An inquiry into the quality and financial sustainability of adult social care in England has been launched by the Communities and Local Government committee.
The inquiry will look at whether local authorities have sufficient funding to meet their statutory duties under the Care Act to assess and meet the needs of people requiring care and support.
The impact of the National Living Wage policy and the 2% council tax precept, which were announced in last year’s spending reviews, will also be assessed.
The National Living Wage policy, which introduced a compulsory wage floor of £7.20 for workers aged over 25, came into force on 1 April this year. Councils and care providers have warned that without adequate funding it is undeliverable. The Local Government Association said implementing the policy would cost councils an extra £1bn a year by 2020.
Similarly, sector leaders have warned that the council tax precept, which gives councils the opportunity to raise an additional 2% a year for adult social care, will not go far enough.
‘Increasing pressure’
The inquiry will also look at the role of carers and look at alternative funding models for financing and providing care. It will cover all adult social care provided or commissioned by local authorities and not just the support given to elderly care users.
Clive Betts MP, the committee’s chair, said: “Adult social care provides a lifeline to some of the most vulnerable people in society but it is coming under increasing pressure as a result of growing demand and declining local authority budgets.
“Our inquiry will look at the financial sustainability of this care and support to see what can be done to allow councils to continue to meet their legal obligations for future generations.”
Written evidence should be submitted via the committee’s website by Friday 19 August. Local authorities, care providers and government ministers will be invited to give evidence at public sessions. The CLG committee is a scrutiny committee and monitors the policy, administration and spending of the Department for Communities and Local Government.
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We are all well aware that the aging population (of which I am one) is increasing and that increasing demands are made on both local government and National Government for its welfare.
The latest demand on the council tax payer is unfair and as it transpires, not enough. Of course it is not enough and never will be because families on the whole, are taking less and less responsibility of their aged.
We will at some time or another, all use adult care to some degree and consequently any need for funding should come from the whole taxpaying public and not just the council tax payer. Households where there are more than two adults are getting away scot free, they are not paying any share of the demands made – how can that be fair?
Funding of Adult care must be included in general taxation. Of course no Government will or wants to do this, it is a vote loser. Is this why when I have written to the Treasury to ask them the simple question Why? I just receive the answer Localism? Not acceptable. The Government, whichever is in power must take responsibility. Just one penny on income tax would be sufficient.
If the two percent demanded by local government continues year on year, which it may well do, to cover any further wage increases enforced by Government, how long before many of us are pushed into penury by a tax which is so discriminatory?
This Government or any other Government for that matter, must bite the bullet and centrally fund the ever increasing demands of Adult care. A penny on income tax would pay for the care of the present and future older generation.
I work in mental health Merseyside, obtaining funding for users of mental health services has severely slowed due to la introducing online web based commissioning system that requires us to complete a huge care act assessment that is far too process and compliance orientated. LA managers argue they have no choice but at ground level this has meant we have to write war and peace to get the smallest amount of care such as a few hours per week for those with high risk. The la seems to be using the care act as a means to push back funding requests from their own social workers who must fill in 154 boxes with reams of writing covering 12 care domains. These assessments take days to write up, it’s far too idealistic and such a grossly over inflated bureaucratic burden. I accept the LA’s had to implement the Care Act but the inquiry needs also to consider the impact if the impact on the workforce. in my service alone out of 45 social workers I know of 10 who have left and more who are so unhappy due to the impossible burdens of this legislation. we accept the honourable intentions to ensure service users are consulted and that the assessments should concentrate on how their problems impact on their own wellbeing rather than the assessment being service lead but this philosophy doesn’t carry through to funding decision makers who are refusing care package requests, rejecting assessments for ‘not enough evidence’ when we supply enough which requires repeated and laborious redrafts of assessments and even then…they are getting refused. Multi disciplinary colleagues such as nurses and consultants in the NHS whom we work with are aghast as to what the hold up is for the care package as the impact is delayed discharges and continued risk to the service user or others without the support.
from my end, as a very experienced mental health social worker I am not able to get the care to people I need to get it to and the idea of me as a professional to have to justify with reams of so called ‘additional evidence’ rather than accept my submission seems preposterous. I don’t ask for care packages lightly. The cases we deal with are not low risk; they are high risk adult mental health cases where there are high risks such as severe self neglect, relapse, readmission, and risk to others. However despite citing these things, the LA doesn’t seem to feel the consequences of their decisions, there just doesn’t seem to be a chain of accountability for funding refusals. It’s gone so vacuous as though the service user exists in a narrow vacuum of social care without regard to other stakeholders who manage the risk but are unable to because a care package is not forthcoming. Before the LA and health worked together on decision making but removing this to a back office in the LA far removed from the teams is highly risky. This is what the care act has forced councils’ to do. The problem here is that the Care Act has forced councils to develop a way to meet the requirements of the care acts 12 care domains so in response council’s have procured software packages to manage the whole system, in our case liquid logic. I am not sure if others are better but ours certainly is very clunky and poorly designed. This has also removed the need for the panel decision making system therefore these cases have lost vital overt accountability such as we had with the panel system – analogue admin systems such as panel meetings and administrators to manage the system to ensure cases were not lost or delayed. At the moment delays are increasing and the workflow has slowed from start to finish due to the system relying on one person to ‘log on’. The risks here are that there is nothing to enforce compliance; people can leave the work even as it is not out there in the overt space. It is not uncommon for a case to stay with an approver for anything from 2 – 6 weeks with social workers having to send reminder emails to our own line managers to approve our work before it is even sent to the funding decision maker next who may then reject when it is looked at as they may take issues with it. If rejected the cycle begins again. Repeated toing and froing in a virtual space with extremely ‘time poor’ managers as it is a huge risk across the board and a huge additional pressure on the already stretched system. Goodness knows we already had issues with delayed discharges from hospitals under the old system but we now have the absurd situation whereby we have implemented a piece of legislation with noble goals but in practice, the demands of complying with these gaols and implementing this legislation through such software packages is making it worse than the way it was before and forcing social workers to leave the profession.
Cases have now become virtual and invisible and added to this there is a very narrow decision making chain. Only one person can approve – in our case only two people – can do this from the local authority and they are not embedded within the teams they are approving funding for They are based miles away in an LA office. This sets up a moat mentality. We cant call them and they wont call us to clarify things and we also don’t seem o get a rationale as to why rejections have been made.
What’s more is that if the service users complain about not betting the support they expected or if we bring this up to management they tend to blame us for…yes you guessed it – not supplying enough evidence so we have a situation where local authority decision makers now find themselves ring-fenced from accountability and responsibility but with all the power. It’s intolerable. All we want is a quick phone to discuss an issue which could save many many weeks of delay l but to be fair I imagine the demands of the system mean they don’t have time for this as they must read an awful lot of assessments each day.
Group decision making in these cases though a panel system is vital and more efficient as panel members had a range of experience and were able to iron out or clarify points there and then with each other if there was a query. Managers on these panels had some responsibility for risk and team management and it was also not uncommon for them to be from other organisations such as the NHS. They tended to have more direct knowledge of the impact of risk for organisations and service users when it comes to things like SUI’s or inquiries.
Under the current virtual system this can only be achieved by rejecting a virtual approval request which sends the case back to an online inbox. Then, after sent back a week or so later by the very busy social worker when she gets round to it we may get a decision if we are lucky. At the moment we have a commissioning manager who has no experience of mental health making decisions on their own which is highly risky. My take is that one person will be more risk averse as they have no one to share this with. On the other hand and from a more cynical perspective my NHS colleagues in feel the consequences of this for the LA – are such that the LA will save money by not having a panel system, that the current overcomplicated software package and approval system with one brutal commissioning manager in change, suits the current financial climate in that if changed back to a panel system this will cost more as panel even though risk is get managed better and need will be met quicker. In other words we are prioritising resources of risk.
I have referred to the IT issues here but the admin burden also needs addressing as social workers in adult care now seem to have been reduced to state functionaries travelling through a treacle-like process for process sake rather than meeting the needs of people in a timely and efficient way.
The net result from a practice perspective is that we have are spending way too much time at PC’s typing on average 2-3000 word assessments that take days and days to complete but at the same time this is not commensurate with positive and timely decision making by funding managers which seems to make a mockery of the principles of the Care Act.
This seems a waste of time with social workers spend more time at PC terminals away from service users begging cap in hand via a virtual system for some money for their service users. It’s absurd.
The messages from the council leadership are that we had no choice and we have to be Care Act complaint! But to what end? To the end that in the fight to become complaint with what they can see in front of their faces, they raise the risk of non compliance by way of challenge from leftfield about need not being met or assessments not being done on time due to the chunkiness and totally un user friendly the system is and how it has been implemented.
I do sympathise with local authorities and my own manages. They are stuck between a rock and a hard place. In my area staff are leaving in droves and managers are very stressed (they wont admit this!) fire fighting and having to cover caseloads with highly inexperienced agency staff.
I don’t know what the answer is but things need to change and quickly.