50+ charities say the sustainability of social care and credibility of the Government’s plan now entirely depend on Rishi Sunak’s Spending Review

50+ charities say the sustainability of social care and credibility of the Government’s plan now entirely depend on Rishi Sunak’s Spending Review

New report from Age UK and the Homecare Association adds to growing evidence that #socialcarecantwait

As 95% of providers said that recruitment is harder now than before the pandemic

More than fifty charities and not for profit organisations have written to the Chancellor of the Exchequer, Rt Hon Rishi Sunak MP, calling on him to use his autumn Spending Review to pump the extra resources into social care that the service so obviously needs, as we head towards a difficult winter.[i] 

The vast bulk of the money from the Government’s National Insurance rise will be going to the NHS (c.£30 billion out of a total of c.£36bn), with social care not expected to see any of its subsidiary allocation of c.£5-6 billion until autumn 2023 at the earliest.  

This means that, as things stand, there is no additional funding for social care services for the next two years. Such a situation would be completely unacceptable, the charities say, since it would leave everyone who needs social care now and providers in a precarious position, and care staff with no incentive to remain in their jobs.  

In their letter the charities urge the Chancellor to give local authorities a funding settlement that enables them to stabilise, strengthen and ultimately improve the care services on offer in their areas over the three year Spending Review period. They cite the findings of the Health and Social Care Select Committee, which said last year that “we believe the starting point must be an increase in annual funding of £3.9bn by 2023–24 to meet demographic changes and planned increases in the National Living Wage. However, such an increase alone will not address shortfalls in the quality of care currently provided, reverse the decline in access or stop the market retreating to providing only for self-payers. Further funding to address these issues is therefore also required as a matter of urgency." [ii]

The charities point out that if this doesn’t happen, the Government will effectively be asking older and disabled people and their families and carers to manage with grossly underfunded services that do not allow them to live good lives, and sometimes leaving them with no services at all. Unless the Chancellor acts, provision is bound to go on getting worse in the face of growing demand and rising costs. This would also undermine the chances of local authorities making a success of implementing the proposed Government cap on catastrophic costs from October 2023, making a mockery of the Prime Minister’s ambition to improve social care to an extent that none of his predecessors have achieved.   

The letter is being sent on the same day as Age UK and the Homecare Association publish a new joint report What if you need care at home and there’s no one to provide it? about workforce pressures within homecare, and the adverse impacts on older people in need of support. 

The report spells out the uniquely difficult position care providers are now in as they seek to keep their services going, at a time when it is proving harder than ever to recruit and retain staff. A toxic mix of factors, from Brexit to compulsory vaccination, burn out due to the pandemic and the prospect of higher pay elsewhere, is leading some providers to say they have never experienced such difficulties in holding onto their existing staff and getting new ones on board.  

We know, for example, that because of care staff shortages some disabled and older people are now going without the help they need at home because local care agencies are completely full and some live-in care agencies have stopped taking on new clients. These difficulties are also having knock-on consequences for the NHS, with growing numbers of hospitals finding it hard to discharge older patients safely into the community, because home care providers are unable to take them on.

Startling figures in this new report include: 

• 95% of providers said that recruitment is harder now than before the pandemic and 78% said it is the hardest it has ever been, a worsening position since a previous survey of homecare providers in July 2021[iii]. 
• 90% of care workers are paid less than the real living wage[iv] and the median hourly rate of pay for a care worker in 2019/20 was just £8.50[v]
• One in three care workers said they often don’t have enough time to provide personal care and that it’s a challenge to find the time to prepare a meal or help with washing and toileting.[vi]

Caroline Abrahams, Charity Director of Age UK and Co-Chair of the Care and Support Alliance said:

“It’s no exaggeration to say that Rishi Sunak, the Chancellor, holds the future of social care in his hands, because his Spending Review decisions will make or break the services on offer to the public over the next three years. 

"Many commentators are sceptical that any of the £36 billion from National Insurance will ever come care’s way, but even if it does it won’t arrive until late in 2023. For millions of older and disabled people who use care, and their families and carers, that’s far too late. They need reliable, adequately staffed services now, delivered by care workers with enough time to give everyone the attention they require, and motivated to do the best job they can because they are properly rewarded for the important and skilful work they do. The only way of delivering these things is for local authorities to receive a generous Spending Review settlement in a few weeks’ time. In the absence of this social care will simply go on getting worse, letting down the public and jeopardising the future success of the cap on catastrophic costs that’s the centrepiece of the Government’s reform plans. The numbers of workers now leaving the care sector are frightening and it is imperative that Ministers recognise how perilous the position is becoming and act." 

“The Prime Minister may have made the promise to ‘fix social care, once and for all’ but how close he gets to fulfilling it now depends almost entirely on his Chancellor. Rishi Sunak bears a huge responsibility where social care is concerned, but he also has a great opportunity to show us how much he cares.” 

Jane Townson, chief executive of the Homecare Association said:

“Demand for homecare is rising due to pent-up demand following the pandemic and increasing numbers of older and disabled people with multiple long-term conditions. At the same time, we are experiencing the worst shortage of homecare workers in history.

Employers are struggling to retain and recruit staff and national data show vacancy rates steadily increasing. Our members fear for the safety of older and disabled people unable to access the care they need. 

We call on the government to:

• Fund social care adequately so that homecare workers are paid fairly for the skilled roles they perform, and at least on a par with equivalent public sector roles.
• End the practice of councils and the NHS of purchasing homecare “by-the-minute”, alternatively focusing on achieving the outcomes people want.
• Support development of an expert-led workforce strategy for social care and a 10-year workforce plan, aligned with the NHS People Plan.
• Create a professional register for care workers in England, covering all paid social care workers in both regulated and unregulated care services. Registration of care workers needs to be adequately funded and carefully implemented.

The £500m the government has ear-marked for social care workforce training and well-being is welcome. Shared between a workforce of 1.5 million, though, means only £100 per year per person is available, which will barely scratch the surface of what is necessary.

We need enough well-trained care workers to support older and disabled people to live well at home. Homecare can help to extend healthy lifespan, enhance quality of life, take pressure off the NHS, and save money for the health and care system.

[i]   Joint letter to the Chancellor

[ii] https://committees.parliament.uk/publications/3120/documents/29193/default/

[iii] https://www.homecareassociation.org.uk/resource/homecare-workforce-shortages-continue.html

[iv] https://www.skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/documents/Pay-in-the-adult-social-care-sector.pdf

[v] Hayes, L.J.B. (2015), Are the minimum wage rights of homecare workers at risk under the Care Act 2014? Industrial Law Journal 44 (4): 492–521.

[vi] Unison, (2017), Home Care Survey, Accessed via: https://www.unison.org.uk/content/ uploads/2017/09/ UNISON-home-caresurvey-2017.pdf