Free personal and nursing care, Scotland, 2011-12

2. Main points

Care Homes

• The overall number of older people in care homes has reduced slightly over the years since the Free Personal and Nursing Care policy was introduced, from nearly 32 thousand people in 2003-04 to just under 31 thousand people in 2011-12.
• The number of people in Scotland receiving Free Personal Care and/or Free Nursing Care (FPNC) payments to help pay their Care Home fees increased steadily in the first few years of the policy and in 2011-12 there were nearly 9,700 people receiving Free Personal Care payments. These payments are available to self-funding care home residents who have assets (including property) worth more than £25,250 from April, 2013. Over the last 5 years to 2011-12, the number of people receiving Free Personal Care payments has levelled out at just over 30 per cent of all older people in Care Homes.
• Around two-thirds of people receiving the Free Personal Care payments also receive the Free Nursing Care payment (just over 6,000 residents in 2011-12).
• The remaining 70 per cent of residents in care homes are publicly funded. These residents contribute to their care home fees from their pensions and any other income they may have and the local authority funds the balance which will be greater than the free personal and/or nursing care payments received by self-funding residents.

Home Care

• The number of older people receiving personal care services in their own homes has increased from 33 thousand people in 2003-04 to nearly 47 thousand people in 2010-11 and 2011-12. Since July 2002, Local Authorities in Scotland can no longer charge for these services.
• This large increase in people receiving services in their own homes reflects an increasing older population and a move away from long-term care in hospital and care homes toward providing care in a person's own home for as long as possible.
• People receiving personal care services at home received on average nearly 7 hours of care each week in 2003-04. This has risen steadily to over 8 hours of care each week in 2011-12, showing that people receiving care at home have increasing levels of need.
• In 2011-12, 91 per cent of all older people receiving Home care services received personal care services as part of their package of care. This has increased each year since 2003-04 when only 57 per cent of clients received personal care.

Expenditure

• The amount of money spent by Local Authorities on Free Personal care and Free Nursing Care (FPNC) payments to self-funding residents in Care Homes has increased each year from £86 million in 2003-04 to £111 million in 2011-12. This increase reflects the increasing number of self-funders up until 2008-09 and the annual increases in the FPNC payments from April 2008. All of this is new money arising from the FPNC policy.
• The amount of money spent by Local Authorities on providing personal care services to older people in their own homes has risen from £133 million in 2003-04 to £347 million in 2011-12. This more than doubling of spend over the last 8 years reflects the fact that an increasing proportion of older people are cared for at home, rather than in hospital or care homes; that increasingly home care workers are providing personal care services rather than domestic services; and that people living at home have increasing levels of need. It should be noted that this is not all new spend arising from the FPNC policy, but prior to the policy Local Authorities could generate income by charging people for these services.