From the Chairs of the Care and Support Alliance
There’s a huge amount going on at the moment and a lot for our politicians, indeed all of us, to worry about. The war in Ukraine and the cost of living crisis obviously head a long list, but this doesn’t mean that the need to reform and strengthen social care has gone away. However, it is having to compete with many other issues and concerns for public and political attention. In these circumstances it is no doubt tempting for some to conclude that social care is ‘job done’.
Unfortunately, it really isn’t – and worryingly, many of the trends are heading in the wrong direction, including those relating to the recruitment and retention of staff. The latest ADASS survey was a further wake-up call, showing that more than half a million people are waiting to be assessed – the first step in a process that may or may not lead to them actually receiving care. And just a couple of weeks ago the Kings Fund put out a score card marking the Government’s performance on social care. The scoring was quite generous, but even so there was an awful lot more red and amber than green – a B minus at best.
We believe the Care and Support Alliance should tackle this ‘cognitive dissonance’ head on. By tapping into the views and experiences of the vast constituencies of people with whom our member organisations are in touch, we want to show what’s left to do and keep pressing together for constructive change.
That’s why we are refreshing our campaigning activities in 2022.
In phase one we will be asking every member to take part in our Social Media Day of Action on Thursday 16th June, and then to mark the anniversary of the Prime Minister’s pledge to ‘fix social care’ in late July, with assets provided by the CSA. In phase two, Autumn/Winter 2022 we intend to refresh our seven tests and hold a Parliamentary event, among other activities.
‘Fixing social care’ was never going to be easy, but the starting point must be an honest acknowledgement of what’s really happening to people. Below is just a flavour of what the three of us are hearing and seeing from our own organisational standpoints – from Mencap, Carers UK and Age UK. Does this reflect others’ experiences too? We would be interested to hear.
“As we start to put the pandemic behind us, social care is emerging weaker and more stretched than it already was” – Caroline Abrahams, Charity Director at Age UK
At Age UK we are hearing a lot of stories from older people who are struggling to access care services. Some are stuck on the waiting list for an assessment, while others are self-funders who are struggling to find any decent or reliable care to buy in their local area.
We are also hearing about day services of various kinds not having resumed after the pandemic, leaving a sizeable gap in the affected localities, both for older people living at home who used to enjoy attending them, and/or for their unpaid carers. Charges for services are also reportedly going up.
None of these reports are surprising, and they all tend to point in the same direction: as we start to put the pandemic behind us, social care is emerging weaker and more stretched than it already was. Plus, care needs have often increased after two years during which many older people’s long-term health conditions went untreated or under-treated, and they were stuck largely at home, unable to move around. The impact on the physical and mental health, and resilience, of many has been very severe.
“It’s hard to see how any of the changes we’ve had so far have fixed social care for working age disabled people” – Jackie O’Sullivan, Executive Director of Communications, Advocacy and Activism at Mencap
We were pleased by Putting People at the Heart of Care, because it promised to do exactly that. But it’s hard to see how any of the changes we’ve had so far have fixed social care for working age disabled people.
Only 14% of the Health and Care levy is going to social care – and the bulk of that will be eaten up by charging reform. This is hugely complicated and will eat up Local Authority resources, whilst not actually benefiting working age adults. It will take decades to reach the cap and, in the meantime, disabled people have uncertainty hanging over them and are unable to save like everyone else can for a home, a car or their old age.
The rise in the Minimum Income Guarantee is also welcome, but at 3.1% is a real-terms cut. This hasn’t gone up since 2016, and as we face into the cost of living crisis, I don’t know how anyone can be expected to exist on £91 per week – let alone live. Disabled people, who cannot work, are expected to pay towards their care from their benefits. They can’t increase their hours, get a better job or take a second one. And people with a learning disability need support to manage budgets, navigate energy suppliers and cook on a budget. I am fearful of what will unfold over the next few months for disabled people.
While most of the country is getting back to normal, some disabled people have barely left the house for over two years now. And when they do, many find that their day and respite services have vanished; the money has been reallocated, and the organisations that ran them can no longer get the staff or volunteers. In the meantime, we are facing an epidemic of loneliness leading to poor mental health which ultimately will cost the public purse even more.
It’s hard to know exactly what the Government sees as a fixed system. But surely it is not one that still denies many people access to the care and support they need, that continues to limit their choice when it comes to the support they want and maintains an alarming trajectory towards bankruptcy. If this is a social care system that is fixed, it is certainly not one to be proud of.
“It’s no wonder that carers feel pessimistic about the future” – Emily Holzhausen, Director of Policy and Public Affairs at Carers UK
Talking to families and friends who provide care, it’s clear that they don’t think that care is fixed. From the person trying to support her husband who has been in and out of hospital over 20 times in the last six months; to families having to step in time and again because care is cancelled or unavailable; to families being asked to foot big bills by their local authorities.
We’re very clear that family is not an elastic resource or an “asset” to continually draw on. Expecting families to provide ever more care has serious consequences in terms of their ability to continue to work, their health and wellbeing, their relationships and their finances.
One in five carers providing significant care said they’d have to give up work if they didn’t get affordable and accessible social care. In these times of a tight labour market and with the costs of living, that’s causing extra unnecessary costs for business as well as financial challenges for carers themselves.
It’s not just about impacts in the here and now. Providing so much care has longer term impacts – effectively storing up problems and challenges that will last for decades.
Asking families to provide more and more care is also not what we campaigned for in terms of disability rights: the right to choose how care is provided and by whom, and the right to live your life in a way that you choose. For unpaid carers we’ve campaigned hard for the basis of the Care Act, having a choice about providing care and having a life outside caring. For us, it feels like the clock is being turned back.
Sadly the “offer” to unpaid carers through People at the Heart of Care is in danger of getting thinner as rights for unpaid carers juggling work and care, a week unpaid Carer’s Leave, was left out of the Queen’s Speech this year. Although Government says it remains committed to bringing forward legislation, as a manifesto commitment, time is running out.
It’s no wonder that carers feel pessimistic about the future. They have given so much more during the pandemic and are being left with even less support than before. Whilst we’ve seen some improvements in the identification of carers and the digital boost has benefitted many, the hands-on care that so many people rely on is falling far shorter of what they need.