Nobody seems to disagree, as such, with the assertion that Adult Social Services and Care are in crisis.
The adult social care budget constitutes the biggest area of duty-based and discretionary spend for councils, and supports some of the most vulnerable people in society. Ensuring sustainable levels of funding is critical – but no party is promising (rather than threatening) to raise tax to make up for a decade’s disastrous economic policy in this field.
The winter A&E pressures, lonely older people, caring families unable to work, and disabled people struggling to live independently are all urgent, challenging issues for any Government, but the current sector and departmental leadership has seemed worryingly incapable of making the Treasury LISTEN.
Analysis by the LGA estimates there to be a potential funding gap of at least £2.6 billion, including £1.3 billion by the end of the decade and a gap in the region of £1.3 billion now, that reflects the difference between what providers say they need and what councils are able to afford.
A raft of organisations agree that short term interests of any party in power are a poor guarantee that decent care and social work will exist when our own relatives need it.
These include the local government ombudsman, the Care Quality Commission, ADASS and the LGA (representing local government), the Care Providers’ Alliance, representing at least 6 national associations of care providers, The Independent Care Group, The Kings Fund/Nuffield Trust and Joseph Rowntree Association and the Centre for Welfare Reform.
The Association of Directors of Adult Social Services (ADASS) warned earlier this year in its annual budget survey report: “Financial risks are rapidly increasing … the quality of care is compromised.”
The King’s Fund/Nuffield Trust 2016 report, Home Truths, concluded that councils were struggling to meet basic statutory duties.
Independent Age commissioned an analysis of a range of migration scenarios pre- and post-Brexit. It found that the workforce gap could grow to anything from an optimistic 750,000 workers to a pessimistic 1.1 million by 2037.
In 2016 its annual state of care report the CQC issued its starkest warning yet. The “fragile” social care system is approaching a “tipping point”, it says. Far fewer people are being supported than those who actually need help. Steady attrition of provision is becoming more likely. Providers are (at last), handing back contracts, selling up and exiting the market. Investors considering the returns on care sector investment are also walking away, choosing to finance up market provision for those who can pay.
In adult social care complaints investigation the ombudsman (the LGO) upholds around 58% of complaints related to social work and care home and home care. The ombudsman has seen a 25% rise in complaints about home care alone. There’s been a 6% rise in complaints and enquiries about all areas of Adult Social Care in the last year; and 70% of detailed investigations were upheld about care planning – which taking into account complaints about assessment, as well, generated 600 local authority conduct-related complaints to the LGO.
And responding to a Public Accounts Committee report on the financial sustainability of local authorities, Cllr Claire Kober, Chair of the Local Government Association’s Resources Board, said: “Councils experienced a 40 per cent reduction in core central government funding over the last Parliament and funding pressures will continue over the next few years. This means difficult decisions continue to have to be made about which services are scaled back or stopped altogether to plug funding gaps.
The current funding settlement entirely disregards demographic change, the pressure on the market, and the impact on people receiving care. The Treasury thinks it has fixed the problem with the social care precept, a regressive tax that raises funding where it is needed least.
We need a government that will take heed and action to reverse a trend of gradual but definite erosion of this sector, a lifeline for many vulnerable people. The sector is a vital connector to other public, private and voluntary sector services. And it contributes some £43 billion to our national economy (see the LGA’s report: state of the nation: adult social care.) Allowing the axe to fall on social care, in the context of an ageing population, is ECONOMIC and LEGAL illiteracy, piling greater pressure on an already overstretched NHS.
The Chancellor’s own Autumn Statement will hopefully take some notice of all these warnings and calls for action, for fear of making the Conservatives appear determined to go down in history as dismantling what should be the residual safety net in any civilised society. That is, the right to be cared for, if one has insufficient money or support or capacity to meet one’s own needs.
Ros Altmann has today suggested that we are sleepwalking into a care funding crisis, in terms of pensions inadequacy – so let us hope that she is not ignored too.
Adult social care should be everyone’s concern, now, not just at times of personal crises, when need strikes one’s own family….