Editorial Comment: The state we’re in

“People tell us they want services that offer them privacy, choice and dignity, and we have seen a year-on-year improvement in these standards.” So says an upbeat Paul Snell, chief inspector of the Commission for Social Care Inspection, commenting on the organisation’s influential State of Social Care report released this week.

The report, based on the watchdog’s monitoring of standards in England, suggests that social care services for adults and children are being successfully modernised and improved. Children’s homes and fostering agencies are getting better. So are care homes for older people.

In 2006, more people were using direct payments, and children benefited from improved co-ordination between health and social care services. Progress is welcome but our enthusiasm over the new wins has to be tempered by the persistent problems. Improvement has been “gradual” and patchy. Some services are still not meeting national minimum standards, and many are struggling to offer adequate choice and control over services.

Quality services cost money and CSCI warns, as if we needed official confirmation, that eligibility criteria are being tightened across the country with the result that many people just do not qualify to receive care services.

Paltry funding, inadequate staffing and growing demand are taking their toll, and councils are focusing on services for those with the highest and most complex needs.

The preventive sentiments of government policy could remain just that.

An increasing proportion of people will either have to pay for their own care or rely on the support of friends and family. And the report calls for councils to provide more support for unpaid carers. They need to take a more comprehensive approach, improving access to carer assessments and respite services. But we have to accept that there are limits to what unpaid carers can achieve and they should complement effective, publicly provided care.

Again, the annual State of Social Care report sends a timely reminder to the government that their policies and efficiency drives will go only so far.

We need a renewed commitment to a basic provision of care for people with lower level needs, so that we don’t have a swathe of disenfranchised service users whose quality of life steadily deteriorates until they meet our increasingly restricted, crisis management criteria.

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