With local authorities under incredible financial pressure because of government cuts, care services in the UK are in crisis, and the level of care quality has been significantly reduced as a result.
The social care budget has been cut by a massive 26%.
The Association of Directors of Adult Social Services’ (Adass) annual budget survey sends a very clear message – adult social care services in England will soon be `unsustainable’ if current budgetary pressures continue, and significant measures are not taken to inject new money into local social care economies.
ADASS President David Pearson said: “This is the third year of continuing cash reductions and the fifth year of real terms reductions in spending. Since 2010 spending on social care has fallen by 12 per cent at a time when the number of those looking for support has increased by 14 per cent. This has forced departments to make savings of 26 per cent in their budgets – the equivalent of £3.53 billion over the last four years. Nothing can be starker than the truth these figures point to.
“In March this year the National Audit Office said that ‘need for care is rising while public spending is falling, and there is unmet need. Departments do not know if we are approaching the limits of the capacity of the system to continue to absorb these pressures.’ Our survey shows beyond doubt that we have reached the point where, as the NAO feared, we are unable to absorb the pressures they, and our survey, have identified.
He went on: “substantial additional financial burdens will flow from implementing the Care Act. These will include the welcome additional rights to be given to carers; implementing the Dilnot proposals, and responding to the Supreme Court judgement on Deprivation of Liberty Safeguards.
“But combined with these budget reductions, as resources reduce and need increases, directors are increasingly concerned about the impact on countless vulnerable people who will fail to receive, or not be able to afford, the social care services they need and deserve.”
David Pearson also acknowledged the `Herculean success’ of his colleagues and their staff in making sure that, as far as all national polls suggest, services are maintained at stable levels of customer satisfaction. “This is a solid tribute to the capacity of social care staff to work well under pressure, and to their sustained commitment to caring for the people who need them.”
Mr Pearson concluded: “Let nobody underestimate how hard we have all worked – adult social services departments alongside central and local government politicians – to minimise the damage that our current austerity might do to the vulnerable people for whom we have responsibilities.
“Nor how policy makers and politicians might be putting too much faith in the benefits of integration with the NHS to help prevent this impending unsustainability. Joining up care and health services is the right thing to do. But any financial benefits are likely to be far outstripped by the sheer scale of the reductions in funding.
“It is not directors’ job, but that of the country as a whole and its politicians, to debate how much, in times of the most severe adversity, vulnerable people should be protected from the consequences of that adversity by the introduction of new money into social care. I hope this survey will help get that debate started; fuel that debate, and help the people engaged in it reach a fair and humane decision.”
The survey also shows that directors feel gloomy about the future, with the pace of adult social care savings projected to continue at an accelerated trajectory for 2015/16. This will create further significant instability at the crucial time when the Care Act reforms and the Better Care Fund plans are due to be implemented.
- Nearly 50 per cent think that fewer people will be able to access care services,
- An equal number believe that people will get smaller personal budgets,
- Over a half think care providers are facing financial difficulty, and
- Nearly 60 per cent think there will be increased costly legal challenges.
Oxfordshire county council has for the past four years pulled out all the stops to avoid passing on a 38% cut in its grant for services for homeless people. But now the authority says it has nowhere left to turn and is reluctantly planning to phase in the reduction, including stopping all funding for dedicated support for those with substance misuse problems.
Jackson thinks the county council has a sustainable – if unpalatable – four-year plan for social care. His political boss, Conservative cabinet member Judith Heathcoat, has told the Oxford Mail she is “as comfortable as I can be” with the planned 38% cuts in housing-related support, which are part of a £64m savings package across the authority over four years.
Other savings will come through cheaper support for people with learning disabilities, moving them either out of residential care or perhaps from two-person flats to shared accommodation for five. Older people will also be hit: those attending health and wellbeing centres may next year be charged £20 a day.
Jackson’s fear is that growing numbers of legal challenges will be incurred over people’s statutory rights to care. “In the end we cannot not meet people’s care needs” he says. “We would want to do that morally anyway, but the law is very clear about it. We don’t need the courts to tell us that.”
“It’s not something I like to do, but we’re not unusual in doing it,” says John Jackson, the council’s director for social and community services. “The reality is that I have to protect services for people I have a statutory responsibility for.”
Richard Humphries, assistant director of policy at the King’s Fund thinktank, says the survey rings painfully true. “This is the consequence of the 2010 spending settlement that supposedly protected the NHS but left the social care system totally exposed,” he says. “It was all entirely predictable.
“What we are seeing now is a double whammy with both the NHS and social care simultaneously facing a crunch year next year. Most people cannot see how to get beyond this without extra money – not just money for more of the same, but for transformation of services. The Better Care Fund is OK, but it’s a very small step towards much bigger measures that are needed.”
Source: The Guardian
The quality of care support is also being questioned by social care Directors. In the survey, 19% of Directors say they do not know if care providers (much of which is outsourced) pay the minimum wage to their employees. 75% said that they commissioned visits to vulnerable people of just 15 minutes just to check on the person’s wellbeing or medication.
With social care directors looking for cheaper and cheaper outsourcing, the gates are wide open for unscrupulous companies to provide very poor care using unqualified (or dubiously qualified) staff at the cheapest hourly rate, often targeting immigrants with little or no experience in social care.
The impact on other services is obvious. As we reported, the NHS are struggling to cope with the number of people occupying beds because there is no social care in place for them to leave.
Through their ill-implemented slashing of budgets the current government have created a crisis that does (and will in the future) have a significant impact on the vulnerable in our society.
Any government coming into power next year will have to try and rectify the mess the current coalition leaves behind. It will not be an easy (or quick) task to place resources where they are needed, with foreign aid and other wasteful expenditure being protected by legislation implemented by this government – mostly for their own benefit.
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