Extending free personal care to under 65s: feasibility study

Section 2 : Information On Personal Care

Definition of Personal Care

The legal definition of personal care is set out in the Public Services Reform (Scotland) Act 2010 Schedule 12 at paragraph 20 ^[2] .

“Personal care” means care which relates to the day to day physical tasks and needs of the person cared for (as for example, but without prejudice to that generality, to eating and washing) and to mental processes related to those tasks and needs (as for example, but without prejudice to that generality, to remembering to eat and wash);

and

“personal support” means counselling, or other help, provided as part of a planned programme of care.

Guidance on the definition of personal care is published on the Scottish Government website ^[3] .

Comparisons between age groups ^[4]

Around 9,000 adults between the ages of 18 and 64 currently receive personal care services, for which they may currently be charged. These services may be provided as home care or through direct payments. To put this in context, around 47,000 older people receive personal care services in their own homes free of charge.

Local Authorities provide or purchase around 400,000 hours of personal care for older people each week, and around 150,000 hours for younger adults. Older people receive around 8 to 9 hours of personal care per week on average, and younger adults average around 18 hours per week of personal care.

While the predominant recipients of personal care are frail older people and people with dementia in the over 65 category, in the age bracket of 18-64, most recipients of personal care are people with physical or learning disabilities.

Around 95% of older home care clients receive personal care (up from 55% at the introduction of Free Personal Care in 2002), while fewer than 75% of younger adult clients receive personal care.

Expenditure on Personal Care

The latest published figures show expenditure on personal care at home for older people as £371m in 2015/16 ^[5] . The estimated gross expenditure on personal care for younger adults was around £132m in 2015/16 ^[6] .

Based on Local Financial Returns, it is estimated that younger adults contribute around £8 to £10m in charges for their personal care. Therefore around 6- 8% of gross expenditure on personal care for younger adults is funded through client contributions. While the contributions from individuals will vary significantly, on average, this is a contribution of around £17 to £21 per client each week. In order to further verify these costs, a survey of Local Authorities and HSCPs was undertaken which is considered further in section 5.

Free Personal Care in residential care

Just under 31,000 older people ^[7] and around 3,500 younger adults live in care homes ^[9] in Scotland. The number of older people has remained relatively unchanged over the last 5 years, while the number of younger people in care homes has shown a small but steady decline over the last 5 years.

Of those 3,500 younger adults the majority are Local Authority-funded and supported by Local Authorities in care homes, although some younger adults are supported by their Health Boards. Younger adults currently do not qualify for Free Personal Care in care homes, and any self-funders would not currently be eligible for Free Personal Care. Our estimates suggest that there are at the most around 120 younger adults in residential care who are self-funding.