By an adults’ social worker
When frontline workers in my local authority raise issues regarding the current crisis in adult social care, our senior managers and politicians throw back at us that there is a commitment to integrating services fully with the NHS. “Integration” has become a watchword, a talisman that will bring about a new dawn in the provision of care.
This is all well and good (and we have been working productively with NHS colleagues for a long time), but it’s blatantly obvious that the ongoing financial deprivation that the government is imposing on local authorities and the NHS is making this very difficult, if not nigh on impossible. The situation is worsened by the fact that workers struggle to engage in productive integrated-working when, for much of our time, we’re able to do little more than “firefighting” in maintaining those services that are still available and desperately seeking to fill the gaps.
All this has been brought into sharp relief by recent local events. Our local NHS Trust is (secretly) formulating “Sustainability and Transformation Plans” and, despite a stated objective of reducing the length of hospital admission, important and successful (and, I would suggest, cost effective) preventative resources are being shut down due to funding restrictions.
‘Earmarked for scrappage’
A rehab ward, described as “excellent”, was closed last week, despite sustained campaigning by the public, unions, service users, professionals and political parties. The ward provided a fine service for patients and played a major role in care planning and the reduction of delayed discharges. Staff, which comprise a social worker, reablement workers and assistant practitioners, now face redundancy or redeployment and even more pressure will be imposed upon acute hospital wards and their staff as well as upon social care systems.
Alongside this, the last Admiral Nursing service in the county has now been earmarked for scrappage. This is following a recent “promise” that the service’s future would be secure. Admiral Nurses are dementia specialists who work with people with dementia and their carers in the community. The service has repeatedly proved that it is more than fit for purpose.
These examples are only the tip of the proverbial iceberg. Add to this situations such as social workers having to go cap in hand to panels to get clearance for even the most basic of services to be put in and you have a picture of health and social care systems that are under the kind of pressures that should have no place anywhere in the 21st century, let alone in a highly developed country like ours. Staff morale is on the floor.
‘Creaking system’
I suppose that at least one positive note is that the grandees who oversee our creaking health and social care systems are beginning to acknowledge that the crisis is almost wholly down to systematic underfunding by central government. It’s also heartening to see the rise in grass roots activism by service user and community groups. Of course, more of this is needed, and, as a union rep I’m always encouraging colleagues to join and become active in defending services and working conditions. At the end of the day, though, the buck stops at Downing Street and Parliament and, until we get a government that pays more than lip service to decent health and social care, things can only get worse.
Also, until then, integration between our services (which are currently barely integrated within themselves) will be nothing more than a selling point.
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As a Hospital Social Worker in a foundation trust which is an intergrated service, i am constantly under pressure to get beds clear so we can get the breaches down “at the front end”.
However Today 02/11/16 our only Care agency we can use due to Efficiancy savings have over 2000hrs per week outstanding packages of care equating to just under 200 people waiting for home care.
Also today there are only 15 vacancies in Residential Homes and 1 nursing home placement
no intermediate care vacancies. I have 18 people in Hospital waiting for Intermediate care beds. The costs of care and placement have increased however what the service will pay is over 20% less than the cost, therefore requiring clients family to pay Top up. More and more clients are now being re admitted to hospital due to inadiquate care, Carer Stress & breakdown or inappropriate placement. Clients wishing to return home to die are being denied this due to lack of care or placements.
This service is constantly under strain, and they are still closing down services that could support, prevent or delay admission to hospital, reducing reablement beds reducing OT & physio services and saying the best place is home with support. However this support is being reduced and closed.
I am working in the dark, Hands tied behind my back, legs shackled and gaged. Yet management want the bed cleared, meet targets and save money, we even have to buy our own stationary and justify printing remember it costs 4p to print and 15p for colour…
Sainsburys is looking good.
Only today have I assessed someone under the MHA as a result of failed discharge and no appropriate resources so the option to refer for psychiatric care was tried as a last resort costing a large sum of money. Counterproductive.
Sainsbury’s not what it seems 🙂
I’ve only just qualified as a Social Worker and work in an adults care team where my last 3 requests for help with crisis was refused by the team manager. Advised we need to look at preventative approach and use the strength of the client to help them overcome barriers. Still, they can’t get up washed or dressed but I have to promote community centres and walking groups. One client fell trying to put their pants on and broke their hip. Further advised by the manager that we can’t do anything to prevent falls. I have tendered my resignation after only 3 months in post. Call yourself a care professional, what a joke!! Government need to wake up and look at what they’ve done! I’m ashamed to have studied for 3 years to just say no to people all day.
I can’t help thinking its all part of the plan ! Government are fully aware of what they’re doing and Mays days are going to be every bit as harsh as Cameron’s ! Brexit is a carefully orchestrated distraction !!
So where’s it all leaving us ? Don’t you feel we are being pushed into the other darker side care provision? I do ! And I can’t help feeling we’ve already lost the battle and it’s just a matter of time ! That’s not to say I don’t think we shouldn’t go without a fight! I think we should be fighting now ! Not after the deed has been done. We have to stand up for our service users on a way we’ve never had to before. And yet….is that realistically going to happen ???? I’m not naturally pessimistic.
Why are we such a divided profession ? I look at the junior doctors and I’m impressed with their unity. We need to follow their example and unite.