Reaction to the Commission for Social Care Inspection’s report on the state of social care

Reaction to the the state of social care report

General Social Care Council

Lynne Berry, GSCC chief executive said: “We share the assumption of this report that services must be judged against what service users say they want and against the government’s reform agenda; both require a trained and trusted workforce delivering high quality services in ways that put service users at their heart.

CSCI’s report gives cause for celebration and concern. It is great news that the percentage of those working in younger adults’ residential services who have met the training standard has risen from 49% in 2002/3 to 73% in 2005/6 and that the percentage of those meeting the qualifications standards in older people’s residential care has risen from 47% to 72% in the same period. However a substantial number of home care services are not meeting standards relating to the selection of staff and supervision – key aspects not only of the national minimum standards but also the GSCC’s codes of practice for social care workers and employers.

In children’s residential services, although the percentage of people who are trained and competent increased from 46% in 2002/3 to 70%, this has been the same figure for the last two years. A third of children’s homes do not meet standards relating to health, safety, security and the adequacy of staff. In homes for younger adults, 53% had insufficient verification of the suitability of staff through recruitment checks and references, as did 40% of care homes for older people.

Overall there is a great deal to welcome. Much has been achieved; quality is up. However the rate of improvement must be maintained. Good recruitment procedures, effective training, personal accountability and effective safeguarding measures are essential to achieving a respected and skilled social care workforce”.

Social Care Institute for Excellence

The Social Care Institute for Excellence responded to the CSCI report by reiterating the need for local authorities to ensure that all services are based on reliable and relevant good practice evidence.

Chief Executive of Scie, Bill Kilgallon said: “Scie welcomes the publication of this excellent and vital report. It recognises the difficulties faced by people who need social care services and by the local authorities who are unable to fund services at the level required. We support the call for a national debate on social care funding and the balance of responsibility between the state and the family.’

Disability Rights Commission

Britain’s social care system is close to the point of no return and needs urgent investment to reduce the unbearable pressure that its shortcomings are placing on disabled people, carers and families, according to the DRC.

It said: “The report paints a bleak picture of increasing demand for support against the backdrop of ever tightening criteria for getting it. What threadbare services there are contain massive holes that are claiming millions of families who are now at breaking point.

The job of keeping many families together today rests on the shoulders of an informal army of relations and friends which includes thousands of children who provide over 50 hours of care a week. In a developed society this is nothing short of a disgrace.

The current settlement we have is producing disadvantage and needless costs across society – to women who overwhelmingly fill the gaps left by inadequate social services, to the children of disabled parents who represent one in three of all children living in poverty, to the taxpayers who support the huge numbers of disabled people without the support to enter the labour market.

Investment and reform to social care should be a top priority for the 2007 comprehensive spending review. Further neglect will only compound the pressures that families are already experiencing and store up even greater problems for future generations.”

Counsel and Care

Chief executive of older people’s charity Counsel and Care Stephen Burke said: “This report exposes the reality for older people needing care and support in Britain today. Older people and their families and carers are struggling day in day out to live independently in their own home or to pay the high cost of care home fees.

With our ageing population, there is a widening care gap between what older people need and what care and support is available in their local community. Older people face a care lottery. Access to care depends on where older people live and their income; it depends on their local authority and its policies on charging and eligibility criteria for home care. It is now almost impossible for older people to get support in their local community unless their needs are severe.

Counsel and Care is calling for proper funding of care home places and fair implementation of a new continuing care funding framework. It also wants to see independent care advisers in every community and a national care advice service.

Urgent action is needed to help older people live independently rather than condemning them to isolation or dependency. Older people, their families and carers will not continue to tolerate care services which are patchy, inequitable and costly.”

Alzheimer’s Society

Neil Hunt, chief executive, Alzheimer’s Society said: “This CSCI report is confirmation of what people with dementia and carers across the country know. The care system is in crisis with the government unwilling to ensure investment to help people with serious medical conditions.

Additional investment in the NHS has not been mirrored in social care.

Inevitably the result has been that as need increases, local authorities skew what care there is available to people with high levels of need.
Thousands of people who need extra help to remain independent are being ignored. This trend is the opposite to the government’s stated policy to improve preventive and low level services.

We are well beyond the need for policy papers and fine words. The government needs to prepare a rescue investment plan for social care services.”

Association of Directors of Social Services

Directors of children’s services and directors of adult social services fully support the thrust of the CSCI report.

According to ADSS president John Coughlan, the commission has “entirely complemented and confirmed the messages that have emerged from ADSS and Local Government Association research and the Wanless report.

Social care service for elderly people, people with disabilities and children are faced with growing need, increasing number of elders in our population, and a dwindling amount of money with which to fund them,” says ADSS.

Iain Carpenter, Professor of Human Ageing at the University of Kent

“The CSCI report has highlighted the problems faced by people with disability in the presence of increasing demand for resources. Many commentators bemoan the lack of funding to match need, however a far more urgent and appropriate first step would be to ensure that what resources there are targeted fairly.

The way that assessment of need is conducted in the UK is shameful. There exist very high quality assessment systems that provide reliable comparable information on the needs of an individual but they are not used.

In medicine, the NHS and doctors are damned if they do not practise evidence based medicine. The same must apply to social care and the biggest impact first step would be introduction of research evidence based assessment of need.”

United Kingdom Home Care Association

“While there has been a marginal increase in local authority spend on homecare services, much of it has been directed to service users who need the highest level of support. People with less intensive needs – those who fall below local authority eligibility criteria – are left to pay for their own care, or continue to live with their care needs largely unmet.

This situation demonstrates a disparity between the government’s aims for social care (including preventive services and greater choice) and the experience of people who need social care services. We must not forget the significance of unmet needs, as failing to take early intervention now is likely to increase costs in the future.”

NCH, the children’s charity

Clare Tickell, NCH chief executive of NCH, said: “The provision of social care is a lifeline for many children, young people and their families but not all those who need it receive support.”

National Care Association

NCA expressed “very grave concerns” at one of the report’s key findings, that councils in England are having to raise the criteria for accessing care due to increasing numbers of people needing care and the financial pressures this puts on councils.

NCA chief executive Sheila Scott said: “This of course is something we were already aware of but it makes very sad reading that the criteria for accessing social care continues to rise when it is widely recognised that intervention at an early stage for older people can have a dramatic impact on the level of service required in the long term.

NCA has also highlighted issues relating to the funding of those people whose care is paid for by the state, which is currently around 60%.

Ms Scott said: “There is a real issue about the funding of frail and vulnerable people wherever they live and receive their care.

“It will not be possible in the long term for standards to be continually raised unless fee levels reflect the added costs that care providers are facing.”

The Children’s Society

Kathy Evans, policy director, said: “The Children’s Society welcomes the publication of the CSCI report. The commission identifies as a major concern the fact that too many people continue to have too little, if any, choice and control over the social care services they use.”

Local Government Association

David Rogers, chair of the LGA’s community wellbeing board, said: “This report exposes the deeply worrying trends within social care which the LGA has consistently highlighted. Councils will hope it proves to be a wake up call to the government, which has starved the sector of investment for far too long.

Central government funding – which accounts for a significant proportion of a council’s budget – has not kept pace with the needs of an ageing population.

The withdrawal of services is an issue many people are rightly concerned about. Councils want to provide high quality social care at the right time and in the right place. Authorities also want to deliver the best possible support to carers and service providers who do such an important job in often difficult circumstances.

A lack of funding means councils have been placed in the invidious position of withdrawing some services because they have been forced to concentrate resources on people with the most severe needs.

Unless the government takes urgent action, older people may not receive basic care to help them stay at home by April 2009. Hundreds of thousands could lose or have to pay for the little services that mean so much, like help with washing or getting dressed.

There must be a serious debate about how the care needs of an ageing population are funded.

It is to the credit of people working in social care that services are improving year on year in such difficult circumstances.”

On the commission’s findings that NHS budget deficits in some areas were impacting on services, Rogers said:

“It is not our place to comment on the financial problems of some NHS trusts, but we do not expect the council tax payer to pay for them. We need to bring decision making between health and social care much closer together and make all public service leaders accountable to the people they serve. Only then will we avoid a repeat of the recent cost shunting that has led to cuts in services.”