Here are some of Community Care‘s predictions for the social care sector in 2012
Dilnot will be rejected
It is becoming increasingly apparent that the government will not stump up the £1.7bn a year required to implement Andrew Dilnot’s proposed reform to care funding, put forward in the economist’s report to ministers last year.
Dilnot’s central – and most costly – proposal was a £35,000 cap on the costs of care for individuals, after which the state would pick up the bill for their support. However, soon after his report was published in July 2011, the Treasury made clear its opposition to a plan of such expense.
The public spending situation has since deteriorated, meaning cuts to local authorities are set to be deeper than previously predicted from 2013-17.
The White Paper, due this spring, was supposed to have at its heart a long-term reform of care funding. Instead, it looks set to be focused on other issues: taking forward personalisation, reforming the law around adult social care, in the wake of proposals in 2011 from the Law Commission, and establishing new systems for assessing and measuring quality. There will be some funding reform, such as the introduction of a national system for assessment and eligibility to replace the postcode lottery, but it is likely to be minor.
The target to have all care cases completed within six months will be watered down
On average, care cases currently take 13 months to complete. Review chair David Norgrove said the new limit would reduce “shocking delays” in the system that are leaving children’s lives in limbo.
The recommendation, which will require legislative change, has already been endorsed by government. From January 2012, the government will publish league tables of court performance on processing care applications.
However, the recommendation – first mooted in the review’s interim report – was met with strong opposition from social workers, many of whom hoped the “unrealistic” target would be scrapped.
Personal budgets for all by 2013 target to be revised
The government’s target of having all ongoing users of publicly-funded care in England on personal budgets, preferably as a direct payment, by April 2013 is increasingly being questioned.
At the last count, about 35% of users were on personal budgets, but the majority were using budgets managed by councils, not direct payments that they themselves managed. Morover, direct payment numbers stalled in 2010-11.
Sector leaders describe the target as “challenging” and have warned that, while councils may nominally get 100% of users on to personal budgets by next April, many service users will not be receiving the choice and control over their support that personal budgets are supposed to provide.
In particular, it is argued, council-managed budgets, in many cases, are not providing service users with choice and control as authorities restrict how much say they have over how a budget is spent.
For this reason, the New Local Government Network think-tank called for the government to relax its target in a report last month. And the emphasis on personal budgets for all, at the expense of other goals, was criticised in a report by Demos in October 2011, which argued that this risked excluding people with complex needs for whom a budget may not be appropriate.
The government will need to respond to this context in the forthcoming White Paper, in which we expect some revision of the 2013 target.
The dispute between the College of Social Work and British Association of Social Workers will run on
It remains to be seen whether the College of Social Work will push ahead and form a partnership with Unison, despite strong protest from the British Association of Social Workers (BASW) that this would be, in effect, a “closed shop” deal.
If the tentative partnership deal falls through, the College will no longer be able to launch with Unison’s 40,000 social workers members at its base.
BASW took its concerns about the deal to the education select committee in November, where tensions between the association’s senior leadership and the College’s interim board reached breaking point.
BASW has threatened to seek a judicial review of the entire process of setting up the College. In the meantime, it has vowed to carry on working towards its target of having 15,000 members. It looks increasingly likely that BASW will relaunch as a rival college of social work in the new year.
The Care Quality Commission will survive but with a change of leadership
2011 was an annus horribilis for the Care Quality Commission.
It was slammed for failing to intervene to stop abuse at Winterbourne View hospital for people with learning disabilities after it did not respond to three reports from whistleblower Terry Bryan.
It was criticised by MPs for having “distorted priorities” after cutting inspection levels for adult social care by 70% to switch resources into its programme of re-registering all providers last year.
And the year ended with one of its own board members, Kay Sheldon, calling for a change of leadership at the regulator, including the departure of Cynthia Bower, the chief executive.
The government shows no appetite to abolish, restructure or reform the CQC, on the grounds that this would cause unnecessary disruption. But it will be a surprise if both Bower and CQC chair Jo Williams are in post at the end of 2012.
Four reports will be key: those of the public inquiry into the Mid-Staffordshire Hospital scandal, the serious case review into Winterbourne View, the Department of Health’s capability review into the CQC and its separate probe into Sheldon’s comments on the CQC’s leadership.
While the Mid-Staffs scandal predates the CQC, it coincided with Bower’s leadership of the West Midlands Strategic Health Authority, which was responsible for performance managing the hospital. Moreover, Sheldon gave her evidence on the CQC’s leadership to the inquiry.
The two DH probes could be the make or break as it goes to the heart of whether the CQC’s leadership is fit for purpose or not.
Care applications will continue to rise but resources will slashed
Cafcass reported a 9% increase in care applications between April and June compared with the same time last year. Figures have jumped more than 40% since the middle of 2008, causing the family justice system to buckle under the strain. We predict this situation will escalate even further in 2012, leading to more demand for better resourcing of the care system.
More industrial action over pay cuts and pension reforms
Social care workers in Southampton, Shropshire, Birmingham and Doncaster – to name but a few – protested throughout the year over proposals to change their terms and conditions and, in some cases, slash staff pay.
At a national level, care workers who are members of Unison, Unite and GMB joined in the general strike on 30 November over the government’s proposals to reform local government pensions.
Unions have threatened ministers with further strike action in 2012. At a local level, it looks likely that more councils will revise pay and conditions in order – they say – to protect jobs.
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(Pic: Everett Collection/Rex Features)