It looks as if the new year may bring some sort of resolution to the Dilnot dilemma. We at least have a firm commitment to implement a cap on the contribution individuals have to make to their care.
If there is follow-through from the statements made in association with the coalition mid-term review this will be a welcome step forward.
A change to the architecture of funding social care is needed. The current system is complex, and catastrophic costs fall randomly on individuals who have no means to plan or insure against them. So a commitment to implement the kind of funding system proposed by the Dilnot commission is welcome.
With the Care and Support white paper published and implementation under way, there remains one further commitment local government and the care sector would like to see central government make.
We urgently need the government to resolve to properly fund care and support for older and disabled people, people with mental illness and other vulnerable adults.
Councils and directors of adult social care continue to work with partners nationally and locally to develop health and wellbeing boards, agree strategies, improve quality of care and use of resources and to co-ordinate and personalise care for individuals. Yet there are huge strains in the system.
With council budgets being reduced in the face of rising demand for care and rising levels of need, there is a squeeze at every stage. Tight council budgets mean tight personal budgets, just about adequate to meet eligible needs.
The call for savings puts pressure on expenditure on discretionary activity, which includes preventative services, and the need to save significant amounts on budgets largely spent on services provided by the independent sector means a squeeze on price. This in turn puts pressure on visit times, training and on the pay of care staff.
The impact of this multi-layered squeeze falls on the people in need of care and support.
There is huge support for the vision and aspirations set out in the white paper and bill. But without a commitment to adequate funding, there is a real risk of a growing gap between what we want to deliver, the way we want to work and the reality of what is affordable on the ground.
Sarah Pickup, president, Association of Directors of Adult Social Services