Have Your Say

Community Care’s new online discussion forum “Have your
say” has just been launched giving readers of the magazine and
visitors to the website the opportunity to express opinions on a
current issue.

All you need to do is click on the e-mail link below and
give us your view. We will post the opinions here on the website
for you to read.

This week’s opportunity to “Have your say” focuses on the new
occupational standards for social work. Do you agree with the
introduction of the standards? How wide should their remit be? And
what specialisms of social work should they cover?

Last week’s discussion centred around the care home crisis and
the home owners’ threat to close some homes unless local
authorities increase the fees they pay.

We received four contributions on this issue, and two others on
the recruitment crisis and the financial difficulties faced by many
social services departments.

First contribution:

“No discussion really, central government control finances, both
parties are powerless to make government pay up, as local
politicians will not stand up to them, and social work has never
really developed or used its muscle to make local politicians
listen. So my advice is to get the patients to stage a walk out,
and sack all of the professionals involved. I expect that would get
someone’s attention.”

Nick Savage

“The issue is a lot wider than you mention. It is not just
private providers who struggle to get enough money out of social
services to meet the ever increasing costs of running a quality

The voluntary sector is also affected. ‘Not for profit’ means we
do not have any leeway. Settlement figures over the past years
have, at best, matched DSS increases. This in no way matches the
need to raise salaries to keep pace with social services staff
salaries, let alone the other rising costs.

Also, it is not just care homes for the elderly that are
affected. Those for people with learning disabilities, etc are also
affected by these cuts in real terms. Reduced fees means a reduced
service, just when the new national minimum standards are due to be
implemented, with their requirements for improvements all

Andy Graham, Manager, York House, Shrewsbury.

“One thing people tend to forget in this debate is the position
of those such as myself who own and run a private care home for
adults with learning difficulties and challenging behaviour. Yes,
we do obtain relatively high fees for a minority of service users,
but we do not have economy of scale, having a maximum registration
of 10 residents, unlike some large nursing homes which are
registered for 50 plus residents. Also our clients can be very
destructive both of the home environment and of their own clothing
and property, day in and day out over very many years, and this is
not allowed for in the fees. Thirdly, our clients may expect life
long care with us, during which time they remain chronically
under-funded as regards their personal allowances. and never have
enough money to purchase clothing, holidays etc without financial
help from myself. I know other private home owners do the same.

None of our clients have any personal resources, and none of
their families contribute towards their care, so every single penny
that comes into my business comes from the public purse. I cannot
“subsidise” local authority clients on the back of private sector
clients – there aren’t any. Therefore the local authority that
purchases care from me can literally make or break my business.
Requests for re-assessments of service users needs can take over
six months to complete, and then, if a financial need is identified
it can take a further six months to come to an agreement with the
authority and actually achieve payment. On the current basic rate,
we are paid £1.60p an hour per person to provide 24/7 care. If
we had 50 residents and employed staff on minimum wage, we might
just get by. If you have five of your 10 residents on basic rate,
and you have to obtain and keep motivated, trained and competent
staff, who may very well get a fist in their face or a table hurled
at them on a daily basis, then it just doesn’t add up. As an
employer I have a duty of care to my staff, and as a provider I
have a duty of care to my residents, which I need resources to
fulfil. But when I have to go cap in hand to the local authority
for every penny and they can then ignore the terms of the contract
between us, ignore notices to remove residents, ignore default
notices, and in other words just mess me about exactly as they want
knowing that the only real “power” I have is to go out of business,
no wonder the list of care homes selling up is growing longer by
the day.

I was surprised to see that other authorities such as Devon have
already given a 4 per cent increase and are offering 10 per cent
more for new placements. Bristol social services, while cutting
back sharply on day service provision for service users in
residential care so that providers have to increase the level of
service without a penny extra in fees, have given us 1.9 per cent a
year for the past three years, although the increase in “unit
price” for their own mainstream learning difficulties home has been
over 38 per cent this year alone. And yet their own home is full to
bursting, and they are refusing to place new clients in vacancies
in the private sector, possibly with the intention of making us so
desperate to fill beds that we will accept any price they are
prepared to pay, with no thought to the quality of service

Gloria Carwithen from Bristol. 

“After having to place my own mother in a care home. I feel
strongly that care homes should be given more funding per resident,
but stipulating that some of the extra funding be passed onto care
staff. I see that homes find it difficult to employ staff, or to
maintain staff on the present pay structure. I believe they need to
have the respect and recognition via their wage packet. This
situation then causes at times inconsistencies with staff, when
ensuring my mother’s needs are being met. This also can dis-empower
my mother when her feelings or wishes have been ignored due to
staff shortages.

Individuals living in care homes are at times not in control of
their own life, and have to rely on others and the only
independence they have is to have choices. I feel that as staff in
care homes work extremely hard trying to meet just the priority
one/two needs, choices like having your room cleaned once a week
can go straight out of the window. My mother’s wishes are that she
would like at times to experience staff having more time to sit and
chat with her, and not be rushing around doing two jobs at once. I
am aware that assessing clients we have to look at priority one and
two’s needs, but it’s very difficult when your own mother’s
emotional well being is not being met as this is not a priority or
because the home has not the funding.

My job is that I am a qualified social worker within a social
services department, in community care (physical disabilities
team). We are required from the home to get a break down of the
total home’s costing per individual. So if in future they require
further funding for a resident, the home will then have to provide
the evidence, of where the extra need is to be met.”

Ann Ackland

Social services overspends

“The £205m overspend by social services departments during
2000/01 is only the tip of the iceberg.

During the last four years, whilst I have been chairman and
subsequently cabinet member for West Sussex social services, our
unavoidable extra responsibilities have grown by £49 million,
but the government has only funded £23 million of that. To
cover the £26 million shortfall the county council has
provided a subsidy of £11.5 million, we have had to withdraw
services to the tune of £9.5 million and been forced to
tighten eligibility criteria thus leaving increasing numbers of
people outside our net. All that in spite of efficiency savings
averaging nearly 4 per cent a year.

From the ADSS surveys I know that this unsatisfactory position
is mirrored across the country. Whilst this has impacted on all
care groups, it is the services for older people that have been
hardest hit. This is unfair to those being denied the help they
need and very stressful to the managers and staff who have to put
budgets above their professional judgement. In such circumstances
it is galling to hear the minister of state for health, John
Hutton, saying that there is plenty of money in the system and that
we should be able “to provide satisfactory services for the people
in (our) catchment area”.

This is indeed a badly neglected service.

Barry Mack

Recruitment crisis

“Rather than adopting short term solutions to a long term
problems, isn’t it about time that the whole issue of training,
recruitment and staff retention was addressed. As a second year
student social worker who has to work 18 hours a week to exist, the
whole issue around 2, 3 and 4 year qualifying periods where
everyone starts on the same salary irrespective of the length of
time spent studying (and lesser and greater degrees of debt)
rankles. It would appear that academic, professional and ethical
standards can be compromised at will.

How would we feel if doctors, lawyers dentists, etc all
shortened the length of time needed to qualify and were then
responsible for addressing your needs?

It would appear that the DipSW certificate is more important
than the journey that gets you there?”







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