Self-Funders’ Preferences in Navigating Social Care

The position of ‘self-funders’ of care was once considered almost enviable. They were in theory able to optimise their choice and control over support and maintain independent and fulfilling lives. However, research has found that this is often far from the case. When the need for care is urgent, or where information is hard to find and process, for example, choice may prove illusory.

As well as anxieties for individual self-funders, this may lead to poor long-term outcomes for them as a result of choosing inappropriate care, or their needs going unmet with longer-term consequences for health and ASC services and family carers.Our knowledge of what support self-funders need is limited, with little knowledge of preferences or how choices are made.

Older people who receive social care at home or in the community may have to pay for this themselves if they have a certain level of savings. This is known as “self-funding”. However, self-funders should still get information and help to find, choose and arrange the right care for them. Existing sources of support include local authorities, voluntary organisations, consumer groups, GPs, financial advisers, among others.

Previous research has found that older self-funders and their families often face significant problems, such as:

• the process of finding and choosing care is often stressful and time-consuming;
• information is too general;
• the many different types of social care are not made clear;
• there is not a one-size-fits-all as some can manage without much assistance, while others want more advice.

It is not known ‘who wants what’ when considering the type of information and guidance needed to help people choose care, so it is unclear what changes to make.

• Aims

  This study is exploring what self-funders most value when seeking, choosing and arranging their social care, and how different groups of self-funders make their decisions. It also aims to identify how to improve support for self-funders in taking social care decisions.

   

• Design and methods

  This study involves:

  • a ‘discrete choice experiment’ with a group of people who self-fund their care
  • interviews with a subsample for more detail discussion on their particular preferences
  • a workshop to discuss what must change to improve the experiences of older self-funders
  • development of resources for local authorities and self-funders.

   

• Findings

  Full findings report

  This activity was not research and so does not seek to recommend change in practice. However, it does seek to offer a collection of views to contribute to agenda-setting discussions that will be of value to both practice and research.

   The conclusions are that:

  • Little appears to have changed since the Care Act to ease and improve self-funders’ access to community social care
  • Most attention is being paid to how information should be shared with self-funders, with Key Informants suggesting some successes. There remain difficulties thinking though how to link together different types of information at different levels.
  • Little attention is being paid to supporting self-funders to process and evaluate this information. There is an implicit assumption that if people get the ‘right information’, then it follows that they will make the ‘right choice’.
  • Research has not examined whether the different approaches to navigating social care actually matter in terms of outcomes.
  • Self-funder inequalities do not receive meaningful attention either within practice or research. It is important to reflect on the different routes into self-funding, as well as how different groups of self-funders have diverse experiences.
  • ‘Market-shaping’ appears to be limited, with care ‘blackspots’ around the country where labour supply and viable provision is severely constrained. Research could help to examine whether new models of commissioning can promote capacity and whether they are scalable.

   

• Resources and publications

  Jasper, Rowan, Wright, Stuart, Rogers, Stephen, Tonks, Sarah, Morfitt, Richard, Baxter, Kate, Birks, Yvonne, Wilberforce, Mark, A Discrete Choice Experiment of Older Self-Funders’ Preferences When Navigating Community Social Care, Health & Social Care in the Community, 2023, 6642636, 12 pages, 2023. https://doi.org/10.1155/2023/6642636

  Baxter, K., Wilberforce, M., & Birks, Y. (2020). What Skills Do Older Self-Funders in England Need to Arrange and Manage Social Care? Findings from a Scoping Review of the Literature. The British Journal of Social Work, 51(7), 2703–2721. https://doi.org/10.1093/bjsw/bcaa102 

  Poster presentation (Curiosity Partnership ASC Research Festival 2022)