"The Issues We Face": a new report from Care and Support West

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Care & support West have published this comprehensive report on the the state of care in 2017, seen from the care providers' perspective. The author, Mik Alban, Development Director at Care & Support West said that he felt that it was important that care providers had a voice too.

"..this is a very accurate and true picture of the current market. Well done to whoever produced and created the report. We need to make sure it gets circulated as far as possible!! " Sam Notaro from Notaro Care

"I think this is a very good document and reflects what providers have been saying well.  Good Job!" Deian Glynn from Manor Communities

You can read the Executive Summary below and download the full report here.

EXECUTIVE SUMMARY

 

1.  Care and Support West engaged with a broad selection of members, all providers of adult social care services, over a one-year period to mid-2016. The key issues that arose were the challenges of staff recruitment and retention which were descried as ‘dire’ and ‘as bad as it has ever been’. This is consistent with the national picture where Skills for Care estimate that there are around 84,000 staff vacancies in adult social care in England at any one time. Managers reported having to dedicate far more time and effort to staff recruitment and yet they were still struggling to attract both the numbers and the calibre of staff they require.

2.  The post-Brexit uncertainty for non-British workers has had a further adverse impact on sector recruitment and retention, deepening the crisis of Registered Nurse recruitment. This, together with the ageing workforce and regular negative press only worsen the recruitment challenge. The recruitment pressures in turn place additional burdens on those who are dedicated to delivering quality support; sadly, it is still seen as an industry not a profession and, being so heavily regulated, is often subsumed under the weight of paperwork.

3.  For the adult social care sector to remain viable, pay rates for front line staff are going to need to remain ahead of increases in the National Minimum Wage (NMW). This seems to be an intellectual leap too far for central government and local authorities and yet until recently many providers were paying more than the NMW. If that pay advantage is not re-established the sector will increasingly haemorrhage staff to other areas of the economy.

4.  A significant proportion of the current social care workforce in the UK are non UK nationals and the need for social care staff is growing. The reality for the social care sector is clear; we need significant numbers of workers from overseas to keep the sector operating. These routes need to remain open for overseas nurses and care staff otherwise the social care system will collapse.

5.  To place the status of social care on a similar footing to social work, nursing or other healthcare professions, there should be a recognised social care degree. Like social work and nursing there should be bursaries available to encourage people to achieve this qualification. Given the fact that the cost of getting a degree is becoming increasingly prohibitive for many, offering a highly subsidised  route would help attract people into the sector and offer higher status career progression to those working within it. This would both acknowledge the increasing professionalisation of the sector and serve to develop the leadership of tomorrow.

6.  Oversight by CQC and other stakeholders is an essential part of the work of social care; it is however performed by too many bodies all of whom seek similar information but often in different formats. All of this unnecessary duplication adds to the workload and provides no benefits to the service. In addition, inspections need to be more consistent, fair and accurate, not least owing to their potential impact on lives and business. We would recommend a more supportive and integrated regulatory approach involving the key stakeholders.

7.  The relationship between providers and commissioners is often an uneasy one. Much is said about working in partnership, but the two parties are working to very different financial agendas. Providers understand that local authorities have been placed in an impossible position by central government but they currently do not feel they are being treated fairly by commissioners and social workers.

8.  We make a series of recommendations within this report, the majority of which are designed to recognise the actual issues faced by providers and to address these head on. There are costs associated with some of these, but the reality is that it is the dramatic underfunding of social care which is resulting in the looming crisis.  The issues facing the sector will not go away or be addressed by being ignored. In fact, the longer they are ignored, the worse the situation will become.

9.  The sector needs to see the additional funding that is being made available both via increases to council tax and the £2billion over three years announced in the Spring 2017 budget making its way through to providers as enhanced rates payable for existing services rather than being used to fill holes in Social Service’s budgets or to pay for more services at the same inadequate rates.

10. Our recommendations are designed to support the continuation of a viable social care sector in line with society’s increasing requirements. They are deliberately designed to take a longer-term view of care and support delivery and move away from the dominant short-termism implicit in current cost-saving measures.

11. We explore the ideological slant towards Supported Living as a means of acquiring care and support and consider that there needs to be more objective  view of what residential care can provide in the round for people. We concluded that too many commissioners look to Supported Living as a cost-saving opportunity rather than a genuine option for specific individuals. The separation of housing and support is not the strong argument it is purported to be and has proved damaging in many cases and we would argue is serving as a barrier to the development of more individualised housing and support options that people could really benefit from.

12. Overall we have shown that the relationship between commissioners and providers would benefit from an element of truth and reconciliation with a mutual recognition of the drivers for each element of the partnership. In many areas an impasse exists, from which the future of social care will not flourish if it is not urgently addressed.

13. There is a significant degree of frustration amongst providers with the Care Quality Commission (CQC). CQC know the extent and nature of the problems and yet all they have really said publicly is that the sector is at a ‘tipping point’ or it is ‘straining at the seams’. Providers feel that CQC are not sufficiently vocal in relation to the problems facing the sector and are actually adding to these with their ever increasing regulatory expectations.

14. Those in power must step up to this challenge or the sector is going to go beyond the tipping point highlighted by CQC and it will increasingly collapse in upon itself and the country will find itself in a position where there is less and less available provision required by more and more people. It is difficult to see quite how it will recover from there. As a strategy, starving the sector of money until such time that central government has to provide some money for it is a dangerous game to play. There is a very real risk that intervention will come too late or that the cost of resurrecting the sector will be far greater than if the sector was simply being adequately funded.