The government must act to stop the continuing social care crisis

7 May 19

Two years after the proposal of a green paper on urgently needed social care reform, over a million older people have either died waiting for a care package or had their requests refused, says Age UK’s Caroline Abrahams.

 

In the weeks leading up to April, ministers and civil servants were talking about it as the month in which they hoped to publish the government’s proposals for reforming social care. But April came and went without the paper appearing and we witnessed the sixth postponement since the idea of producing this paper was originally announced, some two years ago now.

Our research estimates that more than 50,000 older people have died waiting for a social care package since then. Over the same period, in excess of half a million older people (626,701) have had their requests for social care refused by their council, and 7,240 older people have had the hugely regrettable experience of running down all their savings on care bills, leaving them reliant on the state to fund their care in future and with nothing to leave for loved ones after their death.

In addition, in the past 24 months, 1,263,844 older people have developed an unmet need for care, such as being unable to wash or dress. Although councils and NHS bodies have worked hard to reduce delayed hospital discharges among older people, this has reportedly often been achieved by diverting as much resource as possible to supporting this specific group of older people. The problem is that this leaves many older and disabled people in the community struggling without the help they need.

A couple of years ago, the Care Quality Commission said that social care was approaching a “tipping point” and that urgent action was needed to stabilise it and ensure the system was sustainable in the longer term. There will be varying views about whether that tipping point has now been exceeded, but, regardless of the semantics, the reality is that social care is doing no better than staggering on, while demand continues to grow with an ageing population.


'The absence of strong government leadership on social care, as would be evidenced by a bold and ambitious green paper, is also a problem when it comes to the recruitment – a huge issue within social care, since vacancies are running at more than 100,000 every day, while churn is as high as one in three among some providers.'


Meanwhile, continued uncertainty gives providers no reason to be confident that things will improve any time soon. It is not surprising that significant numbers of care-home providers are switching to the self-pay end of the market, in localities where this is buoyant, leaving those dependent on the state with less and less choice.

The same is true of nursing homes, which are struggling to recruit and retain the nurses they need to keep their registration. We are hearing of nursing homes de-registering to become care homes in order to avoid this problem, or mothballing some of their provision because they cannot staff it. This is really worrying since, by definition, those in need of a nursing home place have particularly serious needs.

The absence of strong government leadership on social care, as would be evidenced by a bold and ambitious green paper, is also a problem when it comes to the recruitment – a huge issue within social care, since vacancies are running at more than 100,000 every day, while churn is as high as one in three among some providers. Social care is a people business, and the stability its clients need is undermined by such an unstable workforce.

It is really positive that the government is running a social care recruitment campaign but, arguably, a vibrant public debate about care, prompted by the consultation on a very positive green paper, would be more helpful still.

In theory, the spending implications of the green paper should be considered as part of the Spending Review, scheduled for later in the year. The ongoing delay of the green paper unfortunately also raises questions about whether the opportunity potentially afforded by the Spending Review will be seized.

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