Councils are managing budget cuts by stripping back social care support to the minimum needed to get people through the day, a committee of MPs has warned.
The communities and local government committee said social care funding was in need of “urgent” reform after its inquiry concluded the current system would likely see the quality of care deteriorate further and leave many councils unable to meet their statutory duties under the Care Act.
The inquiry found a series of issues in adult social care. The reduction in care provided by councils meant there was an increasing reliance on unpaid carers, but the cost of assessing and supporting these carers was also placing significant pressures on budgets, it found.
It also found evidence of poor commissioning practices. Some councils were pursuing low fees for care which, combined with the cost of implementing the national living wage, meant providers were going bust, exiting the market or handing back contracts.
The report said the diversion of resources away from preventative services was contributing to a rise in delayed discharges and emergency admissions to hospital. It said extra funding was needed to enable councils to provide preventative services for people with lower levels of need, which is likely to reduce the demand for higher-cost services later on.
The committee also highlighted the failure of councils to monitor levels of unmet need for social care and urged them to address this.
‘Extend CQC role’
The report set out a number of recommendations. These included extending the Care Quality Commission’s remit to oversee the market shaping, commissioning and procurement activities of councils, which are currently unregulated, in order to address the fragility of the care market.
The Department of Health should also review the guidance on commissioning that accompanies the Care Act and a standard process for assessing the costs of care should be designed by an independent body and agreed by providers and councils.
Other recommendations included:
- Extra funding should be made available to enable councils to meet their duties under the Care Act 2014 to assess and support carers.
- The Department of Health should consider a programme similar to Teach First or Step up to Social work to improve the status of care work. It should also set up a charter with the Local Government Association, which sets out what care workers can expect from their employer on terms and conditions, training and career development.
- Councils should annually audit the services they commission and carry out regular ‘spot checks’ to ensure people are receiving the care they require.
Clive Betts, chair of the communities and local government committee said: “A long-term fix, working on a cross-party basis and involving the public and social care sector is urgently necessary to meet the ever-increasing demographic pressures on the system.
“This review must be ambitious and consider a wide range of potential funding sources, looking again at age-related expenditure, options such as a hypothecated tax for social care, a compulsory insurance scheme, and differences in how individuals contribute.
“It must also take a wide look at what we will spend this money on in the future – on support, preventative care and intervention, the care workforce – and ensure that care users are at the centre of how care is organised and that they get the assistance they deserve.”
David Pearson, honorary treasurer of the Association of Directors of Adult Social Services (ADASS), said the report highlighted the worrying consequences of pressures on the sector.
He added: “Social care needs to be treated as a national priority to ensure thousands of elderly and disabled people and their families get the personal and dignified care they deserve. Not only are people living longer and with increasingly complex needs, care workforce challenges, including the welcome national living wage and retention of staff, are creating further pressures – the need to future-proof the social care system cannot be ignored.”
A spokesperson for the Department of Communities and Local Government, said: “We recognise the challenges councils face in delivering social care and the need for a long-term sustainable solution. That’s why we’re giving councils an extra £2 billion to help deliver these services, taking the total to £9.25 billion over the remainder of this Parliament.
“It’s also why we’re committed to having a fair and more sustainable way of funding adult social care for the future, especially given people are living longer. We’ll be setting out our proposals in a forthcoming green paper.”