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The Care Sector is without doubt under-funded and under-resourced as a whole

Enham Trust response to the Parliamentary Review of Social Care 2016

Enham Trust response to the Parliamentary Review of Social Care 2016

The care sector gets a lot of bad press. Rightly so when things go wrong. But as demonstrated by the recent Parliamentary Review, there are many great providers doing truly extraordinary things in a difficult sector at a difficult time.

The Care Sector is without doubt under-funded and under-resourced as a whole. This is clearly acknowledged in the Review. Costs are rising as demand increases due to the growing and aging population, but they are also being pushed up by the increase in the national living wage. The Review also acknowledges that there is no consequential rise in spending. In fact, government is cutting budgets for the sector, making it harder to provide the services we so desperately want to offer the most vulnerable in our population, and the services they need.

The Review quotes statistics from LaingBuisson, sector analysts, showing that local authority settlements rose on average 1.9% against a rise in costs of 2.5% in 2015/16. Cumulatively, that has meant state-supported residents of care homes, for example, receive 6% less than they did five years ago. Clearly this is unsustainable. Either the quality of the services will fall, or the volume provided will drop as resources shrink.

So financially, the care sector is facing problems. But it doesn’t stop there.

Reading between the lines, the Review highlights a frustrating lack of communication and education within the care sector between the different parties – the providers, the budget holders, the commissioners, GPs, social workers, nurses. This makes it harder to work together effectively. It wastes money and resources. We believe there needs to be a mechanism where data is shared – far too much time is wasted asking for the same data, which is kept in silos. This is so inefficient and also risks creating and maintaining disparate records for the same homes, even residents.

Enham Trust is a third sector provider and able to deliver care services that complement our partners in the NHS and local authorities. We believe the creation and maintenance of a central database of care resources could help stop new care opportunities from falling between the cracks. Our experience tells us that referring parties are often unaware of some of the country’s best and most innovative care facilities. The result: patients are left with sub-standard care, or worse, no care at all... We know first-hand how entrenched this problem is – in July we launched desperately needed respite care facilities but despite a sustained outreach programme and the growing problem of bed blocking, we have struggled to fill our places. We know we are not alone.

We, along with other third sector agencies, would love to work more closely and consistently with government agencies to make sure all the resources aimed at the care sector are used efficiently and effectively. Sadly, that is just not happening today.

Another theme to emerge from the Review is linked to this. The lack of co-ordinated budgets within the health and social care fields creates inefficiency and waste. It makes no sense that one commissioner makes decisions only with a view on how it will affect their budget – not the knock-on effects. Care must be looked at holistically, in terms of the economy. A saving in one place often has a disproportionate, adverse effect on another. Again, this is an area where we would welcome close co-operations between the third sector and government agencies.

As if all that were not enough, the sector is also facing a number of recruitment challenges. The national minimum wage increase will bring retail worker pay to the same level as that for care workers. This poses the very real threat that care workers, who do difficult, emotionally and physically demanding jobs, will decide that they would prefer to earn the same money in a shop and get a 20% staff discount.

Finally, social care is already a lottery, with winners and losers. The risk is that the odds are going to be stacked more unevenly once the offer of the Social Care Precept is taken up by local authorities... The Review described the 2% cap as to how much they can raise for social care from increasing council tax rates as “woefully short of what is needed”.

The fear is twofold. While the new money may be ring-fenced, existing spending is not. This means the new money could replace existing funding. Second, the precept, which is optional, risks creating an inconsistent approach to funding across the country, with some authorities levying it and others not.

So we have a situation where the demand is growing, the budgets are shrinking, the costs are rising, recruitment is getting harder, and while we have some wonderful providers there is no overarching mechanism co-ordinating efforts or collecting data. The Review shows that Parliament knows all this, but government has failed to step up to the plate and set out short, medium and long-term strategies to deal with it.

There are vast resources within the Third Sector that could go a long way towards improving the provision of social care in the UK, working alongside existing NHS and Local Authority providers. What is now needed is a strategic approach that acknowledges this and incorporates it in an effective way. While we are far from crisis point, without action today it won’t be long before we get there.


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