The adult social care sector is in a “precarious state” and has “no credible plans” for how care could be sustainably funded, according to the Public Accounts Committee (PAC).
Published last week, the government report on the adult social care workforce found the sector was underfunded and revealed that staff were suffering from low pay and low esteem.
The implications of Brexit were also discussed as the committee warned the UK’s departure from the European Union (EU) could have “a significant impact on the care workforce”.
Between 2010–11 and 2016–17, spending on care by local authorities reduced by 5.3% in real terms.
Despite acknowledging that the majority of local authorities were managing to fulfil their minimum statutory duties under the Care Act 2014, the PAC found there were “clear and obvious signs of significant financial stress” with “high and rising” levels of unmet need.
Unclear benchmark costs
In particular, the report made reference to the fact that over four-fifths of local authorities were paying below the sector’s benchmark cost for commissioning homecare.
“The Department does not have its own benchmark costs and therefore has no way of knowing whether local authorities, either individually or collectively, are paying enough for homecare”.
Committee members said the sector required “future investment” and outlined the importance of this summer’s green paper in establishing a “sustainable” and “credible” plan.
“The Department should establish quickly the funding local authorities need to commission care at fair prices, to support a workforce of the right size and shape to deliver a sustainable care sector in the long-term,” said the report.
Concern regarding short-term funding fixes aimed at adult social care was also expressed by the committee, which described temporary solutions as “not sustainable”.
In addition to discussing the need for a financially sustainable care sector, the committee highlighted problems with the recruitment and retention of staff.
Low pay and low esteem
It found that care professionals were not valued in the same way as workers within comparable roles in the health care sector and were suffering from low pay and low esteem as a result.
This had led to significant problems for care providers who have experienced high turnover of care workers, particularly in care worker, registered manager and nurse roles.
Sharing the frustration of Skills for Care, the Department’s delivery partner for leadership and workforce development, the report called for the implementation of a workforce strategy and greater recognition around the role of social care professionals.
“The Department should establish and secure the funding Skills for Care needs both to support the training and development of the care workforce fully and to implement the forthcoming workforce strategy.”
Need for a ‘long term solution’
Linda Thomas, vice chair of the Local Government Association’s (LGA) community wellbeing board, said the government could no longer ignore financial problems within the sector.
“Councils have done all they can to prioritise and protect adult social care, but the combination of historic funding reductions, rising demand and increasing cost pressures means many councils are having to make significant savings and reductions across their budgets, including within adult social care itself.
“This is leading to an ever more fragile provider market, growing unmet and under-met need, further strain on informal carers, less investment in prevention, and continued pressure on an already-overstretched workforce
The vice chair continued, stating that the funding gap facing adult social care would “exceed £2 billion by 2020” and urged the government to take “immediate action” to help overstretched council budgets.
“A long term solution that delivers genuinely new and sustainable funding for social care is desperately needed, otherwise councils risk not being able to fulfil their statutory duty under the Care Act.”
“This need to be supported by a realistic workforce strategy which recognises and values the vital roles played by the front-line care workers, managers and nurses,” she added.
The UK’s departure from the EU was also mentioned in the report as it warned Brexit could have “a significant impact on the care workforce”. It described how the work of people from outside the UK was “hugely valued”.
London and southern England were named as the regions that could be most affected by new immigration policies, with these regions having the highest proportion of non-British EU workers.
“The Department needs to understand fully the impact that the UK’s departure from the EU [and]… should put plans in place to address any shortfalls that might arise, to ensure that there is a sustainable workforce to meet the populations’ future care needs.”