David Brindle – A Strategic Adviser for HCC – comments on a new report from the APPG on Adult Social Care – The Vision and Value of Social Care.
Now the government is committed to a cap on personal liability for social care costs, attention is shifting to the promised white paper on wider adult care reforms. And there’s a growing consensus on what those should look like.
A Vision for Social Care, a new report from the All Party Parliamentary Group for Social Care, captures this well. We need, it argues, a care system based on human rights principles, shaped at local level through co-production, delivering much more personalised and community-based forms of support that draw on people’s strengths and place greater emphasis on prevention and early intervention. In other words, it should be the antithesis of the broken, deficit-based and last-resort model that typifies the sector today.
Underpinning this transformation should be demonstrable parity of esteem between health and social care, the report says. That must mean real parity, not just warm words.
Nowhere is this more important than in relation to workforce issues. As the APPG warns, any reform programme will fail unless it addresses the sector’s workforce crisis which is now of a scale unprecedented in anyone’s experience. Turnover is running in excess of 30%, and rising, with care providers in several parts of the country saying they are unable to fill vacancies even with costly agency temps. One leading homecare operator reports that job applications have collapsed by 75% in recent months.
Providers are already handing back contracts they cannot fulfil and unless this crisis is tackled with utmost urgency, there is a very real prospect of widespread failure of services this winter, leaving disabled and older people without the support they depend upon.
In the immediate term, the sticking-plaster solution has to be an emergency injection of funding to enable providers to get that bit closer to matching pay rates being offered by resurgent hospitality and retail businesses. Once that helps stabilise things, there must be what the APPG calls a “people plan”, or workforce strategy, for adult social care, setting out a road map towards pay parity with the NHS, new training and development opportunities and clear career pathways that attract young people into sector for the long haul.
All of this has to be built on what the report calls “credible” data and intelligence about the workforce, putting a finger on the great weakness of a sector that comprises some 18,000 separate employers in England alone – not counting 70,000 individual recipients of direct payments who employ their own personal assistants.
Will ministers accept that central government must take a lead on this, even though the overwhelming majority of care providers are independent businesses? That will require a big change. Until now, the position of governments of all stripes has been that it is for the sector itself to put its workforce house in order. The furthest the current administration has gone is to fund a national campaign encouraging people to consider working in social care and to instruct local authorities to monitor recruitment and retention pressures in their areas and, where necessary, develop local plans in partnership with employers.
Available and mounting evidence now surely proves that this stance is unsustainable. Left to its own devices, the sector is never going to be able to piece together, launch and sustain a national workforce strategy, even with the sterling support of the chronically underfunded Skills for Care workforce development agency.
This is a nettle that ministers must grasp. They cannot on the one hand refuse to make care work a shortage occupation, which would enable overseas workers to obtain visas to fill the tens of thousands of current job vacancies, while on the other continue to fail to give employers the means and funds to recruit and develop UK staff, as per the official policy line. Truly, this is expecting the sector to make bricks without straw.
And let’s hear no doubting of the value of investment in the social care workforce. As the APPG says, and this cannot be repeated too often – especially to the Treasury – “the adult social care system is a major economic driver in the UK, and one of the few areas which contributes to local economies in every part of the country”.
David Brindle is a strategic adviser to Healthcomms Consulting and former public services editor of the Guardian