mistrust

The study identified mistrust between the financial and adult social care sectors as a major obstacle to people accessing advice.

“Local authorities could view financial advisers with suspicion because they work on a for-profit basis and are assumed to help self-funders avoid paying for care; these views were shared by some voluntary organisations and care providers,” it said. “Regulated financial advisers could view local authorities as sources of misinformation, not acting in the interest of advisers’ clients, a view which was shared by some care providers and information services.”

A lack of signposting towards financial advisors represented a failure of joint working, researchers said. Despite this, they found good examples of joint working – for instances by councils and information services working together to help self-funding members of the public understand financial information at times of crisis.

All stakeholders, the study found, shared a common purpose: “keeping self-funders self-funding so they could have choices and afford their preferred care for life, without falling back on local authority funding”. The research team also noted that factors such as ‘choice’ and ’empowerment’ used by the financial sector also echoed terms used in relation to adult social care’s personalisation agenda.

With uncertainty over long-term care policy creating a challenge for all parties, both sectors demonstrated “a desire for cross-sector, cross-party working, and to rekindle the joint working that had fizzled out after the Care Act implementation in 2015”, the study report said.

Building blocks for joint working

Kate Baxter, a research fellow at the University of York’s Social Policy Research Unit and one of the study team, said: “This research shows that an aversion to and ignorance about financial advisers and products acts as a barrier to self-funders seeking financial advice about paying for care. However, people who did seek financial advice described non-financial as well as financial benefits, for example, a sense of empowerment and reduced anxiety.

Baxter added: “There was also a lack of understanding between adult social care organisations and the financial services sector. Cross-sector mistrust was a key challenge, when in fact both sectors aimed to keep self-funders self-funding for as long as possible. Terms typically used in adult social care, such as choice, control and holistic planning, were mirrored by the financial services sector; this common ground can be seen as the building blocks for future joint working.”

Responding to the findings, York council’s Sharon Calline said: “The findings from this study provide important information that can increase understanding between local councils and the financial advice sector, and emphasises common purposes. It is clear that local authorities need to work closely with financial advisers, to ensure that self-funders receive the best possible information and advice. This will enable them to have choice and to be confident that they have made the best use of their resources in providing for the cost of their future care needs.

She added: “By establishing links with Later Life Planners, members of our local council team that undertake the financial means test are now equipped to identify and refer people who would benefit from independent financial advice. Similarly, the council can support self-funders to claim attendance allowance, and we are starting an awareness campaign in local care homes about financial advice. This approach can only have positive outcomes all around.”

Potential of assistive technology in adult social care

Posted on by Anji Mehta

Councils not yet tapping potential of assistive technology in adult social care, study finds

Survey of English local authorities reveals savings-focused use of telecare and other technologies can compound recipients’ isolation and loneliness

Local authorities’ using telecare and other assistive technologies are failing to exploit more than a fraction of the potential benefits to recipients and their families, new research has found.

A survey of all English councils with social care responsibilities, backed up by selective interviews, found almost all deployed telecare as part of a strategy to reduce the need for care, safeguard and enhance quality of life.

Authorities, which are having to deal with rising social care demand at a time of shrinking resources, had mostly developed their approaches “unilaterally”, with only a quarter working collaboratively with health partners.

The NIHR SSCR-funded study found considerable variation in the quality of assessments for telecare.

It also concluded that reviews of systems, often carried out remotely, tended to focus on the performance of equipment rather than on the needs of users.

Diane Buddery, a project manager at the Skills for Care charity, said the study posed questions for councils as to why assistive technology’s positive potential was “not mirrored by sufficient investment or development of skilled staff”.

She added that Skills for Care would be continuing work to promote learning and skills around assistive technology provision. The NIHR study made a number of recommendations for practice improvements, including around investment in training and better recognition of how telecare could be used to identify and address loneliness.

Risk management

The research found most local authorities used assistive technology to manage risks faced by older people around independent living, for example by using sensors to monitor their routines, or enabling them to call for assistance.

The online survey revealed that assessments were “conducted by a range of community professionals, including social workers, care managers, occupational therapists [and] specialist telecare workers” and in a variety of settings.

The assessments were variously carried out separately or as part of wider evaluations of need, with only 16% of councils saying that a formal assessment was ‘always’ carried out before an installation. Less than half of councils provided training to telecare assessors; in most cases this was delivered by an equipment manufacturer and was not accredited.

While most authorities reviewed assistive technology installations annually, the survey found “reviews are usually done by telephone and often seemed to focus on the technology, not the needs of the telecare user”.

Only a third of authorities described their telecare service as “person-centred”, in that it avoided standardised packages in favour of prescription according to specific needs and the ability to deliver bespoke packages. More than a fifth said their service was part person-centred and part service-driven.

Compounding isolation

The study concluded that many local authorities are using assistive technology in a “problematic” way, “because of the potential [for it] to compound social isolation”.

The strategic focus on managing independent living was too narrow, it concluded, with almost no local authorities considering how technology might be used to address feelings of loneliness. “Many ‘false alarms’ made to call centres may arise from a need for human contact, and this should be recognised rather than seen as an inappropriate use of a device,” the research report said.

The study recommended that councils should consider whether different groups of professionals had the necessary skills to optimise the benefits of assistive technology installations.

“Given the level of investment in telecare, exploration of training effectiveness and more investment in training might help better equip assessors – regardless of professional background – with the skills to enable recipients to get the best out of telecare,” the report said.

Barriers to better use

Responding to the findings, Skills for Care’s Diane Buddery said the organisation, which seeks to promote skills and leadership in adult social care, welcomed the study.

“The report found that skill deficits among professional staff responsible for assessing for telecare, and lack of staff with the right skills to install telecare, were cited by commissioners and senior managers as barriers to better use of telecare,” Buddery said.

“While this study demonstrates wide agreement about the many positive aspects of telecare, it poses questions about why this is not mirrored by sufficient investment or development of skilled staff, who can maximise imaginative and knowledgeable solutions from a wide range of suppliers to meet need.

New journal for adult social care research

Posted on by Anji Mehta

A new international open access journal for social care research has launched, supported by NIHR SSCR. 

The international, peer-reviewed Journal of Long-Term Care (JLTC) has been established to advance the research evidence base for all aspects of long-term care for adults.

The open access journal has been commissioned from the International Long-term Care Policy Network (ILPN) at the London School of Economics and Political Science.

The NIHR SSCR supports the principle of open access to the outputs of research, which can offer both social and economic benefits as well as aid the development of new research and stimulating wider economic growth.

Professor Martin Knapp, Director of NIHR SSCR, said:

“It is very exciting to see this new journal emerging. The aim is not only to get high-quality research evidence on adult social care out into the public domain, but to do so in a way that puts no restrictions at all on access.”

Dr Jose-Luis Fernandez, Executive Editor of the Journal, added:

“The journal fills an important gap in the academic market, and will provide a much-needed home for the rapidly growing volume of high-quality long-term care research. The evidence published in JLTC will allow us to share robust evidence about key aspects of long-term care policy and practice, research methods and education, and thus help maximise its potential for impact.”

The first articles in JLTC include findings from three NIHR-funded studies – one on the economics of unpaid caring, another on whether age matters in the social care workforce, and the third on priorities for long-term care resource allocation in England.

Submissions to JLTC are currently free, and further details can be found on the JLTC website. All articles are published online as open access on the journal’s website to encourage maximum impact for all work.