Tag Archives: cutbacks

Social care providers worry about maintaining service quality

These are worrying times for service users, carers and families involved in social care; with the uncertainty over service provision, eligibility criteria, benefit cuts and future policy all causing stress. Now, care providers are adding to that by saying that services may get worse.

A survey published last week by accountants PricewaterhouseCoopers (PwC), Fair care crisis? An independent survey of social care providers for the elderly,  found that many care home and domiciliary care providers are worried about the effects of cutbacks on service users, and have warned that some have ‘unrealistic expectations’ of the services they receive and ought to revise their expectations downwards.

Providers said a key challenge is maintaining the quality of services against a background of rising costs and downward pressure on fees. Indeed, 80% worry that quality of care services will suffer due to cost reduction measures.

While it has to be remembered that these are the views of care providers, who are always going to say they need more money – the majority want a fair fees policy for local authority commissioners, for instance – this survey nonetheless highlights some of the current concerns among the sector.

Respondents also fear that smaller providers may go out of business because of cost pressures, which could lead to reduced choice for service users – so much for the increased choice and control promised by the personalisation, it seems.

OK, that’s the scary part over with. The survey also had some positive messages; 97% feel they are equipped to meet current or future challenges and 94% are already taking action to address market challenges.

Of those taking action, 83% are increasing skills and capacity – meaning better-trained staff – but 78% are controlling costs, which can be a double-edged sword, depending on where the cuts come.

This survey provides an interesting snapshot of the mood of social care providers. While there is optimism about meeting the future challenges, it is worrying that some say that service users should not expect so much of them.

While this may be realistic talk from providers – if you know how to do more with less please tell me – it does not augur well for service users; it seems they will face increased eligibility criteria, fewer services, less choice and less care.

The uncertainty in the sector is also not helping. The survey notes that 79% of providers want the government to outline its vision for the future of elderly social care, but they are likely to be disappointed. While there may be some measures outlined in the plans for the NHS today, for the definitive standpoint I imagine we will have to wait until the independent commission on the future of adult social care reports back sometime in the next year.

Only when policy is confirmed, along with budgets – we’ll find out what local authorities have to spend in October when the comprehensive spending review is announced – will providers be able to plan with certainty, and therefore give service users a better picture of what services will be provided – or not, as the case may be.

While PwC’s report closes on an optimistic note from a business point of view – many expect to cope with the future challenges and see opportunities in an expanding marketplace – I can’t help feeling that the outlook for service users, their families and carers is much more pessimistic.

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

Dementia care still falling short

Dementia makes the headlines again today, with news that half of all patients with dementia leave hospital in a worse state than they arrive in.

The Alzheimer’s Society says patients with dementia stay longer in hospital than those without the condition and a third have to move into a care home afterwards because they can no longer care for themselves, such has been their deterioration.

It is easy to see why people with dementia decline in hospitals – they can be noisy, disorientating and distressing places and someone with dementia is less able to cope with this than someone without.

And with 80% of nurses admitting in the Alzheimer’s Society’s survey to receiving no or not enough training in dementia, it is easy for the quality of care to vary and, in some cases, patients to not receive appropriate care for their condition – help eating and drinking, for example.

But there are already measures in place to address this; the Dementia Strategy, published in February, had an objective to ensure all health and social care staff who may be involved in caring for people with dementia have training in caring for people with the condition. This would be through basic training and continuous professional and vocational development.

This research highlights how urgently this training needs to be rolled out. With the numbers of people with dementia growing as the population ages, it shouldn’t be delayed.

But (as ever in social and health care, there is a but) it will come down to finances. Training is usually one of the first things to be shelved when cuts need to be made and with budgets already being tightened – and bigger cuts to come in 2010 and 2011 – this could well get quietly put to one side.

If it does, then little will change for people with dementia, and they will continue to cost the NHS millions by staying in hospital for longer and continue to deteriorate more rapidly than they could do. The training needs to happen.

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Councils gear up for hard times

After a summer of dire warnings of public sector cutbacks, yet another article is out in today’s Daily Telegraph. But what makes this one stand out is the figure it uses – £100 billion.

While we are back in the world of mind-boggling figures – oft seen in this recession – everyone can appreciate that this means that cuts will have to be made quickly and deeply to all areas of service.

The government has previously stated that frontline services won’t be affected, but if the figures quoted are true, it is impossible to see how they won’t be – with the inevitable effect on quality that comes with it.

It is already affecting social care services – children’s homes, adult day centres and the like are closing across the country, the article says – and this will heap yet more pressure on already over-stretched services.

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Another Baby P waiting to happen?

Today’s news story comes from Greenwich where an – inevitably – unnamed social worker has broken ranks and said that another Baby P could happen because of a shortage of social workers and unmanageable workloads. http://www.newsshopper.co.uk/news/4712961.GREENWICH
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This scenario will be familiar to most children’s social workers. Vacancy rates nationally are said to be running at more than 10%, with the resultant knock-on effect in workload for current social workers.

It’s nothing new and one of the biggest problems the profession faces. The government can produce all the new initiatives and guidance it wants to try and improve practice and safeguarding but these mean little without the time – and personnel – to be able to carry these out effectively.

And this is where the problem lies. With local authority budgets set to be slashed in the next couple of years because of the recession, finding extra money for more social workers will be difficult at best for many councils.

Sadly, it seems this problem will remain and it is just a matter of time before another Baby P hits the headlines.

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