A STANDARD hourly rate for carers is to be introduced this week by the government as part of a “common-sense approach” to long-term care benefits.
Social Security Minister Lyndsay Feltham said the change would also ensure a “sustainable home-care sector”.
With demand on the long-term-care sector expected to grow in the coming years, questions of sustainability – and how to achieve a more sustainable future for the sector – have to be considered.
Deputy Feltham laid out proposed changes to the long-term-care scheme in her “ministerial action plan”, which responds to an independent review into the sector carried out by LaingBuisson for £70,000.
Commissioned in 2023, the review was due to be released at the end of last year, with all changes implemented in the first half of 2024.
But January’s vote of no confidence – which included a reshuffle of the Council of Ministers – meant there were unforeseen delays, and the current Social Security Minister only received the report this summer.
What is the scheme and how will it be changed?
The long-term-care scheme, introduced in 2014, provides financial support to Jersey residents who need long-term care for the rest of their life, either at home or in a care home.
The scheme is designed to meet the cost of care up to a maximum level, which varies with an individual’s care needs, and is funded by contributions from all income-tax payers.
To encourage the growth of the home- care sector, providers were given the freedom to set their own hourly rates within the scheme.
Ministers last year committed to undertake a long-awaited review of the Island’s home-care market – the LaingBuisson report – which has now also been published.
This was intended to form the basis of a restructure of the calculation of home-care package costs and how they are paid from the Long-Term Care Fund, as the government looks to “move towards a more sustainable and equitable domiciliary care market”.
The review gave all providers in the home-care sector an opportunity to discuss and explain their costs, charges and business models, with all data being reported anonymously.
It found that the government was paying 31 different home-care providers at varying rates for providing the same level of care.
Following recommendations from the review, the government decided on an action plan to introduce a standard hourly long-term-care benefit rate for home-care packages to provide fair support to all people using the scheme.
Care agencies, however, will continue to set their own fees to support a diverse market.
The new rate is designed so that the overall cost to the Long-Term Care Fund remains about the same, while not putting increased pressure on it.
But the introduction of standard hourly rates will help to stabilise the costs met by the fund in respect of individual claims, acknowledging that overall costs will increase as the number of people requiring care increases driven by demographic changes.
New rate
The new standard rate will be set at £34.80 from 1 January 2025. It is above the current rate for nearly all providers.
The rates currently supported through the scheme range from £28 per hour to £37.70 per hour.
Ministers also pledged to carry out an engagement event with care providers to discuss the changes – and another report, responding to other recommendations of the LaingBuisson report, will be released next year.
Support for Islanders
Islanders will receive support from government up to the standard £34.80 hourly rate.
Where someone has the means to choose a provider with charges above this standard rate, they will make a “co-payment” in respect of the difference between the standard rate and their chosen provider’s rate.
People who require means-tested support will be allocated a care provider and will receive full financial support.
Existing care packages with hourly rates above the standard rate at the end of 2024 will continue to be supported for up to two years.
Minister
Speaking to the JEP, Deputy Feltham said the changes were designed to ensure “fairness”, “long-term sustainability of the fund”, and the health of the home-care sector itself.
She said: “We do need to have some control over what a suitable rate is that should be coming out of the fund, and this is what appears to be the most common-sense approach to me.
“When we looked at the figure LaingBuisson recommended, and we looked at factors related to Jersey, we wanted to make sure that the figure would actually see the vast majority of home-care providers in a better position, and I hope that will then lead to the further sustainability of the sector.
“We also want to encourage people being able to stay in their own home, if that’s what they wish to do.”
She added: “I think there will be a growing demand on the sector, and that’s something that I’m really keen to work on in conjunction with my ministerial colleagues.”
Deputy Feltham said she was “conscious” about recruitment and retention in the sector, which has been in the headlines recently.
Chief Minister Lyndon Farnham said in June that Jersey needed more than 4,000 extra care staff by 2040 in order to manage the Island’s population as it moves to an older demographic.
Deputy Feltham referred to a previous States Assembly commitment to create a Jersey Ethical Care Charter which covers care provided in people’s homes and what is expected.
She hopes to revitalise that work in the coming months, she continued, saying: “That is quite important, so that people working in healthcare know that we have standards around employment and how they’re treated as employees.
“That is a piece of work I will take forward in conjunction with the Health Minister as well.”
The minister added that this robustness of the home-care sector played into Health Minister Tom Binet’s vision of a “holistic, single, seamless, integrated health service” which he has spoken about in recent weeks.
Deputy Feltham said: “It’s really important that we see our whole health system as one, so that we can ensure that people have the right care no matter where they are going within the system, and also that the system is able to work efficiently and effectively together.”
Carers
The Jersey Care Federation welcomed the release of the “long-awaited” report on the cost of care in Jersey.
JCF chair Cheryl Kenealy commented: “This report has been a long time in the coming, and we welcome its final release.
“I hope it is good news for the sector as a whole.”
