Social Care in England

Lord Cashman Excerpts

Thursday 14th October 2021 Lords Chamber

[Lord Cashman (Non-Afl)]

My Lords, it is good to be back and to be engaged in this important debate, for which I thank the noble Baroness, Lady Pitkeathley, whom I also congratulate on her wonderful, excellent opening statement. I also welcome the Minister to his position. Of course, I know him well from our many years together in the European Parliament.

During the pandemic, I am sure that others have felt that there is a fear of growing old or of becoming frail or ill. I believe it is our duty as the fifth-largest economy and as a civilised society to remove those fears immediately. I refer to my interests as set out in the register, particularly as a trustee of the charity Neighbours in Poplar. Indeed, I have decided to focus on an April 2021 grass-roots report, of which I am one of the co-authors, which was commissioned by Neighbours in Poplar, which is led by Sister Christine Frost. The organisation serves needs across the London Borough of Tower Hamlets. The report includes input from medics, paid and unpaid carers, care recipients and volunteers. It is a report from the front line, observed, witnessed and reported. It is not a parochial approach. It is evidence-based and, I believe, a microcosm of what is happening across England and what is being experienced by many councils and agencies. Social care is broken and can be fixed only by a holistic approach, with adequate funding. It cannot be done on the cheap. That has been tried, and it has failed catastrophically.

The report, which I will make available through the Library, along with the follow-up report, took this holistic approach across a range of topics such as nutrition, housing, quality of care, access to health services and communications. I will read from the report. Its summary dealt with meals on wheels post Covid. Sadly, the meals on wheels service in that borough had been cut just prior to Covid. Who decides whether our carers are adequate to the task? Are carers engaged or unengaged? How do people excluded from social media and without internet access find out what is going on? How do they engage? How are we meeting mental health and inappropriate housing needs? The report states:

“Please do not take this report lightly. We need to you to be aware that the majority of those to whom we have brought meals and contact with the rest of humanity during the past year were vulnerable, frail individuals of all ages, evidence of which is the 50-plus clients who have passed away since we started on 17 March 2020, two of whom were single, elderly, disabled men living alone and one on the top floor of a block of flats without a lift. He had been unable to get out and meet friends for the last four years. We sent questionnaires to each meal recipient asking two questions: Is there anything you are worried about and what do you need to help? Which services do you most need or want improvements on: health, social services, meal delivery, day centres, carers and others? We have 200 people on our delivery list and we received over 100 responses from the clients and the major need mentioned is hot meal delivery.


We also asked the volunteers to give us their impression, viewpoints, perspective on the seriousness of the recipients’ needs. Many volunteers have been consistent in their deliveries and have noticed the deterioration and increasing needs in the clients and as the majority of these clients are disabled, elderly or frail, their need is increasing rather than decreasing. We ask now: whose responsibility is it to deliver meals on wheels post-Covid?


Our second major concern for the future is the quality of care being delivered to those entirely dependent on the care, expertise, sensitivity and time of those who care for them, a service the client is paying for. We have come to the conclusion that it is not so much the agency which is the issue but rather the quality, standards and suitability of the individual carer. Therefore we ask that every paid carer be required to reach agreed national standards and that registration be required. Every paid carer should be registered as are foster carers. We ask also that the commissioning of care services be far more rigorous, ensuring that what is promised is actually delivered.”


I am coming to the end of my time, so I will chase quickly towards the conclusion. The report goes on:

“Communication has appeared as a major concern. How do people who are not on the internet find out what is available? It came to our attention that many are not in receipt of pension credit simply because they do not know how to go about accessing it. Many spend hours fruitlessly on the phone to council helplines. Mental health and communication are interlinked. Funding and time need to be put into joining people up and rebuilding communities.”


Finally, it is clear that we need to be proactive where we can and help prevent people needing social care. Now is not the time to cut services; long-term negative consequences will follow. Will the Government therefore commit to end the underfunding of local authorities and ensure properly funded services and a high standard of social care for those who need it?