Social Care

Anna Turley Excerpts

Wednesday 25th April 2018 Commons Chamber

[Caroline Dinenage]

We have not abandoned the cap. The Prime Minister said very clearly that we would continue to consult on the cap, and that will come forward as part of our plans for the Green Paper later in the year. We in this Chamber often hear about Labour’s recession and how it led to some hard decisions about public spending to get the country back on track, but we often forget—

[Anna Turley (Redcar) (Lab/Co-op)]

rose—

[Caroline Dinenage]

Let me make a little progress, then I will happily take the hon. Lady’s intervention.

We often forget that we inherited not only difficult spending choices but a social care system that was on its knees because successive Governments—not just Labour—had failed to act. Labour acknowledged the problem in its 1997 manifesto, promising to find a solution. However, 13 years later, after one royal commission, two Green Papers and the 2007 spending review pledging to address the situation, Labour left office without delivering it. Worse than that, by the time Labour left office, despite the booming economy, council tax had doubled and every year 45,000 older people were forced to sell their home to pay for residential care costs.

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[Anna Turley (Redcar) (Lab/Co-op)]

There are few career commitments more commendable than dedicating time to the care of others, especially our elderly and vulnerable relatives. I am disappointed that the Care Minister is no longer in her place. I was shocked by some of her comments. She accused my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) of not mentioning or thanking social care workers. I listened very carefully to my hon. Friend’s speech, and it was imbued throughout with a passionate defence of the people who work in the care sector—their terms, their conditions, their pay and their commitment. I would like the message to go back to the Minister that I thought what she said was very unfair. All of us on both sides of the House know that people in our social care workforce deserve a huge amount of respect and gratitude for the hard work and long hours they put in to deliver the best care to our elderly parents and grandparents.

There is no doubt that social care has been in crisis for a number of years. Time and again, commitments have been reneged on and the issue has been kicked into the long grass. Government cuts have put pressure on the ability of local councils to deliver key services. Redcar and Cleveland has lost £90 million since 2010 and has had to cut £5 million from social care over the past three years. There is no way that that will not have an impact.

[Faisal Rashid (Warrington South) (Lab)]

Warrington Borough Council faces funding pressures of more than £3.3 million to meet its adult social care needs in 2018-19. Does my hon. Friend agree that it is up to the Government to support councils in their efforts to provide quality social care to their communities, not to pass the buck—

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[Mr Deputy Speaker]

Order. I need to correct that. When I say “order”, it means you should stop. I am not trying to cause any problems. We must have short interventions. If not, I will have to put a time limit on speeches. Intervene, by all means, but interventions must be short.

[Anna Turley]

My hon. Friend the Member for Warrington South (Faisal Rashid) is spot on. It was telling that the right hon. Member for Ashford (Damian Green) made the point that local councils have reached the point where they do not want to deliver social care any more. We know perfectly well what the reason is. If they had the funding, I am sure they would be delighted to deliver social care, but we know what impact the cuts have had.

Ministers have focused on squeezing more out of local taxpayers, which provides only a drop in the ocean compared with the extra funding that is needed to close the gap.

[Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)]

My hon. Friend will be aware that increases in the precept have regional variations, so 2% in Redcar is very different from 2% in Stoke-on-Trent. That then causes greater regional imbalances.

[Anna Turley]

My hon. Friend is absolutely right. This is a regressive form of taxation. Every time the precept or local council tax is raised, people pay twice: they see less of a service, but they are still paying through their income tax and through council tax.

I want to talk about the people who are the backbone of our care system: those who work in the care sector. In my local authority area, just over 170 social care staff are employed to support about 5,750 people. That is an average of 33 to 34 cases per member of staff, with all the challenges and safeguarding issues that come with that. The more experienced staff often deal with many more cases than that. As people live longer, with multiple and increasingly complex health conditions, the time and effort required from staff becomes greater. Currently, about 22% of residents in Redcar and Cleveland are over the age of 65. That is expected to increase to 27% by 2030. There are also many working-age disabled or vulnerable adults who have long-term care needs.

The needs of the individuals who need care vary hugely, from those who are frail and need physical support to those with learning disabilities or mental health problems. Mental health poses a particularly difficult challenge, with one in 14 people over the age of 65 developing symptoms of dementia in their lifetime. The care demands required of staff to support these people are ever more complex.

[Mike Hill]

I praise Redcar and Cleveland Borough Council for being the first council in the north-east to adopt Unison’s ethical care charter, which promotes staff training and pay and quality care. It has also been adopted in Hartlepool. Will my hon. Friend join me in supporting the further ambition to establish local care academies to guarantee that such training and care packages are written into employment contracts?

[Anna Turley]

My hon. Friend raises an important point. Much has been said today about the prestige of the sector and that suggestion would go a long way to addressing that.

[Melanie Onn (Great Grimsby) (Lab)]

To follow up on the issue of training, it is important that people who are going into people’s homes to care for them or who care for people in a home setting have all the training they require to perform the duties that are expected of them. Too often, they are not given the training they need and are expected to do far more than they are qualified to do.

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

I believe there is a voluntary time limit of seven minutes. We are in danger of spoiling that. If we do, I will have to bring in a time limit of about 5 minutes. I do not want to do that, so I need Members to help me ensure that everybody gets an equal amount of time.

[Anna Turley]

My hon. Friend the Member for Great Grimsby (Melanie Onn) is absolutely right and I welcome all the interventions, but I should probably now crack on with my speech. She is spot on in saying that there is a critical need for training in the workforce and that not enough has been invested in them.

My hon. Friend the Member for Hartlepool (Mike Hill) mentioned Unison, which has done fantastic work in the sector. Its biennial survey with Community Care magazine last year revealed a worrying picture of care workers having a lack of time to spend with residents. Nearly half the respondents to the survey said that the volume of cases they were responsible for left them feeling “over the limit” and more than half blamed staff shortages for their heavy workload.

As well as providing direct care, practitioners often have a responsibility to support the army of family carers who themselves are working to look after relatives at home. The shadow care system, as it is known, is running alongside the care system, keeping the whole thing going through the love and good will of unpaid family support and kinship carers, as has been discussed. For example, the Junction Foundation in my constituency, which I am proud to support as my charity of the year, does a lot of work with young carers who bear the pressures of looking after relatives while their peers are enjoying growing up. In Redcar and Cleveland, we have a fantastic organisation called Carers Together, which provides support and tailored services to people in care roles. It is aware of around 7,000 carers in the borough, but the 2011 census suggests that the number could be much higher.

I want to say a bit more about the workforce. As my hon. Friend the Member for Worsley and Eccles South said, they are underpaid, undervalued and overworked. The National Audit Office report from February was damning in its assessment that the Department of Health and Social Care

“is not doing enough to support a sustainable social care workforce.”

Data from the Skills for Care charity suggests that there is currently a turnover rate of 32% for the role of care worker in adult residential care in England, but that rises to a shocking 44.3% for care workers in adult domiciliary care. It is completely understandable that people working in this tough environment decide to leave the care profession when the pressure becomes too great. If people are to see social care as a viable career, they need to feel valued, and too often that is not the case.

With demand for social care increasing as our population ages, the workload will only get larger for the staff who remain. As the National Audit Office report also suggests, the Government are simply not providing the leadership that is needed. Local councils and care partnerships that are commissioning care are not being given the confidence of a national strategy designed to support the workforce and recruit new carers. A national strategy, for example, could see health and social care brought more closely together. The silo mentality between the NHS and social care has meant that the two services have passed patients to and fro, duplicating resources and missing the opportunities to work together to deliver better outcomes.

It is welcome that the Government have endorsed more partnership working, and these relationships are already getting results. In Redcar and Cleveland, our current partnership, which is led by the health and wellbeing board, has been given a rating of excellent by the National Audit Office. Our better care fund shared budget with the local clinical commissioning group is already leading to some positive outcomes, with a reduction in the number of non-elective admissions to hospital. This joined-up working is also leading to the establishment of an intermediate care centre in Eston in my constituency, which will help elderly patients to avoid long hospital stays and receive recovery support closer to home. It is a great initiative, with the local council and the NHS working more closely together. These initiatives show the huge possibilities from integrating health and social care, but on their own, they barely scratch the surface in dealing with the crisis facing services.

Social care is in desperate need of an urgent cash boost to address the funding gap, to ensure that social care services are properly staffed, and to ensure that the workforce get the pay and development support that they deserve for the work they do. The social care levy and grants in the autumn 2017 Budget have staved off collapse, but the disastrous bankruptcy of Northamptonshire County Council shows what happens when the pressure from cuts becomes too great to manage.

In the longer term, the system needs reform and these decisions cannot be kicked into the long grass any more. It is time for a care system fit for the 21st century, which puts social care on an equal footing with the NHS, and does not leave elderly people and their families worrying about needing to sell their home to pay the care bill.