Tag Archives: service users

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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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.

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Recruitment drive paying off for social services

This will be music to the ears of beleaguered HR officers in children’s social services departments; 40,000 people have registered an interest to join the profession since last September.

Figures from the Children’s Workforce Development Council  demonstrate that the government’s recruitment drive – launched in the wake of the Laming Review last year, along with a national PR campaign – is starting to pay dividends.

Called Be The Difference, the campaign has run – and is currently running again – on the major commercial terrestrial channels and Sky, complemented by radio, print, cinema and billboard advertising.

The campaign has painted social work in a positive light – heavily sugar coating it, some cynics in the sector have said to me – and the difference it can make to children’s lives. And it seems to have worked, judging by these figures – indeed, 5,000 signed up in one day earlier in the month.

While some of those who have signed up won’t make it to, or through, the social work course, it is still a significant boost to ordinary recruitment levels.

Of course, it will still be some time before any of these recruits are ready for the frontline – a postgraduate conversion course takes 2 years, for instance – but it indicates that the recruitment crisis, in children’s services at least, may start to ease in the foreseeable future.

While those struggling under mountainous caseloads may still say that this is too long to wait, it is nevertheless good news for everyone involved in children’s social work. If a majority of these eventually make it to the frontline, it will help to reduce workloads, enable social workers to dedicate more time to individual cases and, hopefully improve outcomes for service users.

Let’s hope this early evidence of the strategy making a difference convinces the powers that be to maintain this drive – in recruitment and other areas – so that it does deliver positive change to the sector in the next few years.

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Consensus needed on future of social care

As the debate continues over the announcement in yesterday’s Queen’s Speech of plans for free personal care at home for those in most need, what it does highlight is a lack of political consensus over the future of social care.

Leaving aside the debates on whether the announcement was just electioneering or if the government’s got its sums right with the £670 million per year cost, the hammering it got from the other main political parties’ shows that all have different ideas about the future of social care.

Labour has pinned its hopes on a National Care Service, which yesterday’s announcement is a trailer for and has been covered in the recent green paper.

Meanwhile, the Conservatives have mostly criticised Labour’s plans, while their own proposals have been relatively thin on the ground. The main one has been the idea of the insurance scheme, where people would pay £8,000 and then get free personal care as and when they need it.

As for the Liberal Democrats, they have advocated greater integration of health and social care, and that care be provided on the basis of need rather than ability to pay, but nothing much else recently.

It is widely accepted that social care needs overhauling but surely on something as big as this, and that affects so many people, the parties should be working together on it.

After all, service users and social care professionals surely want to know that policies will be consistent and not changed every time a new government is elected – that can be as harmful as doing nothing.

Finding a way forward is difficult – the debates over the green paper demonstrate this – but this should surely rise above the usual politicking for the good of the millions of service users and carers out there. It should, but I doubt it will.

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Celebrating innovative approaches to care

Last week, I attended the launch of the Big Boat, billed as a ‘healthy living centre on water’ in Poynton, near Stockport.

Despite it being a typical November day in the North – cold and wet – more than 40 people enthusiastically crowded into the small marquee in Lord Vernon’s Wharf to see its launch and have a look round.

The Big Boat is aimed at mental health groups, who can book it out and use it for meetings or wellbeing days – the relaxing effects of cruising through the Manchester countryside, for instance – as well as those with learning or physical disabilities, or just those who want a day out on the canal.

The boat has been specially designed and built to accommodate wheelchairs – including a disabled toilet – and has a fully-functioning galley, as well as mood lighting throughout.

The idea for the boat first came from a group of service users, who put their idea to mental health services in Stockport Council, who ran with the idea and secured funding for it. It was project-managed by a team from Big Life Centres (part of the Big Life Group, which includes the Big Issue) and the boat was built from scratch.

It has received a tremendous amount of interest so far, and it’s easy to see why; not only is the boat fantastically well equipped, it is also quite different to traditional care services, such as day centres, and gives service users a different experience.

It is great to see such innovative approaches being taken to social care projects and has really engaged service users – they have been involved at every stage of the Big Boat – and creates something good for the whole community.

Hopefully, other local authorities will take note of schemes like this and start thinking about new ways they could deliver care services too.

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