Free personal and nursing care, Scotland, 2014-15

1. Introduction

Free Personal and Nursing Care (FPNC) was introduced in Scotland on 1^st July 2002. Since then:

Care Homes

• care home residents aged 65 and over who are assessed as self-funders can receive a weekly payment towards their personal care
• people of all ages who live in care homes and are assessed as self-funders can receive a further payment if they require nursing care
• the remainder of the care home fees are paid by the resident

Home Care

• people aged 65 and over can no longer be charged for personal care services provided in their own home. Such individuals can still be charged for certain domestic services but any charge would be subject to a financial assessment

This Statistics Release presents the latest figures (financial year 2014-15) to give a picture of the number of people that benefit from FPNC and the amount that local authorities spend on personal care services.

1.1 Number of FPNC clients

Approximately 77,000 people in Scotland benefit from Free Personal Care, with more than 30,000 people in Care Homes and nearly 47,000 people living in their own home. Over 10,000 self-funding Care Home residents receive weekly payments for Free Personal Care (ages 65+) and / or Free Nursing Care (all ages).

Figure 1: People receiving FPNC, 2005-06 to 2014-15

1.2 Care Homes

The overall number of older people in Care Homes has reduced slightly over the last ten years, from around 32,020 in 2005-06 to 30,260 in 2014-15.

In 2014-15 there were around 10,280 people receiving Free Personal Care payments, a slight increase on the previous year. These payments are available to self-funding Care Home residents who have assets (including property) worth more than £26,000 (from 7^th April 2014). Over a third (34%) of all Care Home residents received FPC payments in 2014-15.

The remaining Care Home residents are publicly funded and also receive Personal and Nursing Care services for free. These residents contribute towards their Care Home fees from their pensions and any other income they may have. The local authority funds the balance, which will be greater than the FPNC payments received by self-funding Care Home residents.

Over three-fifths (63%) of people receiving the Free Personal Care payments also received the Free Nursing Care payment in 2014-15 (around 6,500 residents).

1.3 Home Care

In 2014-15 there were around 46,750 older people receiving personal care services in their own homes, a slight decrease on the previous year but a rise from 40,750 in 2005-06. Since July 2002, local authorities in Scotland can no longer charge for these services.

The overall trend of an increase in people receiving services in their own homes reflects two underlying factors: an increasing older population; and a move away from long-term care in hospital and Care Homes towards providing care in people's own homes for as long as possible.

People receiving personal care services at home received on average 8.6 hours of care per week in 2014-15. This reflects an increase from an average of 6.4 hours of care per week in 2005-06, which indicates that people receiving care at home have increasing levels of need.

In 2014-15, 93% of all older people receiving Home Care services also received personal care as part of their care package. This compares with 71% in 2005-06.

1.4 Expenditure

Due to differences in recording practice across local authorities, the expenditure figures presented in this report have been adjusted to include estimates for overheads. The figures at Scotland-level are broadly comparable year-on-year, but contain some degree of estimation. For more details on expenditure see Sections 4.3 - 4.5 of this report.

Figure 2: Estimated Expenditure on FPNC (£ millions), 2005-06 to 2014-15

Source: LFR03 return / Scottish Government FPNC validation return.
Figures presented contain estimates for overheads.

In 2014-15 the amount spent by local authorities on FPNC payments to self-funding Care Home residents totalled £144 million, an increase of 5% on the previous year. This figure has increased year-on-year from £97 million in 2005-06. This trend reflects the increasing number of self-funders across the period and the annual increases in the FPNC payments from April 2008. The increase represents new money arising from the FPNC policy.

In 2014-15 the amount spent by local authorities on providing personal care services to older people in their own home totalled £368 million, a slight increase on the previous year. This figure has increased year-on-year from £189 million in 2005-06. Large increases in expenditure in the years following 2005-06 gradually diminished and recent years show smaller rises.

The increase in expenditure over time is driven by a combination of factors. Firstly, an increasing proportion of older people are cared for at home, rather than in hospital or Care Homes. Secondly, Home Care workers are increasingly providing personal care services rather than domestic services. Lastly, 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. Prior to 1^st July 2002, local authorities had discretion to charge for these services and a variety of charging policies operated across the country. Any charges were subject to a financial assessment which meant that in practise many people received these services for free.