Have Your Say report

    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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