If we continue to be distracted by Brexit an entire generation will suffer because of the lack of social care

In this the first of my blogs for 2019. I must apologise for returning to that thorny subject of Brexit which has taken up so much political time in 2018 to the detriment of everything else. Spare a thought not least for those who continue to live their lives without the care services they need, who are at the behest of politicians who have failed and reneged on their promise to publish the Green Paper on Social Care.

In addition, the delay has seen the decline in the social care industry, with increasing care home closures and fewer home care startups because of the uncertainty within social care which continues to be in limbo.

It’s right that ministers and officials focus on what is arguably the biggest upheaval in British politics since the Second World War. But with the internal mechanisms of Westminster and Whitehall snarled up by the huge task of negotiating our future relationship with the European Union, we risk losing sight of the many other issues which could have life-changing consequences for an entire generation.

According to Dr Anna Dixon is Chief Executive of the Centre for Ageing Better, near the top of this list, alongside climate change, must surely be how we respond to the seismic demographic change we’re experiencing. We are on average living 10 years longer than our parents’ generation and nearly two decades longer than our grandparents’ generation. In just 15 years, the UK will have 1.2million more people aged 85 and over than it does today – an increase of nearly 70% in this age group alone. Like Brexit, our longer lives will have colossal implications for everyone in our society.

Two of the most pressing challenges are health and care. We have waited over a year for the Government’s long promised Social Care Green Paper for it only to disappear amidst the recent Brexit blizzard. The Long-Term Plan for the NHS has recently been published, but we continue to wait for the Green Paper.

Simon Stevens made clear when he launched the NHS 5 Year Forward View – his first attempt at a strategy for the NHS – that success depended on the government meeting two further tests. Firstly secure funding for social care and secondly maintaining investment in public health. Neither of which have been met. Local authority funding cuts mean social care services have been stripped back to the bare minimum in most areas. For families struggling to fill the care gap, the NHS is the last resort in a crisis when their elderly relatives become too ill, frail or confused to manage at home.

But even if the health and care services receive increased funding to put them back on a more stable footing and transformation in service provision happens, the huge increase in the numbers of people living to very old ages means this will not be enough.

While, many people enjoy their longer lives, with wellbeing and happiness rising throughout people’s 60s and 70s, longer life also means more years managing disability and illness. At 65 men can expect to live a further 18 and half years of which about half is with some disability, while women can expect to live a further 21 years with 11 of those with disability. But disease and decline in old age is not inevitable. We can do better.

In 2019, we need to focus on prevention, stopping people from developing the long-term conditions and preventable disabilities which can reduce their quality of life. Many of the diseases experienced in old age have common risk factors. We need bold action to tackle the biggest drivers of poor health in later life – smoking, poor diet, excess alcohol and lack of exercise.

It is right that Matt Hancock, Secretary of State for Health and Social Care, has made prevention his priority. The recently announced Prevention Green Paper needs to make promoting healthy ageing a key part of its focus and propose evidence-based interventions such as regulation and incentives, as well as changes to the environment, that are more effective at changing behaviour than education. Beyond government, it will need employers, communities, businesses and service providers to play their part in enabling us to age well. For example, designing communities to be more walkable, with decent and affordable transport links, and green spaces that we can all enjoy.

To reduce pressure on our social care services, we must improve the environments in which people live so that people can remain independent for longer. Addressing the inexcusable lack of age-friendly and accessible housing in Britain means a commitment to building new homes that are accessible for people of all ages and abilities. It requires developing more affordable and attractive products to adapt the home and ensuring that people who need aids and adaptations get timely and personalised access.


No one can deny the importance of Brexit which tantamount to the biggest upheaval in British politics since the second world war. But the truth is governments of either persuasion fail to keep pace the speed of social change. Our population continues to age and if we are to take action to ensure a reasonable quality of life in later years for the many then we need action now.

Albert Cook BA, MA & Fellow Charted Quality Institute
Managing Director
Bettal Quality Consultancy

It’s that time of year again

Let’s hope 2019 is a better year for Social Care Services

Looking back over the year 2018 I have tried to bring to your attention articles and blogs that you might find interesting in the world of social care. I have covered topics ranging from the crises in social care funding to the use of Alexa to help those suffering from dementia.

The central purpose of my blogs as always is to keep you informed of innovative practice that may improve the quality of life of people who use social care services. In addition, I bring to your attention new requirements placed on providers by the Care Quality Commission.

Overall the year 2018 in social care is ending as it began. Social care is still in crises because of underfunding, and has reached a tipping point. A number of care homes have decided to call it a day, and some domiciliary care providers have even handed back their contacts to local authorities because they are uneconomically viable. What is most disappointing is the continued delay of the Green Paper which, could you believe it, is now being blamed on Brexit.

However, as a long standing optimist I am sure 2019 can only get better. Surely, during the year, we will see at last our newly confirmed relationship with the European Union. It may also see the publication of the long await Green Paper. Regardless, of either outcome, people will always require social care services and we will need committed people to provide them.

Here at Bettal we have seen a continued growth in providers subscribing to our Quality Management System Policies and Procedures which are used for registration purposes at the start of new businesses. We can take this as a positive light at the end of the tunnel.

All the best to you and yours for 2018.

Happy Christmas

Albert Cook BA, MA & Fellow Charted Quality Institute
Managing Director
Bettal Quality Consultancy

NHS Digital innovation £1m up for grabs for adult social care technology pilots

It was good to hear that Local authority projects that use digital innovation to help benefit people who access adult social care can bid for share of £1 million in funding.

The funding, provided by NHS Digital and managed by the Local Government Association (LGA), with support from the Association of Directors of Adult Social Care (ADASS), will be awarded to local authorities that put forward projects that support forward-thinking uses of digital technology in the design and delivery of adult social care.

Twelve will receive £20,000 to design a digital solution to address a specific issue with their service, with six receiving up to a further £80,000 to support its implementation.

Those bidding will need to focus on one of three themes:

  • efficiency and strengths-based approaches;
  • managing marketing and commission; and
  • sustainable and integrated social care and health systems.

Formerly known as the Local Investment Programme, the Social Care Digital Innovation Programme aims to encourage the adult social care sector to make better use of technology.

This new initiative builds upon support for the strategy advocated by the CQC who for some time have been encouraging providers to make more use of technology in the provision of care services.

James Palmer, programme lead for the social care programme at NHS Digital said: “Last year’s projects delivered inventive, forward thinking and creative solutions to local challenges in social care. They have led to successful outcomes for both services and the people who use them.

“This year, the funding will help to identify and address some key pinch points within local authority services, especially those around the integration of health and social care systems. We are looking forward to seeing the innovative solutions that councils come up with in response to our latest round of funding.”

Previous projects to have received support include home video-conferencing in Essex, voice-activated home support in Hampshire and electronic referrals for home care packages in Hampshire and electronic referrals for home care packages in Sefton and Knowsley.

Sefton and Knowsley Mayor Kate Allsop, deputy chair of the LGA’s Community and Wellbeing Board said: “We are committed to enhancing the role that information and technology can play in the commissioning and delivery of health and social care services.

“As part of this agenda we are pleased to run another funding round in collaboration with NHS Digital, to stimulate digital solutions to social care challenges at a local level.”

The closing date for applications is 4pm on 1 June.

An NHS Digital-commissioned review of the state of IT in social care revealed a myriad of challenges.

This latest initiative by NHS Digital is just one of many such funding approaches with the aim of increasing the use of technology in social care. There is little doubt that the funding crises that is affecting social care, has prevented investment in the use of technology. Many providers ae aware of the benefits that technology can bring to adult social care services but where is the money coming from to pay for it?

Those who work in the social care industry are full aware that the use of technology will play an increasingly important role in the future provision of adult social care services. We can also expect it to be included in the Governments Green Paper on the future of social care services to be published in the summer.


The offer of more funding from NHS Digital to fund specific technology projects should be welcomed. But this piecemeal approach is only scratching the surface when it comes to the technology needs of adult social care services.  What is needed is a government funded worked-out strategy for the implementation and use of technology that is available to all providers and commissioners.

Albert Cook BA, MA & Fellow Charted Quality Institute
Managing Director
Bettal Quality Consultancy

A strategy for improving recruitment and retention of staff in social care services

The difficulties faced by providers in attempting to recruit staff for social care services continues to present significant challenges. Low wages, conditions of service and lack of career opportunities are often cited as major reasons why it has become increasingly more difficult to attract people to work in social care.

In December last year, Health Education England published Facing the Facts, Shaping the Future: A Health and Care Workforce Strategy for England to 2027.

  • The adult social care workforce is larger than the NHS workforce but has lower average pay, fewer qualifications and more part time staff.
  • Turnover is high and there are 88,000 vacancies.
  • Required growth of between 14% and 31% is forecast by 2030.
  • 18% of the workforce is from overseas with regional variation.
  • 20,300 independent organisations provide care in England.
  • The government is consulting on changing aspects of the system.

The report highlights that the majority of the care workforce is likely to earn at or near the National Minimum Wage. The workforce is 82% female with an average age of 43 and nearly half work part time including 54% of care workers. Zero-hour contracts cover 24% of all staff and 33% of care workers. Turnover is high at over 25% with around 347,000 staff leaving roles during 2016/17, 33% of those leaving the sector altogether.

The sector faces recruitment and retention challenges at all levels, in both regulated and unregulated professions. Vacancy rates are higher than the general economy at 6.6% compared to 2.5%, with approximately 88,000 vacancies. Workforce diversity, as with the NHS, means a combination of interventions are needed to support an adult social care workforce for the future. The government has recognised pressures on the social care system with an additional £2bn, however a number of factors such as pay, large numbers of small employers, contract status and retention and recruitment make workforce issues challenging for the sector.

Increasing demand for adult social care

Demand is growing as people live longer with more comorbidities leading to more complex health and care needs. According to “Horizon 2035: health and care workforce futures”, by 2025 unconstrained demand for lower skilled direct care staff is likely to increase by 12%, (around 120,000 more jobs), and an overall workforce demand increase of 14% (190,000 jobs). Skills for Care suggest that need might be as much as a 31% increase or 500,000 jobs by 2030. Factoring in vacancies approaching 90,000 and the challenge of the current staffing model to meet these demand projections is clear. It also has implications for the wider economy, with labour used to meet this increase not being available to other sectors. There are interventions that can alleviate some of this increasing demand whilst meeting peoples’ desire to remain independent and well at home for longer. These include social care staff supporting prevention and public health interventions; better join up between health and care; more support for carers; and new technology.

Maximising recruitment

There are two focus areas for ASC recruitment. The first is training and skills development. Roles tend to have low entry requirements with around half the workforce having no formal social care qualifications. This is especially true of the vast majority of staff providing direct care and support. The regulated professions tend to perform more supervisory roles. There are no standard training requirements across large parts of the sector with too many staff not receiving training or professional development, despite providing direct care for vulnerable adults whose dignity and quality of life is dependent on the quality of their work. The Care Certificate, developed by HEE, Skills for Care and Skills for Health, provides a standard induction framework across social care and health. There is no mandated skills training or development across employers.

The second recruitment challenge is overseas staff. UK nationals make up 83% of the ASC workforce; 7% (around 90,000), are non-UK EEA nationals and 11% (about 140,000) are from the rest of the world. Direct care staff form the biggest group of EEA staff with about 67,000 workers

The majority of roles have low entry requirements and limited career structures. The 20,300 employers separately determine job titles and structures, which makes demonstrating career pathways challenging meaning staff often seek career progression by leaving the sector. Increases in the National Living Wage have driven up pay for those on the lowest wages but also narrowed pay differentials thereby reducing the attractiveness of seeking promotion or progression in some cases.


The Health and Care Workforce Strategy for England to 2027 has involved consultations with those who have a vested interest across the care industry and was due to be completed last month. Any new strategy will need to take into account that if we are to recruit and retain more staff, we cannot continue to have over 20000 care providers determining staff job titles and career structures. We need a national set of employment conditions that give staff encouragement to seek career progression with available training, that is recognised and financially rewarded.

If staff can be supported to gain satisfaction in their work through training that leads to improvement of skills, career opportunities and financial rewards, then we have the basis for a thriving, consistent and high-quality workforce. We may then begin to see an improvement in recruitment and retention of staff in the social care industry.

Albert Cook BA, MA & Fellow Charted Quality Institute
Managing Director
Bettal Quality Consultancy


Support for providers to comply with the General Data Protection Regulation

Given the amount of information available to increase awareness, most providers will now be aware that GDPR comes into force on the 25th May 2018. That being said, if readers carry out a trawl of the internet, they will find that apart from the Bettal GDPR Compliance Tool there is no other company advertising support with compliance designed and tailored specifically for social care services.

The purpose of this article is to give readers an overview of the requirements of the General Data Protection Regulation and how the Bettal GDPR Compliance Tool can support providers to achieve compliance.

Essentially, the responsibilities of managers are contained in the GDPR Principles.

GDPR Principles

Article 5 of the GDPR requires that personal data shall be:

(a) processed lawfully, fairly and in a transparent manner in relation to individuals;

(b) collected for specified, explicit and legitimate purposes and not further processed in a manner that is incompatible with those purposes; further processing for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes shall not be considered to be incompatible with the initial purposes;

(c) adequate, relevant and limited to what is necessary in relation to the purposes for which they are processed;

(d) accurate and, where necessary, kept up to date; every reasonable step must be taken to ensure that personal data that are inaccurate, having regard to the purposes for which they are processed, are erased or rectified without delay;

(e) kept in a form which permits identification of data subjects for no longer than is necessary for the purposes for which the personal data are processed; personal data may be stored for longer periods insofar as the personal data will be processed solely for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes subject to implementation of the appropriate technical and organisational measures required by the GDPR in order to safeguard the rights and freedoms of individuals; and

(f) processed in a manner that ensures appropriate security of the personal data, including protection against unauthorised or unlawful processing and against accidental loss, destruction or damage, using appropriate technical or organisational measures.”

Article 5(2) requires that:

“the controller shall be responsible for, and be able to demonstrate, compliance with the principles.”

Care Services will need to register with the Information Commissioners Office(ICO).

As can be seen the data controller will need to have systems and documentation in place to address the principles and requirement of GDPR.

Data Controllers will need to demonstrate that:

  • they have a legal right to hold information on service users;
  • they are aware of the kinds of information they hold on services user’s staff and volunteers;
  • the information they hold is accurate and up to date;
  • personal data collected is adequate relevant and limited to the purpose for which it is being processed;
  • people are aware of their rights to access information that is being held about them;
  • appropriate security measures are used with the processing and storage of people’s personal data.

Bettal GDPR Compliance Tool

The Bettal GDPR Compliance Tool designed specifically for social care services has taken months to develop. The Tool draws heavily on the GDPR Principles, compliance guidance produced by the Information Commissioners Office and their own Self-assessment (ICO).

The Tool is designed to:

  • Enable managers to understand their obligations to the GDPR.
  • Provide you with the documentation you require and guidance to meet the GDPR.
  • Audit and check your compliance to GDPR.

The Tool includes:

  • An Implementation Plan.
  • Data Processing Audit Register (Form).
  • Example Privacy Impact Assessment (Form).
  • Example Privacy Impact Assessment (Form).
  • Obtaining Consent (Policy).
  • Information Governance (Policy).
  • Data Breech (Policy).
  • Security of Personal Data (Policy).
  • GDPR Staff Training (Policy).
  • Duties of senior Person Responsible for Compliance to GDPR (Guidance).

Overall the contents of the Bettal GDPR Compliance Tool includes over 30 documents.

Please click here for further information on the Bettal GDPR Compliance Tool where you can download free samples and purchase the full package.

Albert Cook BA, MA & Fellow Charted Quality Institute
Managing Director
Bettal Quality Consultancy