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The Care and Support Alliance’s response to the Government’s announcement on setting out proposals for social care

November 16, 2017

In response to the Government’s announcement on setting out proposals for social care on Wednesday 16 November, Mark Lever and Caroline Abrahams said:

“The fact that the Government has stated today that it will be bringing forward a Green Paper on Social Care, in or by the summer of 2018, is welcome news after months when it seemed nothing might happen at all. However, the Care and Support Alliance (CSA) has always been clear that our test of the Government’s proposals will be the extent to which they create a system capable of giving everyone the high quality care and support they need, whether they are disabled, an older person, or an informal carer.

“From this point of view we are very disappointed to learn that the Green Paper will be focused tightly on older people and while it is good news that there will be a parallel workstream to explore the needs of disabled adults, the jury is out for us, for now, as to whether this will be enough to deliver the balanced outcomes required. In this context we are also very concerned that the Carers’ Strategy is so long overdue.

“The fact that this Government is prepared to grasp the nettle of social care reform after so many successive governments have declined to do so is to their credit, but the CSA remains firmly of the view that the only sustainable and equitable solution for the social care crisis is one that delivers equally well for everyone with care needs in our society.”

 

Sign our social care petition

November 1, 2017

More than 1 million are going without the basic care they need. It’s unacceptable, and has to change now. Sign our petition if you agree.

 

The Care and Support Alliance, with its 80+ members representing older people, disabled people and their carers, has launched a petition to put pressure on the Government to bring forward their proposals to fix the social care system so it helps all those that need it.

Right now, over one million older and disabled people are left to struggle each day without the support they need. Very basic support such as help to get out of bed, wash, eat. The numbers of people needing help have gone up by 50% in the past seven years and are only going to get worse.

We need 100,000 signatures on our petition to get the Government to act and release their proposals to make social care fit for purpose, which includes meaningful consultation with those that need care.

Government announces a parallel work stream on working age disabled adults for social care

October 25, 2017

In response to the Government announcing a parallel work streams on working age disabled adults, when they consult on older people’s social care in the New Year.

Mark Lever, Chief Executive of The National Autistic Society, and Co-Chair of the Care and Support Alliance said:

“We are pleased the Government will also look into how to address the social care needs of working age adults when they consult on older people’s care in the New Year. The whole of the social care system is failing – more than 1.2 million people do not get the care they need. Denied basic care such as help washing, or eating, people are being abandoned by our care system.

“Addressing the needs of working age adults needing social care is vital to reforming our care system, as their support represents 48% of England’s spend on social care. We urge the Government to consult with working age adults and listen to their experiences of how social care impacts on the quality of their whole life.”

Our response to the CQC State of Care report 2017

October 10, 2017

The Care Quality Commission has today published their latest State of Care report.

Commenting on the findings of the report, Caroline Abrahams, Charity Director at Age UK and Co-Chair of the Care Support Alliance said:

“According to this report people have only a one in fifty chance of receiving great care, compared to a one in five chance of that care not being good enough. What’s worse, these odds are not evenly distributed so if you’re unlucky you may find yourself living in an area where mediocre care is as good as it gets.

“Really this tells you everything you need to know about the state of care today: it’s like a rubber band that’s been stretched as far as it will go and can’t stretch any further. Meanwhile the demand for care keeps ratcheting up.

“In the report the inspectorate effectively puts the Government on notice that our country’s current approach to care is in the last chance saloon, and that increased investment and reform can’t be put off any more. We strongly agree and we call on the Government to put paid to today’s press rumours suggesting they may be preparing to kick the issue into the long grass. This report shows that any such move would be reckless in the extreme.”

Social workers reveal the extent of social care meltdown

September 20, 2017

Devastating impact of service cuts on vulnerable people laid bare

 

The findings of a new survey of social workers by Community Care Magazine, supported by the Care and Support Alliance, provide shocking evidence of just how threadbare the social care safety net in England has become.

The survey(1) gives a unique insight into how many social workers feel about the frustrations of their day to day work as they ‘tell it how it is’.

Read the full report: CSA Social Workers Speak Out Report 2017 FINAL WEB

There were 469 responses from social workers to the online survey, from every region of England, and their comments reveal the incredibly difficult position they are often in as they strive to support people in desperate need without enough cash in the system. For example:

“[There is] strong pressure from my line manager and commissioners to reduce costs as a main priority.”

“Colleagues constantly battle to keep packages at an adequate level to support clients/assist to keep them safe.”

“Care packages are not getting agreed by the funding panel. I am having to submit reduced care packages to the panel in the hope that some support will get funded, as opposed to none.”

“I cannot get new packages of care agreed or increases agreed when needs have increased.”

These comments need to be seen against a context in which nearly 7 in 10 68%(1) respondents to the survey said they felt expected to reduce care packages because of cost pressures in their local authority; more than 1 in 3 (37%) said they believed they couldn’t get people the care they needed; and, chillingly, more than 1 in 4 (28%) were not confident that the reduced care packages they had to administer were ‘fair and safe’.  In addition, 4 in 5 respondents (81%) said family and friends are being expected to provide more support to ‘fill in’ where care has been reduced.

In the survey the reason given most often by social workers for having reduced a person’s care package was because their needs had changed. However, far more worryingly this was followed by budget pressures and because local authority support is now more restricted. The examples some respondents gave describing the plight of older people and disabled and mentally ill adults whose social care and support is being restricted or removed because of lack of resources were profoundly concerning:

“I worked with a woman who could strip wash but who couldn’t reach her back and intimate parts of her body so had paid carers for years as part of her personal budget to help her…however it was cut as she was physically able enough to strip wash. This was devastating for her.”

“A person with hoarding issues and a tendency to eat rotten food had their shopping and housework call cut, resulting in an admission to hospital with food poisoning.” 

“After one service user was told her care package was being reduced she seriously self-harmed and had to be detained in hospital.” 

“I had to reduce the care package for three brothers who live together. Each has either a mental health problem, physical or learning disability. They had a substantial care package for 15 years. It kept them safe from financial abuse and enabled them to live in the community. After reducing the care package two of them went into residential care and died. The other was admitted to hospital with dehydration and hypothermia.”

“In my local authority I work for managers who will not approve time for a care worker to visit an older person and prepare a hot meal. I am told to record telling the individual about hot meal deliveries as a reasonable way to meet this need. Meals on wheels are self-funded within the authority and can cost a minimum of £42 per week. Lots of my service users worry about spending money and so go without a hot meal.” 

“(Reducing care packages) has led to individuals becoming more isolated, engaging in risky behaviour and being exploited.”

“The person requires support with walking to the bathroom but due to the cost he is now required to contribute towards it so he has decided he would rather have the risk of falling than an evening call.”

“There has been pressure on an elderly husband due to a reduction in assistance to his wife, causing the breakdown of the relationship. He ended up in hospital and she was placed in residential care.”

“Lunch calls and toileting calls are being reduced from 30 minutes to 15 minutes to save costs…”

“[We have] removed lunch calls for service users with dementia.”

The survey also found that support to get out and take part in social and leisure activities was the type of help which was most commonly being reduced (72%), followed by help with domestic tasks such as food shopping and cleaning (67%).

In addition, more than 4 in 5 respondents (83%) did not think there was enough variety and quality of social care provision in their area for people to exercise genuine choice and control over the care they received.

Caroline Abrahams, Charity Director at Age UK and co-Chair of the Care and Support Alliance said:

“This is the first time that England’s social workers have spoken out in such numbers, blowing the whistle on just what a drastic state of decline social care is now in.”

“The social workers’ descriptions of what the cuts mean in practice for disabled people, those with mental health problems and older people make for tough reading and it is impossible not to be angered and saddened by them.”

“It is though important to remember that while social care is a service administered by local authorities, ‘the buck stops with Ministers’ and the suffering that vulnerable people are experiencing today is the direct result of the decisions successive governments have made to underfund social care. The extra £2 billion this Government has pledged will certainly help but the funding gap is far larger, so the situation is certain to worsen without further action.”

Mark Lever, Chief Executive of the National Autistic Society and co-Chair of the Care and Support Alliance said:

“Social care became an important topic during the recent General Election campaign and in the Queen’s Speech, when the Government committed to consulting on proposals to place social care on a sustainable financial footing for the future. Since then, however, it has all gone ominously quiet.

“This survey of social workers demonstrates why it is so crucial that this Government tackles the social care crisis as an urgent priority. Some of the suffering described is sickening and I think decent people in this country will be appalled at how little support is now available for people in need. People should be rightly anxious about what this might mean for themselves and their loved ones if they should they need help.”

Social care budgets have been cut by more than £6bn in real terms over the past seven years(2). As a result, half a million fewer older and disabled people receive care now than did five years ago(3), and research has estimated that more than one million people are not getting the care they need(4).

Jane*, a locum social worker, said:

“As a locum member of staff – I’ve seen social workers again and again and again being expected to make cuts and if you don’t your contract’s cut. It’s brutal. Obviously, we’re not told to make cuts – but we are! It seems to me to be that those who are well informed about their rights are able to get the care they need but if they’re old or unwell and need someone to advocate for them – they go without.”

Social care user Rachel Looby, 30, from Harrogate, needed medical help after the amount of social care she received was cut. She said:

“When my hours were cut it was a stressful time for me. I took the wrong medication and ended up in hospital, and this made me feel like my health had not been considered at all. Being in hospital left me feeling anxious and upset and I worried if something else might happen once I got home.”

Margaret Willcox, President of the Association of Directors of Adult Social Services (ADASS), said:

“This telling and poignant report lays bare the invidious decisions that are having to be made by social workers and managers every day. Working within finite budgets is challenging and staff have to consider how best to meet assessed needs within those financial parameters.

“We welcomed the additional £1 billion in extra funding this year, but we need a sustainable funding solution for social care.

“Adult social care remains at a tipping point and this survey is further evidence of why the issue needs to be treated as a national priority. We look forward to contributing to debates about finding a long-term sustainable solution to adult social care funding and delivery.”

Notes on the survey

  1. 469 social workers and other professionals who undertake care assessments and reviews responded to the survey which ran online on Community Care’s website between 12 April and Friday 9 June 2017. We asked a series of questions relating to instances where they had reduced service users’ care packages over the last 12 months. In one question respondents were asked ‘what is the most common reason you have had to reduce people’s care packages?’ and invited to complete a free-form box. Where respondents mentioned multiple reasons, they have been counted separately.
  2. ADASS, Budget survey 2017: https://www.adass.org.uk/media/5994/adass-budget-survey-report-2017.pdf – total cumulative savings in adult social care since 2010 will amount to over £6.3bn by the end of March 2018.
  3. Comparing NHS Digital, Community Care Statistics, Social Services Activity, England for 2010/11 and 2015/16.
  4. Age UK, Health and Care of Older People in England 2017, February 2017: http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Research/The_Health_and_Care_of_Older_People_in_England_2016.pdf?dtrk=true

Are you a part of our care system, be it as a care user, carer, social worker or family member? We’d love to hear your story. As an Alliance campaigning to get people the care they deserve we want your stories about the state of the system. Please tell us about your experience, or if you want to know more get in touch. We would always contact you by email before we share your story and you have the choice to remain anonymous if you would like.