Social Care and the Role of Carers

Baroness Cavendish of Little Venice Excerpts

Thursday 24th June 2021 Lords Chamber

[Baroness Cavendish of Little Venice (CB) [V]]

My Lords, I congratulate the noble Baroness, Lady Jolly, on securing this important debate. I think all the speakers know what all the issues are. I shall not try to tackle the whole issue of social care in three minutes, but I shall make two points.

My first point is on the paid workforce. The pandemic brought a new influx of workers into the social care sector, many from the hospitality industry, so some of the statistics we are hearing today are probably slightly out of date, but that does not mean that there are not huge issues of retention and attrition. It is important to think about how we are going to keep that new group of people and the existing staff, who have shown in this pandemic that they are extraordinarily dedicated. We need to emphasise that care is, as others have said, not low-skilled. The further you are from a hospital setting and that kind of supervision, the more maturity you need to handle the very real challenges you face in going into someone’s home, trying to figure out what they need and trying to connect with children with learning disabilities, elderly people with dementia and so on. We have heard a great deal about funding in this debate, and it is vital, but we also need to think about what we want to spend the money on. I do not think that throwing more money into an unreformed system will give us the quality of care that we all want.

I want to talk a bit about commissioning. We need a care service which does not just work on a time-and-task basis but gives front-line staff the autonomy to assess what they think is needed and to do what they think is right. Their vocation is to care. Many who drop out of the social care workforce are some of the best people. They have real problems because they are underpaid, but they also have emotional problems because of not being able to give the care needed. We ought to allow that autonomy. We ought to commission for outcomes and not always ask staff to refer to a social worker if they want to change a care package by as little as 15 minutes. That would be a revolution in the way in which we provide care. In Holland, a million patients are cared for by staff who organise themselves and who do what they think is needed. They provide far higher satisfaction levels. They have enabled some vital cost savings, ploughing back money into the service and into staff wages. In this country we do not learn enough from other places. I ask the Government to look at that. Yes, we need better pay, training, career progression and much else that has been mentioned in this debate, but we also need staff autonomy.