Care Act 2014 Social Care & Funding Reform Understanding the Costs The Lincolnshire Model

1. Care Act 2014 Social Care & Funding Reform Understanding the Costs The Lincolnshire Model By Glen Garrod Director of Adult Social Services Lincolnshire County Council

2. Lincolnshire Context • Population of 718,800 • Predominantly Low Skilled, Low Paid Economy, Pockets of Deprivation • Lowest quartile in terms of council tax rates • 29% of total service budget spent on social care in 2013/14 • Cost of in-house services reduced from £27m to £3m between 2011/12 & 2013/14 • Revenue Budgets in 2013/14 • Gross £206.431 • Net £140.709 • Additional ongoing Cost Pressures identified including: • Demographic Growth (Highest Growth of over 75s in East Midlands) • On-going pressures within Learning Disabilities Services • Residential and Nursing rate agreements • Impact of Care Act and Dilnot recommendations • Integration with Health

3. The Lincolnshire Model • Attempts to estimate the additional cost to Lincolnshire County Council as a direct result of the implementation of the Care Act 2014. • Increase in Asset Thresholds • Implementation of the Care Cap • Statutory Responsibilities to Carers • Additional Assessment Activity • Loss of Existing Service User Income

4. The Lincolnshire Model • Concept of the model is simplicity, with the emphasis on local variation so that it can easily adjusted to suit local conditions and is built on the following basis: • Use of Formulae where possible • Use information that is generally available to all (e.g. Service User and Brokerage data) • Use recognised assumptions around areas such as inflation and asset values • Incorporate other pieces of intelligence

5. The Lincolnshire Model • Sources of Data Include: • Existing Service User Data • Average levels of Income for Self Funders • Model the impact of threshold increases on existing SU • Establish Attrition Rates • Laing & Buisson Evaluation of Lincolnshire Residential Sector • Used to calculate estimate of self funders • Detail of self funder rates • Brokerage Data • Establish average hourly rates of Dom Care • Establish average hours of care delivered • Land Registry Datato establish average property values around • Terraced • Semi Detached • Detached • Maisonettes • Staff and Assessment Data to establish cost of additional assessment activity

6. The Lincolnshire Model • Findings: • Cost to Lincolnshire over ten years estimated to be £157m • Impact of threshold will be felt immediately • £6.4m cost of new services users • Reduction in existing contributions £1.7m • Total financial impact including on-going assessment costs in 2016/17 is £11.7m • Impact of Care Cap not felt until Year 7 (2022/23) • Due to lower than average cost of residential care • Impact does not reduce over time, at year 10 (2025/26) additional financial impact totals £20.6m

7. The Lincolnshire Model Analysis Year 1 – from 2016/17

8. The Lincolnshire Model Analysis Year 10 – 2025/26

9. The Lincolnshire Model • Next Steps: • Continued work to establish the cost of reforms with regional and national finance groups • Further validation and correction of the model • Look to establish other examples of best practice and apply to the model • Establish the impact of any significant revisions pre/post general election • Apply further budgetary changes e.g. changes to residential rates

10. The Lincolnshire Model

11. Headlinefindings-support 99%ofcouncilssaidthey wereawareofthetools and supportthat have beendeveloped nationally(Q45).Councilswereaskedwhichtools have advanced theirconfidencein deliveringtheCare Act(Q45a),andalso tooutlineanyadditionalsupport,guidanceor informationthat wouldincreasetheirconfidencefor implementationin2015(Q46).Theirresponsesare below: CareActStocktakeandsupport 10