Social Care

Baroness Bakewell of Hardington Mandeville Excerpts

Thursday 1st December 2016 Lords Chamber

[Baroness Bakewell of Hardington Mandeville (LD)]

I draw your Lordships’ attention to my interests, as entered in the register, as a district councillor and a vice-president of the LGA.

I am grateful to the noble Baroness, Lady Pitkeathley, for securing this important debate and agree with much of what she said. This subject is at the top of everyone’s agenda up and down the country. Many were expecting some sort of recognition of the crisis in social care in the Autumn Statement, particularly as the sector was calling for £1 billion to be invested to stabilise the situation, but there was not even a passing reference. It is astounding that the Chancellor does not regard it as important enough to tackle. Having said that, I look forward to all the contributions this afternoon and especially to that of the noble Baroness, Lady Cavendish of Little Venice.

Government data show that 32 care home businesses failed in 2010. That figure went up to 74 in 2015, while 34 have failed in the first six months of this year. These range from family-owned businesses to nationwide operators. A total of 380 homes have closed in six years, and the care industry is in turmoil. Care homes are enduring an unprecedented squeeze on their finances. Local authority fees have reduced by 5% in real terms over the last three years, while care costs have risen at a faster rate than inflation, particularly staffing overheads. Last year’s 2% rise in council tax for social care was insufficient. The living wage, although to be welcomed for hard-pressed vital staff, has not helped care home budgets.

Four Seasons, the biggest care home operator in the UK, with more than 400 properties, recorded a pre-tax loss of £264 million last year, which includes write-down on the value of its care homes. There are many other similar examples. In Somerset, the county council has a panel which looks at all new packages of care and is currently proposing to reduce 75% of packages for budgetary reasons. Despite this, Somerset’s overspend will be £9 million. Adult social services are having to compete with children’s services, which are also predicting an overspend but are in line for some of the £5 million contingency fund which has been earmarked for them.

The facts are stark. Local authority grants have suffered cuts of approximately 40% since 2010. Despite this, the vast majority of councils have protected services for vulnerable people. Local authorities have substantially reduced the point on the safe hierarchy at which residents will be eligible for care, as we have already heard. Many now provide support only to those assessed as in critical need. There are some councils on the cusp of major service failure due to the funding crisis. What plans do the Government have for picking up the pieces?

Apart from last year, council tax has been frozen for several years, with government incentives, thus curtailing local authorities’ ability to predict and solve their own problems. Should there be another 2% precept for social care in 2017, this will help only marginally, as the problem is now, not next year. As we all know, there are increasing numbers of older people, and this results in more demands. We are now seeing care homes refusing council contracts as local authorities cannot afford to pay enough. Many older people, funding their own care, are subsidising local authority contracts, as the noble Baroness pointed out.

One consequence is more elderly people being admitted to A&E as preventive care is not available. This then puts more pressure on the NHS. Integration of social care with the NHS could be part of the answer, and I look forward to the work my colleague in the other place, Norman Lamb, is doing towards a commission on this subject. But extra funding will be needed to make this happen. The better care fund is a move towards this, but the funds needed are large, and the better care fund is small. Inadequate funding of care means elderly people are ending up in hospitals, adding to the strain on the NHS, as elderly people admitted after falls and infection then become stuck in those hospitals.

My noble friend Lady Pinnock, who is unable to be with us today, tells me that when she was leader in Kirklees, they built two care units to act as post-hospital or return-home places, some residential and some day care. Both of these units can no longer be resourced by the council because of cuts in funding. Council leaders believe the Chancellor’s claim of investing £3.5 billion by end of year is inaccurate. Better-off areas where people can pay will manage, but deprived areas are doubly hit as they cannot meet their own costs.

I leave your Lordships with the personal story of a lady who did have someone to help her have a bath, who has had her hours cut and been told a strip wash will do. Is this really what we, as a nation, mean by dignity in old age?