Care and support services face `collapse`

    Care and support services face collapse without an injection of
    £700 million, concludes a King’s Fund inquiry,
    writes Natalie Valios.

    The 10-month inquiry report focuses on the quality of physical,
    practical and emotional support to adults needing help because of
    frailty in old age, mental health problems, physical disability,
    chronic illness or learning disability.

    Unless the government matches social services funding to NHS
    funding, its capacity to deliver the modernisation agenda will be
    seriously compromised, it said. “Without such investment, care and
    support services will be struggling to stand still. They will be
    unable to address the major improvements needed in quality or to
    meet the additional requirements of new national standards.”

    The inquiry shows that the estimated one million care and
    support workers are lowly paid, poorly trained and inadequately
    supported by managers with too little time to care.

    Two-thirds of the workforce do not hold a relevant qualification
    and the average wage is about £5 per hour. The inquiry made 15
    recommendations, including the need for an urgent review of the
    shortcomings of National Vocational Qualifications. “The attainment
    of a care NVQ has to be something that is seen as a sound and
    reliable indicator of a competent worker.”

    The General Social Care Council should revise its timetable for
    registering care workers so that it does not just rely on
    qualifications, it recommends. There should be an interim register
    to include all unqualified social care workers employed by local
    authorities and the independent sector, with target dates for their
    full registration on the basis of qualification.

    Quality of care and support services fell far short of what
    users and carers should be able to expect. There was a high level
    of staff turnover, which is likely to get worse as the workforce
    ages and competition in the labour market increases; and inadequate
    education and training for care and support workers before
    qualifying and during their careers.

    King’s Fund chief executive Julia Neuberger said: “The
    government must take urgent action to avert a crisis in care
    services. It should make a concerted effort to recruit, retain and
    equip thousands of committed and able people to work in care and
    support services.”

    Without care workers, the government ambitious plans laid out in
    the NHS Plan will not be achieved, she said. “Extra nurses, doctors
    and hospital beds will not make a difference unless they are
    supported by services which enable older and disabled people to
    have an independent life of their own. Failing to invest in them
    would be a false economy of the highest order.”

    A “damaging preoccupation” among commissioning bodies with
    containing costs rather than promoting quality in care services was
    unveiled. It recommended new government guidance to local
    authorities, primary care trusts and care trusts on best practice
    in commissioning, and a review of Best Value guidance to ensure it
    is recognised that improving service quality is not always
    synonymous with driving down contract prices.

    Julia Unwin, inquiry chairperson, said: “If we fail to value
    care workers, we fail to value older and disabled people too. We
    leave them at risk of avoidable illness, dependency, misery and



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