Older Londoners reveal hurdles to accessing home care services

26 FEBRUARY 2010

A new report published today documents the experiences and concerns of older people accessing home care in London and reveals many are struggling to navigate their way through the current system.

Older people in the capital told the London Assembly’s Health and Public Services Committee that the process for assessments can be complicated, opaque and long-winded, leading to many people facing long delays.

The Committee’s report Home Truths[1] says more than 1700 older people in London waited more than three months for an assessment and more than 1500 faced delays of at least six weeks following a successful assessment to receive all their services[2].

The report says many have problems accessing the home care they need because local authorities are dealing with a growing older population and other major pressures on their budgets.[3] In addition, older Londoners are more likely to need home care than older people elsewhere because they are more likely to live alone, in poverty, in poor health and without local family support.[4]

Three quarters of local authorities in the capital currently can only fund services for older people with the most severe needs[5]. While some boroughs such as Westminster and Richmond provide care for those with “moderate” needs and above, most only fund home care for people whose needs are assessed as “critical and substantial” [6]. This means that an estimated 165,000 older Londoners with care needs have to make do without any local authority help at all, or pay for their own care [7]. 

The Committee also says older people often lack clear information and advice, with many not knowing where to get the help they need to access the right care.

The report makes a number of recommendations to improve older people’s experience of the homecare system in the short-term:

  • The Department of Health London Region should develop guidance on fast and effective assessment processes for people who want personal budgets
  • The Mayor should promote preventative services that can plug the gap for people with lower care needs
  • The Mayor should assess the feasibility of setting up a pan-London frontline information line for older Londoners

James Cleverly AM, Chair of the London Assembly’s Health and Public Services Committee, said: “Home care services are a vital lifeline for thousands of Londoners, allowing people to retain their health, independence and dignity.  However, we heard that older Londoners are facing real challenges in accessing home care services that meet their needs.

“Many are facing unacceptable delays in being assessed which can lead to their conditions deteriorating before they get the help they need. Many are finding that their borough’s services are restricted to only those with severe needs, or are struggling to navigate the myriad of information about what they are entitled to. 

“While there are currently debates about the long term future of social care funding, in the short-term budgets are likely to come under even greater strain in coming years, potentially reducing the help that is available even further. We hope the Mayor and the Department of Health will consider our recommendations as they could make a significant difference now in improving people’s access to home care.”

Samantha Mauger Chief Executive at Age Concern London welcomed the Committee’s report: “Older Londoners are particularly likely to need home care but they currently face real challenges in obtaining the help they need.  We support the London Assembly’s recommendations for greater promotion of preventative services and a new London-wide frontline information line to make it easier for people to link with local advice services and so navigate the complex system.”

The report is available in full at: http://www.london.gov.uk/who-runs-london/the-london-assembly/publications/health

Notes to editors:

  1. Home Truths: Older Londoners’ access to home care services
  2. Community Care Statistics 2007-08, NHS Information Centre for Health and Social Care www.ic.nhs.uk
  3. Analysis of the Social Care Market for Older People’s Services in London, 2008, Rse Consulting for London Councils.
  4. Local authority budgets are under increasing strain because of rising costs of delivering more complex and intensive home care services, changes to the central government funding formula that have disadvantaged London and the possible extra costs of delivering the Government’s agenda for personalised services.
  5. Source: London Borough websites and Analysis by Age Concern and Help the Aged; June 2009, available at www.lgcplus.com

Levels of care funded by London Boroughs under Fair Access to Care Services criteria (Most local authorities only fund home care services for people with less than £23,000 savings.):

People with critical, substantial and moderate needs - Westminster; Richmond upon Thames; Kensington & Chelsea

People with critical, substantial and upper/high moderate needs – Sutton, Hammersmith & Fulham, Islington

People with critical and substantial needs – Barking and Dagenham; Barnet; Bexley; Brent; Bromley; Camden; City of London; Croydon; Ealing; Enfield; Greenwich; Hackney; Haringey; Harrow; Havering; Hillingdon; Hounslow; Kingston upon Thames; Lambeth; Lewisham; Merton; Newham; Southwark; Tower Hamlets; Waltham Forest; Wandsworth

People with critical and greater substantial care needs – Redbridge

  1. Explanation of “moderate” ,“substantial” and “critical” needs available at: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4019641.pdf
  2. Getting Care Right for Older Londoners, 2009, Age Concern London
  3. As well as investigating issues that matter to Londoners, the London Assembly acts as a check and a balance on the Mayor.

The Chair of the Committee, James Cleverly is available for interviews.  Please contact Julie Wheldon in the Assembly media office on 020 7983 4228 or 07826 532686.  For out of hours media enquiries, call 020 7983 4000 and ask for the London Assembly duty press officer.  Non-media enquiries should be directed to the Public Liaison Unit on 020 7983 4100.