In the following pages, many different powerful perspectives on adult social care and support are set out. The collection starts with the people who use services or their loved ones. There is no greater or more persuasive argument for demanding real action than these pieces. They articulate with great authority the stresses, strains, frustrations and difficulties faced by people experiencing adult social care in their day-to-day lives.
Caroline Abrahams, writing in her capacity as Co-Chair of the Care and Support Alliance, reflects on the last year – a period characterised by increasing unmet need, long waits for care assessments, rushed care visits or unavailable care, and people not realising their full potential.
Paula Jackson and Donna Macleod, two care workers at Helpers Homecare, provide a powerful promotion of care work. They set out the essential difference they make to people’s lives and the real human connection inherent in their work. But they also lay bare the challenges facing care workers: poor pay, inadequate staff numbers, time constraints and a lack of training.
From employees to employers, Michael Voges writes in his capacity as Chair of the Care Provider Alliance. He stresses the urgent need for the Government to publish its green paper to begin tackling some of the issues providers are facing, such as care home closures, workforce pressures and investors holding off investment decisions. Michael makes clear that the issue is not simply one of funding and that responding to an ageing population requires thinking about how care is supplied, as well as how it is paid for.
Julie Ogley, the new President of ADASS (Association of Directors of Adult Social Services), celebrates the frontline workforce but acknowledges that the current model of adult social care needs revisiting and requires new thinking. Disappointed by the continued delay to the Government’s green paper, Julie calls on the sector, working alongside people with a lived experience of care and support, to ‘get on the front foot’ to develop and deliver change, rather than having change imposed from above.
As Chief Executive of Calderdale Council, Robin Tuddenham, writing in his capacity as Deputy Spokesperson for Wellbeing at Solace (Society of Local Authority Chief Executives), sets out the links between adult social care and the full range of councils’ other services. As social care takes up increasingly more of a council’s budget, Robin makes clear that the budgets of other services suffer. A problem in itself, but also a false economy as many of these services contribute to wellbeing and relieve the strain on social care.
Simon Bottery provides a helpful ‘360 degree’ view of adult social care. He highlights changes in access, expenditure, workforce and quality as issues that need to be addressed in any future reform. While acknowledging that more needs to be done to understand the trends underlying these changes, Simon is clear that, without a national framework for the reform of social care, the system will remain in serious trouble.
Anna Quigley explores the public’s perception of care and support for older people. It is far from positive, but this is caveated by the important point that people’s knowledge of adult social care is limited. Anna sets out why this lack of understanding is problematic and argues it must be addressed without delay.
Finally, Niall Dickson, chief executive of NHS Confederation, offers the health perspective. He is clear about the harm being done to people by continued delays to reform and the importance of effective adult social care to achieving the ambitions of the NHS Long Term Plan. Niall also highlights how the wider NHS is united around the call for a sustainable social care settlement through the Health for Care coalition.
At the time of writing, the leadership contest for the Conservative Party is in full swing. We therefore cannot expect progress on the debate about the future of adult social care and support in the immediate future. However, once a new Prime Minister is confirmed and his or her team is in place, the Government must act. The LGA calls on the Government to publish its social care green paper before the House of Commons rises for party conference season on 14 September. This should include a proper consultation on funding options and be accompanied by a government-led and sector-wide campaign to raise awareness of what adult social care and support is, why it matters in its own right and what it could and should be with the right funding and investment.
It is widely recognised that party politics have been at least partly to blame for the failure of previous attempts to tackle the issue of social care funding reform. The responsibility to overcome this rests with national politicians from all sides of the political spectrum but we acknowledge this is not a straightforward process. The LGA therefore reiterates its offer to host and facilitate cross-party talks aimed at building cross-party cooperation. Building cooperation remains the right way forward and is needed more than ever. The LGA will write to relevant national politicians inviting them to take part in such discussions.
Any reforms emanating from the Government’s green paper will inevitably take time to be implemented. Furthermore, the immediate situation is one of deep uncertainty with no clarity on what will happen with, for instance, the Better Care Fund and the social care council tax precept. This hampers councils’ ability to plan even 12 months ahead. This year’s Spending Review is therefore a crucial opportunity to help stabilise and sustain adult social care for the short- to medium-term and provide much-needed clarity on future funding.
As an absolute minimum, the Government should use the forthcoming Spending Review to close the projected funding gap created by ‘core pressures’ (demography, inflation and the National Living Wage) of £3.59 billion by 2024/25. The percentage increase needed to achieve this would be roughly in line with the 3.4 per cent real terms funding increase given to the NHS, although the total actual funding would be much less: the extra £20.5 billion a year by 2023/24 for the NHS is more than the entire annual net spend on adult social care (£15.33 billion, 2017/18).