Tag Archives: adult social care

Carers need a life of their own

Isolated, lonely, marginalised; that is how the majority of carers feel, according to a survey published to coincide with this week’s Carers Week.

The survey, which took in the views of more than 3,200 carers across the UK – the majority of which care for more than 50 hours per week – paints a fairly bleak picture of a carer’s life.

For example, 76% said they feel like they have no life of their own outside of their caring role, with a similar percentage saying they have lost touch with family and friends as a result of being a carer. Many feel they have no time to socialise, for romantic relationships or even to have children.

Being a carer also adversely impacts on many financially – 4 out of 5 report being worse off, with more than half having to give up work to devote more time to their role. This also exacerbates many carers’ sense of isolation, with work often a vital means of social interaction.

It makes for depressing reading. What makes it worse is that the survey also reveals what many carers feel they need to make their lives better – and they are relatively modest demands. The 4 main needs are:

  • Access to relevant and practical information, to help them with their caring role
  • The opportunity to take a break when they need it
  • Support at times of crisis
  • Financial support.

To my mind, there is nothing in that list that cannot be achieved, if the political willingness is there.

There is the possibility that some of it may be realised in the relatively short-term. The government has said it is committed to providing a week’s respite for carers, although I believe this is only for carers of severely disabled children (please correct me if I’m wrong) and I haven’t yet seen a timescale for when this might be implemented.

Putting mechanisms in place to provide better information for carers and more support at times of crisis are also achievable at a local level through better working with local authority social services and independent social care providers.

The only demand that may not see any action is that of financial support. Current media speculation about the forthcoming cuts to public spending in next week’s Budgets predicts cuts in benefits so any significant rise to the Carer’s Allowance would seem unlikely. I don’t agree with that, but that’s just the way I think it will go.

These demands really need to be taken into account in the forthcoming independent commission on the future of social care.

Indeed, one of the criticisms of last year’s Big Care Debate and subsequent White Paper – now consigned to the dustbin, of course – was that carers seemed to be largely ignored in it. This always seemed like a huge oversight – not only are carers a vital part of the system, they are often the people who know the most about caring and what service users need.

Hopefully the new commission will take more notice of their opinions and needs and surveys like this will not make such troubling reading in the future.

Advertisements

1 Comment

Filed under Carers, social care

Social care possible victim of government cuts

Chancellor George Osborne announced the first wave of cuts to public spending yesterday, but it is still unclear what this will mean for social care – yet.

Most of the announcement dealt in headline terms – talking about millions of pounds worth of cuts to government departments, but not saying exactly where they will be made.

For instance, councils have been told that they will have to cut £500 million worth of services in the next 10 months. In the absence of concrete details, there is lots of speculation about where these cuts could come – such as in residential and home care for the elderly, according to a report in today’s Times.

This would seem likely – a recent poll for the BBC’s Panorama said that more than half of councils were considering making cuts to adult social care provision.

In practice, it may mean that eligibility criteria gets ramped up again, so that only those with ‘substantial’ or ‘critical’ needs will get services – which already happens in many council areas. Also, services such as day centres may be targeted for cuts, as will any service that struggles to demonstrate it provides value for money.

With budgets needing to be slashed other areas, such as the roll-out of the personalisation agenda, may be hit. There is the £237 million Social Care Reform grant scheduled for this year, and there is speculation that might be cut, according to a report in Community Care.

Meanwhile, children’s services were largely protected from the cuts, except for the abandonment of the Child Trust Fund, which wasn’t that popular anyway.

But this is just educated speculation. I assume the details of the cuts will gradually come out in the next few days and weeks, which should shed more light on what will happen and then councils – and service users – can start to plan for the future.

But what is certain is that these are only the first cuts – and not necessarily the deepest. June’s emergency Budget is expected to announce further spending cuts, while with the Comprehensive Spending Review – which sets out council budgets for the next 3 years – there are fears that council funding could fall off a cliff.

1 Comment

Filed under adult social care, social care, Social care funding

Social care needs to be a priority for new government

Since the Conservative and Liberal Democrat coalition took power earlier in the week and started outlining its policies, one issue seems to have been conspicuous by its absence: social care.

As I have previously blogged, in the general election campaign social care seemed to disappear off the political radar, despite it being touted as a key issue in the run-up to it being called. Now post-election, it continues to be ignored in children’s and adults services; nowhere in the policy outline was social care mentioned.

Indeed, Michael Gove, the new head of the (swiftly renamed) Department for Education, has said in a letter to civil servants that education is the priority for the department, thus seemingly sidelining children’s services, although he added that this area will be strengthened and reformed, but didn’t elaborate on how.

Also, Andrew Lansley, the new health secretary, has spoken extensively of the plans for the NHS, while adult social care has garnered barely a mention.

This lack of attention is worrying; ask anyone within adult social care and they will say that reform – especially of the way it is funded – is urgently needed. Children’s services also need to be strengthened and supported. They can’t be left to drift as they have done for the past few years.

Leading social care organisations are also worried. Counsel & Care, a charity working with older people, their families and carers, have called for reform of social care to be made a priority by the new government.

Meanwhile, Carers UK’s director of policy and public affairs, Emily Holzhausen said; “We are deeply disappointed that the programme for Government published in the coalition agreement this week does not establish social care as a political priority.

“Clear plans must be brought forward as a matter of urgency, setting out a sustainable funding model for fair, universal, and transparent care services.”

However, despite the worries, I’m trying not to be too negative. It is still very early days for the government and we shouldn’t be too quick to judge – social care is a complicated issue and it may take more time to put together a policy.

Also, Paul Burstow, a Lib Dem MP with a history of championing issues such as social care funding, dementia and adult protection, has been appointed as a minister for state – the rung below cabinet – in the Department of Health. Having someone with in-depth knowledge of and a passion for the issues involved could ensure that they get the attention they need.

But until the government makes any policy announcements, as with everyone else blogging on this in the sector, everything is speculation and educated guesswork.

A final thought; in among all the speculation, there is one decision on social care that will have to be made soon – whether to pass Labour’s Personal Care at Home Bill. The Tories are against it, as are the Lib Dems, who would prefer to use the money for this to give carers extra short breaks, so I think we know what the result will be there.

Do you agree? Please let me know your thoughts below.

Leave a comment

Filed under adult social care, children's social work, social care, Social care funding

ADASS sets out social care challenges

On the day before the election, and with social care still conspicuous by its absence in the political debate – possibly because none of the 3 main parties wants to touch this controversial subject with a bargepole – it has been left to ADASS to bring the subject back up.

In a 12-page document catchily titled ‘All you need to know about adult social care’, ADASS sets out where social care is and where it needs to go in the coming years. It makes for interesting reading.

On the plus side, ADASS reveals that standards are have improved every year since 2002. In 2009 there were no councils assessed as ‘poor’ (for the sixth year running) and 95% were rated ‘good’ or ‘excellent’. Quality of care has also improved, with three quarters of services assessed as ‘good’ or ‘excellent’ in 2009.

So, in social care terms, we’ve never had it so good. Progress has been made and things are getting better. Good.

But this only tells part of the story – and the rest isn’t so rosy. For instance, it reveals that public spending on social care has increased by 53% in real terms since 1997. Taken on its own, that’s not too bad. But, when compared to the increase in spending other areas have had, such as the NHS (nearly 100% increase), education (60%) and transport (70%), it shows how much of a priority adult social care has been since Labour came to power.

ADASS also outlines the challenges facing the sector, such as how the number of people of people with dementia in the UK – about 700,000 currently – is set to double in the next 30 years. The report also reminds us that 75% of councils only provide services to people with ‘substantial’ needs at least – with the number of older people using services is falling at a time when the older population is rising.

The report concludes with the key issues that need to be addressed: reform of social care funding is “desperately” needed; the need for greater integration between health and social care; how social care should be more joined up with other services, such as housing and education; and securing a skilled, motivated and adequately remunerated workforce.

None of those will come as a surprise and how these issues will be addressed should have been a question put to politicians in recent weeks. As mentioned before, they haven’t, and it is those in social care – workforce and service users – who are set to lose out because of this.

For many people with disabilities, social care is a top priority and many feel ignored by the election debates, according to a survey by ComRes.  With some 1.8 million service users out there – and the election so finely balanced – have the politicians missed a crucial trick by ignoring them? Possibly, but we’ll never know.

Leave a comment

Filed under adult social care

General election: let battle commence on social care

Finally, one of the worst-kept secrets in the country is officially announced; the general election will be on May 6.

It has been said by many that adult social care will be one of the crucial points on which the election is fought. If so, this can only be a good thing, but only if the public know exactly what they will be voting for and currently, they don’t.

We know Labour’s plans for the future of adult social care; they were in last week’s White Paper. They have outlined plans for a National Care Service, along the lines of the NHS. How it would be paid for is still unclear – but don’t let practical details get in the way of a good policy.

But as for the other main 2 parties – and, in the interests of balance, all the minority parties as well – we know that they don’t think much of Labour’s ideas, but other than that, we know very little about their plans.

The Conservatives have been plugging away with its £8,000 voluntary insurance scheme for paying for elderly care. However, those in the know in the sector don’t believe that this will come up with enough to cover the costs. The Tories disagree. Other than that, we know they favour telecare and a national system of assessment and eligibility for care, and that’s about it.

Meanwhile, the Liberal Democrats want to find cross-party consensus on the way forward in social care, as was being discussed in secret by health ministers earlier this year before Andrew Landsley blew the lid on the meetings. They also want yet another commission to investigate possible ways forward, and have said they would spend £420 million to give carer’s an extra week’s respite – as long as they care for more than 50 hours per week.

I haven’t heard much from any of the minority parties on social care – if anybody knows more, please leave a comment below.

But all this shows that we do not have a full debate on social care – that can only be achieved when others announce their policies and can be analysed objectively against the others.

That is the challenge now for the Conservatives and Liberals – show us your plans and let us decide which way forward is the best for social care.

Leave a comment

Filed under adult social care

White Paper reflections

It is now a day since the White Paper came out, and the response from the media, social care organisations and rival political parties has been quick and, in the main, fairly critical.

The White Paper was given short shrift by most of the mainstream media. While its aims of creating a National Care Service were seen as laudable, many focused on the delays to making changes, how it would be paid for – and by whom – and the lingering “Death Tax”.

Those that gave the White Paper the most enthusiastic welcome tended to be the organisations that are government-backed. To paraphrase Mandy Rice-Davies, well, they would, wouldn’t they?

Charities and third sector organisations seem to have generally given the White Paper a good welcome, but again question where the money will come from for it.

Meanwhile, think tank the King’s Fund – an advocate of the partnership approach before the paper came out – welcomed the ‘ambitious’ plan, but questioned where the money to do it would come from, calling for detailed proposals urgently.

I reckon the King’s Fund was spot-on.

Now I’ve had time to reflect, it seems clearer that the White Paper has been geared to the election – it is big on ideas, but short on detail. Style over substance, if you will.

I really like the idea of the National Care Service – its aims are laudable and it is something to be aspired to. In an ideal world it would be here already.

But – and it’s a big but – I cannot work out how it would be paid for, without having to raise taxes, impose compulsory levies on the public or take money from other budgets. Nether, I suspect, judging by the content of the paper, do the government.

Also, given that the original aim of its preceding green paper was to address the funding of adult social care – with the hope that it would get rid of the current means-testing system – it has singularly failed to do it.

Indeed, the whole question of funding was fudged, with a call for another commission to be set up to investigate the best ways. Evidently the government didn’t want to be associated with any new taxes before the election, so has kicked it into the next parliament.

As a result, the system will creak on, as it has done for years, hated by many. A chance for genuine – and needed – reform of the funding system has been lost, sacrificed at the altar of electioneering.

For me, that clouds all the good ideas contained in the White Paper.

1 Comment

Filed under Social care funding

More work needed to raise social care standards

While the Care Quality Commission has tried its best to get a positive spin on the findings in its review of adult social care services  published today, as ever, most people and the media have focused on the negative aspects of it. And they’re right to.

Despite the overall quality of services improving in the past year in all areas, there is still a significant minority of ‘poor’ and ‘adequate’ services being provided to adults and especially older people.

Poor services are always unacceptable and need to be rooted out or given help to improve. Reports like these highlight them, but it means nothing if it doesn’t help to bring about change.

To this end, the CQC’s chief executive, Dame Cynthia Bower, said the CQC is determined to raise standards, hence why 8 councils have been designated as ‘priority for improvement’ councils and another 16 are to have an in-depth inspection of their services.

Elsewhere, the new registration system for adult social care providers, NHS providers and independent healthcare will have a single set of safety and quality standards. Also, the CQC is to get tougher powers and will be able to respond to concerns more quickly.

But local councils also have a role to play in improving services, especially commissioners; they need to look at the services they are purchasing and, if they are failing, move elsewhere. Obvious perhaps, but still needs to be said because it seems some commissioners don’t do this.

Unfortunately, this may be easier said than done. While eligibility criteria for receiving social care remained largely constant in the past year, after the previous 2 years when the number of councils providing care for ‘moderate’ or ‘low’ needs fell markedly, the spectre of eligibility levels being raised again in the coming years because of dwindling budgets looms large.

With budgets being squeezed, commissioners may feel under pressure to look at the cost of services rather than the quality. By the same token, service providers may also be under financial pressure and be looking to make cutbacks, which could affect the quality of their services.

So, in essence, the CQC’s reports are positive – let’s not forget standards are improving – but they show how much work still needs to be done. But by acknowledging this, and laying out strategies to help, the next report should be more positive still. As long as budget considerations don’t impact too much, that is.

Leave a comment

Filed under adult social care, Social care funding