How close to the brink is the social care system? In the severest warning yet that it is fast becoming unsustainable, council leaders will on Wednesday warn that their ability to support older and disabled people is “veering steadily towards the impossible”.
The picture in children’s services is no better. The body representing directors of those services reports that their ability to make any impact at all on the lives of 4 million children living below the poverty line is increasingly constrained by relentless funding cuts.
As leaders of both children’s and adult services in England meet this week in Bournemouth for their annual joint conference, they will reflect ruefully on the deafening silence from last week’s Conservative party gathering in terms of any relevant policy or funding initiative.
Most alarming for the adult sector was the complete absence from the prime minister’s ill-fated conference address of any reference to the system reform that had been flagged in the party’s general election manifesto, promising “dignity and protection in old age”.
It was left to social care minister Jackie Doyle-Price to announce that the consultation trailed in the Queen’s speech in June would not begin until 2018. Without a clear strategy, adult social care will continue to lurch from crisis to crisis
Mark Lever, co-chair of the Care and Support Alliance, a grouping of more than 80 care charities, describes the news as incredibly disappointing: “This year marks the 20th anniversary of the launch of the royal commission on care and there have been 12 separate consultations and reviews since then. Yet the big questions on funding have repeatedly been dodged and the system is on its knees.”
While welcoming the £2bn one-off emergency cash injection unveiled in the spring budget, the LGA says the sector still needs £1.3bn immediately to help stabilise the care provider market. It also projects a £1bn funding gap by 2020 – not accounting for further cost pressures, such as the question of who will pay for care workers to receive the full minimum wage when doing sleep-in shifts.
Izzi Seccombe, who chairs the LGA’s community wellbeing board and is Tory leader of Warwickshire county council, says: “Councils have a proud record of getting on with the job of delivering for their local residents, and doing so in partnership, but it is no exaggeration to say that the circumstances are now veering steadily towards the impossible.”
Seccombe’s reference to partnership is pointed. Relations between local government and the NHS have soured in recent weeks amid recriminations over responsibility for delayed hospital discharges of older patients and intense government pressure to clear beds in time for a feared winter flu crisis. The LGA is furious that some councils deemed to be not pulling their weight face penalties.
One example given in Wednesday’s report is Sheffield council. Despite being one of the 20 authorities with the highest rates of delayed discharge locally, it has nearly halved the daily number of hospital beds occupied by people medically fit to go home – but held up by issues such as arrangement of a social care package – from 171 in February to 90 in July.
A survey by the Association of Directors of Adult Social Services of about 100 councils, also released on Wednesday, will reveal that some have already been fined – by up to £100,000 – since April for causing delayed discharges. More than half are expecting to be overspent on adult social care in 2017-18.
Amid mounting concern over the fragile state of the homecare market, 48% of the councils surveyed say that homecare providers have handed back contracts in the past five months because they cannot fulfil them or make them pay. That’s up on the 37% who said the same in a previous survey in the spring.
More than 45% of councils say they find it difficult to find homecare providers, while 20% report difficulty securing places in residential homes and 52% say spaces in nursing homes are hard to come by.
The Association of Directors of Children’s Services will use the Bournemouth conference to set out an eight-point plan for government to tackle poverty, including making good what the LGA forecasts will be a £2bn shortfall in funding of the children’s sector by 2020.