At long last the Government has published its 10-year plan for social care the Adult Social Care Reform White Paper.
On the positive side the plan builds on Building on the principles of the Care Act 2014, the paper talks about listening to people receiving support; personalisation; prevention; choice and control; information to help navigate the health and care system; support for informal carers; support for the professional workforce; innovation and technology; and oversight of the system.
These are aspirations that are held by all those receiving and providing social care. But that is all they are, they lack detail and substance and will remain just aspirations until they are backed up by financial commitment.
Funding
The proposals in the White Paper contain welcome additional funding for a range of areas, including housing (£300m); innovation (£30m); technology (£150m); informal carers (£25m); workforce (£500m); and testing new ways of providing information (£5m), which will be valued by many, they do not address underlying systemic issues.
These figures need to set alongside a backdrop where Government continues to pour billions into the black hole of NHS acute hospitals. There’s no sign of a meaningful shift in investment towards supporting people in the community, addressing inequalities or tackling the social determinants of health.
Homecare receives only 4% of the amount invested in the NHS.
Criticism of the White Paper
The Government has been heavily criticised for its “insufficient” social care plan as experts say funding will not be enough to make services sustainable.
The white paper sets out a 10-year vision for social care and includes how the government will spend the £5.4bn promised to the sector over the next three years.
The document sets out details of how £1.7bn will be used to improve social care and includes £300 million to expand supported housing and £500m to improve skills within the social care workforce.
However, leading experts, such as Sally Warren from think tank The King’s Fund, have warned the 10-year plan “does not go far enough.”
In a statement she said: “The overall vision in the white paper is the right one and if delivered could significantly improve the experience of people receiving care and those who work in the sector. However, the steps outlined don’t go fast or far enough to achieve this vision and the funding allocated to deliver it is insufficient.”
One expert explained that £500m for the workforce over three years, if multiplied by the current numbers working in adult social care, would only mean £150 per person.
Oversight of local authorities
Hard pressed local authorities have found it difficult to adequately fund community care services. Funding cuts to councils over many years have led to rationing and poor approaches to commissioning and purchasing of homecare. In turn, this has resulted in poor pay, terms and conditions for the workforce.
The Government in its wisdom are putting the Care Quality Commission in charge of oversight of local authorities. But to my mind they seem to be more interested in local government efficiency then ensuring local authorities are adequately funded. Given that CQC will have no enforcement powers in their role in local authority oversight. All they can do is identify and describe problems, give ratings and write advisory reports.
This is hardly likely to improve the growing demand for social care and quality of services if cash-strapped councils continue to purchase homecare at fee rates which are too low to enable quality, compliance or sustainability of provision. how will a CQC advisory report bring about change?
Summary
The Adult Social Care Reform White Paper is disappointing and can be seen as a missed opportunity. At a time when the social care industry is in crises it does little to alleviate the concerns of providers and those who are in need of social care. The plan has vision and aspiration, but lacks the financial commitment to achieve its goals.
It is hard to see what improvements the CQC can achieve without enforcement powers. To me this seems more like the Government passing the buck, focusing upon local government efficiency on how money is spent rather than as we all know acknowledging that local government have been deprived of ring fenced funding for social care over many years.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy