Social care funding equivalent to 176,000 places for over-65s is about to be cut. In what world is this the right response to Covid?
by Joanne Harding, Executive Member for Adult Social Care at Trafford Council
Being appointed Executive Member for Adult Social Care at Trafford Council was one of the proudest achievements of my life. However, it is more than a role: it is personal.
In March 2019 I submitted a motion to Council, asking Trafford to adopt in full the recommendations of the Unison Ethical Care Charter.
As I delivered my speech, I held a photograph of my gran, Annie.
Annie was political, tiny and formidable, and I loved her.
She was an important influence on my life, and I wouldn’t be the woman I am now without having her advice and guidance.
I watched as she was ravaged by dementia: there was confusion; inability to recognise any of us; wandering and putting herself at risk, not able to feed and clothe herself; and needing assistance with the most personal of care.
I saw carers come and go, different ones trying to coax her to eat and drink.
I watched as they watched the clock. Knowing they had limited time to care for her, before they had to head off to the next person needing their support.
I watched as she sat motionless and lifeless, slumped in a chair, as she eventually had to be moved to nursing care.
The woman I knew as fiercely independent was now totally dependent on others to look after her. I remember feeling horrified and terrified in equal measures, every time I went to visit her at the care home that was just too poorly equipped to really care for my lovely gran.
Fast forward to 2020 and here we are in the middle of a global pandemic, with care homes on everyone’s lips.
Little has changed. The social care sector has had years of significant underinvestment: people living longer, with more complex conditions, has led to a growing demand for care and ever-rising costs.
Local authorities are facing a £10 billion black hole due to coronavirus. This will mean a £3.5 billion cut to social care, the equivalent of 176,000 long term adult social care places for over-65s and 23,000 short-term places.
In total, 35,928 places would go in the North West alone.
Stark figures indeed, and behind all of those figures is a person. Not just numbers on a spreadsheet.
The impact of austerity on social care has been devastating.
Providers have struggled to maintain services: in fact, some just withdraw from the market, leaving people vulnerable and uncertain.
Staff feeling overwhelmed and undervalued.
People waiting longer to access services with varying degrees of quality.
This has to change. It wasn’t good enough for Annie back then, and it isn’t good enough now.
At long last we are now, as a result of this crisis, recognising the contribution that social care staff make in supporting people to live their best lives.
We cannot go back.
Frank Dobson said in 1997: arrangements for long term care of older people were so unsatisfactory that “they cannot be allowed to go on for much longer“. But guess what?
There are three areas that I feel Labour must now focus on, as we look to create our future vision for social care:
One. Fix under-funding. The discussion around funding will not be an easy one. It will throw up a whole set of “death tax” “dementia tax” hand wringing, however, have that conversation we must. I am pleased that the Health and Social Care Select Committee have resurrected plans to consider evidence around social care reform. We must push for the kicked into the long grass Green Paper and tackle this issue that successive governments have failed to do.
Two. Address the workforce challenge. A Unison survey of staff found that work schedules are unrealistic with ‘call cramming’ the norm. Inconsistent wages and poor terms and conditions equates to high staff turnover. The person in need of the care then has to deal with a succession of different carers to provide personal care. We must build a workforce that feels valued and invested in.
Three: Effective integration of health and social care. What does genuine integration look like? It doesn’t mean that social care needs to be subsumed into the clunky bureaucracy of the NHS. Not everyone who requires social care has a health need. Local government, the community and voluntary sector know what is needed at a community level. Here in Trafford I have been part of the excellent first response in establishing community hubs. We must build on this model.
To integrate does not mean throwing the baby out with the bathwater.
Let us also talk about people, and not systems. Care homes are being referred to now as some kind of entity: “over there”. These are people’s homes. Not just a business model.
I am delighted with the appointment of Liz Kendall as Shadow Minister for Social Care. In Liz, I see a tenacious determination to hold this government to account. I know that right now, working together with local councils on the ground, she has a real opportunity to map out a whole new deal for social care, and avoid us slipping back into bad habits.
So, I ask Liz and the Labour leadership to involve councillors and communities in how we address the three points I raise.
Let’s be bold in building our Labour vision for social care.
The people we care about who use these services, among them some of society’s most vulnerable, surely deserve better.