Social Care

Helen Hayes Excerpts

Wednesday 16th November 2016 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I want to pay tribute to the careworkers across the country who will be spending today and every day looking after vulnerable adults in their homes and in residential settings. The work they do is hard—often impossibly hard in the current context. On too many occasions, they are paid very little, and they are often provided with little training to equip them for their work.

I am a member of the Communities and Local Government Committee, which is undertaking an inquiry on adult social care. The Committee is yet to report, but, for my part, I think that much of the evidence we have seen and heard to date is damning. The proportion of GDP we spend on social care is falling at a time when need and demand are rising and will continue to rise. That is being felt in a system that is barely able to cope.

The Committee has heard evidence from local authorities that are having care contracts handed back by providers that cannot make them work, with careworkers facing impossible case loads. We have seen evidence of negligent providers, with owners paying themselves six-figure salaries while failing to provide even the most basic standards of care.

Last month, I attended the launch of the CQC’s “State of Care” report. David Behan, the chief executive of the CQC, spoke about how he and his team had agonised over whether to use the phrase “tipping point” in relation to social care, but, in the end, they decided that it was an accurate description for the state of the care sector. While there is much good practice and high- quality care, structural problems in the sector and with the resourcing of care are leading to more and more care being provided on a basis that is simply not sustainable. As that happens, the scope for error and neglect, and for vulnerable people to be let down, is growing.

The Government’s approach to funding social care simply is not working. While take-up of the 2% social care council tax precept is high, many local authorities have told the Committee that the funds raised simply do not cover the shortfall left by the cuts to their budget in preceding years—still less the cost of the national living wage, and still less the increase in demand. The back-loading of the better care fund to the later years of the current Parliament is not working. I asked a local government Minister earlier this year whether he thought that that back-loading created a risk that smaller care home providers would exit the sector in the short term, leading to a loss of capacity at a time when demand is growing. He assured me that that would not be the case, but we are now seeing evidence that that is exactly what is happening. Often, local authority funding does not cover the full cost of providing care, and there is no slack in the system to provide the investment needed to improve facilities and performance where necessary, so many providers are simply moving out of the market.

I recently visited a care home in my constituency that is provided by a small charity and is rated good by the CQC. The manager told me that, time and again, what the local authority agrees to pay does not meet the full cost of the care provided by the care home, and that it regularly subsidises residents from its reserves. That situation is completely untenable in the long term. I am very concerned that, by the time the increase in the better care fund is available in 2019-20, many small providers will have found the financial strain too much to bear, and that there will be a significant drop in capacity at the precise time when we will need capacity to meet growing need.

The quality of our care sector matters so much, because the way in which we look after our most vulnerable residents is a mark of our civilisation, and because the need to care for frail and elderly relatives is an issue for every single family in the country at some time in their lives. Our social care system is not delivering the quality of care or the dignity and compassion that our vulnerable residents need. Neither is it delivering sufficient support for our unpaid carers, whether that is due to a lack of respite provision or to the difficulties that too many carers face in obtaining the assessment of their own needs, which is their statutory right. The underfunding of adult social care is, in turn, having an enormous impact on our NHS through avoidable hospital admissions and delayed discharge, and there is also the mental health impact of loneliness and isolation.

The Government must act now to address the state of our care system. We need more funding for social care—that cannot be denied—and I call on the Government urgently to bring forward the increase in the better care fund. We need a commitment to training for care staff and to fair terms and conditions, and I call on the Government to adopt the Unison ethical care charter as the standard for care across the country, because we know that better paid, better qualified and fairly treated carers also provide better standards of care. We need a fully integrated system that recognises the benefits and savings that can come from ensuring that vulnerable adults are well cared for and supported to live independently and remain active for longer. We also need support for unpaid carers, who save the taxpayer billions of pounds by providing care that would otherwise need to be provided by the state. Cuts in respite care, a lack of mental health support and inadequate carers’ assessments are a false economy, and the Government need to support carers to do their vital work without being pushed to breaking point.

I hope that the Minister will respond to the debate by confirming emergency measures to address the crisis and a wholesale review of the care sector so that it can be established on a fit-for-purpose, sustainable footing for the future. I also hope that the Chancellor will use the autumn statement to introduce proposals for the sustainable funding of social care, to relieve the burden on our NHS and, most importantly, to enable all our vulnerable adults to live well supported, with dignity, for the whole of their lives.