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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