Adopted at NCWGB AGM 2024

Following the Government’s announcement to cancel the proposed recommendations from the 2011 Commission on Funding of Care and Support, also known as the Dilnot report⁽ⁱ⁾ that had looked at a new approach to the funding of Adult Social Care, NCWGB calls upon the UK Government to deliver a robust, fair and efficient alternative to ease the funding crisis that Adult Social Care is in.

The different levels of care required for a diverse society and its many wants, need to be mapped out clearly and fairly across all local authorities around the UK to enable all areas to have equal access to all types of care and funding. Currently, there is no national government budget for adult social care in England. Instead, publicly funded social care is mostly financed through local government revenue. CBP-7903.pdf (parliament.uk)⁽ⁱⁱ⁾

The King’s Fund, an independent charitable organisation working to improve health and care in England explains “unlike NHS services, social care is not free at the point of use.”⁽ⁱⁱⁱ⁾

The Government’s manifesto around social care beings “with a principle of “˜home first’ that supports people to live independently for as long as possible.” For this to happen more support is needed for the many unpaid carers, usually made up of family members and predominantly women. Where “˜home first’ is not a safe option, extra facilities and funding are required to support people away from their home.

Also, in a bid to lower immigration levels government issued health and care visas have fallen dramatically (81% lower in some months) and the care industry say they face a precarious future. Quality training and fair wages, that reflect the immense importance of the job roles and work that is required when caring for people, are needed to help retain good people, give credence to a career in care and the proper respect that should be there for staff and service users alike.

In July 2011, Andrew Dilnot, chair of the Commission on Funding of Care and Support, said:

The issue of funding for adult social care has been ignored for too long. We should be celebrating the fact we are living longer and that younger people with disabilities are leading more independent lives than ever before. But instead we talk about the “˜burden of ageing’ and individuals are living in fear, worrying about meeting their care costs.

The current system is confusing, unfair and unsustainable. People can’t protect themselves against the risk of very high care costs and risk losing all their assets, including their house. This problem will only get worse if left as it is, with the most vulnerable in our society being the ones to suffer.

Under our proposed system everybody who gets free support from the state now will continue to do so and everybody else would be better off. Putting a limit on the maximum lifetime costs people may face will allow them to plan ahead for how they wish to meet these costs. By protecting a larger amount of people’s assets they need no longer fear losing everything.

13 years on, the same issues are still to be addressed and have multiplied.

Proposer: Hilary Hughes, NCWGB Individual Member
Seconder: Alison Newall, NCWGB Trustee & Individual Member
Submitted by: Hilary Hughes, & Alison Newall, NCWGB Individual Members

Speech on Adult Social Care ““ Hilary Hughes

As we all keep being told and many have experienced, the social care system is sinking and many councils are going bankrupt because of the huge costs in keeping it afloat.

So, what is being done about it? What is hindering its success and how can we make the process more streamlined, simpler and more caring, as well as cost effective?

Most people who have to deal with social care are doing it at a time in their lives when they are upset, struggling for money, older and ill and in increasing cases, dealing with dementia (hence the need to access the care system). The administration that is required can be daunting for most people and even more so when in a stressful and time critical situation.

It appears that each local authority runs their social care in a different way, with different rules and different meanings of the terms of reference used.

My family has recently experienced this in Merseyside. Liverpool has 3 different local authorities, and all have different rules, money and although at times use the same words for services, they actually mean different things to each authority. Therefore, crossing county lines, which sometimes families need to do to get the right care, can be very complicated especially when the professionals are all talking differently or using jargon. Added to this, and I have been told by staff using them, the computer systems at times do not seem fit for purpose.

Social Services are based in councils and in hospitals but are not under the same departments, they work separately even though they are in theory providing the same service.

Added to this are the difficulties that the NHS has, and we can all see a perfect storm on the horizon when the most vulnerable of our society can be left in limbo, or fall through the administrative cracks or not get the care they need at the right time.

This is a huge problem and a huge piece of work to investigate and discuss and come up with ideas for. But as we are all getting older or have older family members and friends that we may have to support, it is an important issue. We have to be invested in the need for this sector as most of us will one day need to access it and therefore, we should have and do have the right to support, influence and direct the decision making on how to make it more robust.

History also tells us that the main carers in society are women, this needs to change of course, but it also means that this subject is important to women.

Proper funding is paramount to providing a good service as is providing the right services for each situation.

The Care Sector industry itself is sounding alarm bells and are raising concerns and some are accusing the Government of dropping their pledge to improve social care as it has abandoned the proposed cap on costs and is preparing to scrap a care working training fund (The Guardian 31/08/2024^(iv)).

The Association of Directors of Adult Social Services (ADASS) have recently presented a report, a roadmap to reform care and support in England. Sarah McClinton, President of the Association of Directors of Adult Social Services (ADASS) said: “After decades of false dawns on reforms and funding, never in my professional career have I seen the adult care system so close to breaking point. Millions of people are in pain or distress because they aren’t getting the care they need and family and friends picking up the pieces are being pushed to the edge.^(v)

A few of my own thoughts are as follows:

A&E in hospitals can be frightening, stressful and busy place, a proposal for specific A&Es for the older person that can link straight into social care in an emergency may be a solution rather than the older person getting caught up in the day-to-day A&E emergencies, that can be very frightening.

Bringing back Convalescence Homes/Community hospitals that are geared up for the older population could perhaps help, so that main hospitals can deal with accidents, emergencies and planning surgery more.

Shared best practice across all regions is paramount. Difference areas are starting to approach the issues, for example, one local NHS has announced that it is “launching a Centre of Excellent for Frailty to support the health and care of older residents across Humber and North Yorkshire.”^(vi)

If it is found to work in one area then it may well work in many and therefor may save money by preventing everyone trying to separately “˜re-invent the wheel’ so to speak.

We need to query the use of Government statistics and their desperation in getting many cases closed in a record time just to look good. We recently experienced using the 111 helpline when a doctor told us he needed to close the case that day even though it wasn’t completed and we couldn’t get a reference number for the case to pass onto other processionals as the incident moved across different departments. So, we had to start the conversation again every time we talked to someone ““ no joined up thinking there.

Returning to accessing the care system, as well as the huge forms to complete (yes, the information is required for safeguarding purposes as well as making sure public funds are not abused, they are complicated), families can also suddenly be hit with care home top up fees. This can sometimes have an adverse effect on their own personal situation. Deferred payments are sometimes an option, a bit like a bridging loan, but can sometimes come with an administration fee that can be eye wateringly huge, the list goes on.

Family members who take over the care themselves at home can claim an allowance that then is affected by their own work income (work that may be needed for extra income but also as a break away from their care role). As seen in the news recently some people have come unstuck, mainly due to the Department of Work and Pensions (DWP) not telling them quick enough they were over the limit. Providing care is a huge responsibility and emotionally and physically draining and people who do this are to be respected and supported, so the balance of all money, both income and benefits needs to be clearer and fairer.

The emphasis on good mental health is constantly in the news, so all the above needs to work better for all mental health and in theory less people will require the services of the NHS and care system if we aren’t all driven towards ill health by trying to navigate it!

The NCYW and Up to 30 years old groups can also get involved as this will affect their futures. NCW should link in with other campaign groups on this subject. There is strength in numbers, as we as linking in with care industry providers to discuss their suggestions and the challenges that they face, so that we can present our concerns, ideas and collective suggestions to Government.

Some further reading:

Parts of Labour’s Manifesto ““ Build an NHS fit for future
https://labour.org.uk/change/build-an-nhs-fit-for-the-future/

“Social care reform is just one of Labour’s many policy proposals for the healthcare sector. On social care Labour will:

• create a National Care Service. Servies will be locally delivered, with a principle of “˜home first’ that supports people to live independently for as long as possible.
• develop local partnerships working between the NHS and social care on hospital discharge.
• enhance partnership working across employers, workers, trade unions and government and establish a Fair Pay Agreement in adult social care.
• explore how we best manage and support an ageing population; how integration with the NHS can be secured; how to best support working age disabled adults; and how to move to a more preventative system.”

i. [ARCHIVED CONTENT] Dilnot Commission (nationalarchives.gov.uk)

ii. House of Commons Library Research Briefing on funding problems. (Statistics)
CBP-7903.pdf (parliament.uk)

iii. The King’s Fund a source of information on social care
Social Care In A Nutshell | The King’s Fund (kingsfund.org.uk)

iv. Social care chiefs sound alarm at Labour’s “˜deafening silence’ on sector | Social care | The Guardian

v. Home – ADASS

vi. Centre of Excellence launched to transform health and care of older residents – Humber and North Yorkshire Health and Care Partnership

Speech on Adult Social Care – Alison Newall

Thank you Hilary for presenting us with such an excellent resolution which I’m happy to second.

I thought I’d share some notes from a Briefing from the Kings Fund for a debate held in the House of Lords on 30th March last year.

As we are all aware, demand for care is going up, but access to care is going down. Recent analysis by The King’s Fund shows that overall requests for social care have hit a record high, yet support from local authorities has dropped. 58,000 fewer older people now receive long-term care than in 2015/16.

• Financial eligibility is tighter and charging reform has been put back. If the means test upper threshold had increased in line with inflation since 2010/11, it would have been nearly £5,500 higher in 2021/22. By not rising in line with inflation, in effect, the means test has got meaner. Meanwhile, the repeated failure to introduce a cap on lifetime care costs means that one in seven people over 65 face costs of more than £100,000.
• Carers are receiving less support. Despite the ambition of the 2014 Care Act, no more carers (314,000) receive support than in 2015/16 and fewer receive paid support such as direct payments. More detail on these and other trends is available in the Social Care 360 Report on the King’s Fund website

There is rumoured to be a meeting with the Health Secretary, Prime Minister and Chancellor of the Exchequer on Monday to discuss the promised “National Care Service” and to try and make some progress.

Whether that is by a Royal Commission as has been suggested by some or by a government backed independent review something needs to be done rather than just talked about.