Story updated 14 April 2020
Adult social care provider heads have rejected as “woefully inadequate” council leaders’ estimates that services will face a 10% hike in costs as a result of Covid-19.
The estimate – part of Local Government Association and Association of Directors of Adult Social Services guidance for councils on providing temporary additional funding for providers to deal with the current emergency – drew a sharp response from umbrella bodies representing the care sector.
The guidance is designed to inform councils’ decision-making on how they spend £1.6bn allocated by the Treasury to deal with coronavirus-related pressures.
It said providers would face increasing costs resulting from staff sickness, higher need among service users, the need to fund personal protective equipment (PPE) for workers and administration, as a result of fluctuating care packages.
Initial information from services suggests increased costs would be 10% on average – though variable between services – in April, but the guidance said that any additional funding could only be sustained on a temporary basis, given the additional calls on the £1.6bn.
‘Complete underestimate’
“This statement from local government completely underestimates the very real and current pressures that care providers are under,” said Vic Rayner, executive director of not-for-profit provider body the National Care Forum. “It is woefully inadequate and provides little comfort for those providers who are working night and day to support the most vulnerable members of our communities.
“Care providers need the support of local government to cover the very significant additional challenges and escalating costs of workforce, PPE and supporting the discharge of vulnerable people from hospital into care homes and the wider community,” she added.
Lisa Lenton, chair of the Care Provider Alliance, which represents the NCF and the other major care umbrella bodies, said: “We welcome the efforts of local government leaders to agree a consistent increase in fees to be used by all councils in England, and the inclusion of the care sector in these discussions.
“However, the proposed funding arrangements are inadequate and there is no guarantee that individual councils will follow the guidance. We do not believe that there is a system in place to ensure that £1.6bn of public funds reaches front-line services. In addition, the guidance fails to address the question of how support can be provided to providers who are not currently funded via local authority contracts.”
Lenton and other provider leaders also said that the LGA and ADASS’s estimate that the 6.25% in the national living wage that came into force on 1 April would necessitate a 5% increase in council fees was also an underestimate.
‘Many and growing calls on funding’
Ian Hudspeth, chairman of the LGA’s community wellbeing board, said: “We recognise the challenges and additional costs that social care providers face in delivering services at this challenging time. Councils are already taking action to support providers in meeting the additional costs that they face locally and in managing cash flow challenges. Councils are also pressing government to try and secure much needed PPE for care providers.
“Nobody can say for certain how this situation will develop and what further resources may be needed. The recently published LGA/ADASS statement suggests that councils and providers will need to continue to work closely together to ensure that resources are available, to allow services to continue in this challenging environment.
“The £1.6 billion funding that government has made available to councils to help with additional costs arising as a result of Covid-19 is much needed. However, there are many and growing calls on this funding and additional resources will be needed to allow councils to continue to support social care and other services.”
Need for rebalancing to support social care’
The government announced over the weekend it had approved £14.5bn from an emergency fund to support public services in their response to Covid-19, three times the sum announced in an initial announcement last month.
While there has been no increase on the £1.6bn allocated to local authorities, the sum allocated to the NHS has grown from £1.3bn to £6.6bn. Some of this funding will reach adult social care as it is designed to help free up NHS beds.
But the Association of Directors of Adult Social Services said there was a need for a “significant rebalancing” in the government’s Covid-19 focus, from the NHS to social care.
President Julie Ogley said: “There are two fronts in our response to Covid-19; social care colleagues and family carers are the first line of defence – protecting our communities, at huge risk to their own health and shielding the NHS from catastrophic demand that would overwhelm it.
Their work is so often overlooked, yet they are giving so much for all of us and the government must give them the tools they need to do their vital work. There are key risks of more deaths amongst those supported by social care than people in hospital.”
She called on ministers to:
- Address continuing shortages in personal protective equipment in social care.
- Accelerate testing within social care.
- Focus on safe hospital discharge, not just rapid hospital discharge, and respect care providers who refuse to admit new service users in order to protect the lives of people they already care for.
- Provide additional support to care homes from primary and community health services.
- Enable local systems to continue to identify deaths and outbreaks of coronavirus in care homes and at home and, with Care Quality Commission, to prioritise basic safety monitoring;
- Provide adequate funding for social care to tackle the impact of coronavirus.
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I am clearly mistaken in thinking care providers are private businesses. Strange that the cost of protecting staff and residents is expected to come from council tax and income tax, it as if providers are not the employers themselves. My concern is with the minimum wage staff not business owners. If you accept profit as your baseline you should have reserves to deal with emergencies. Expecting a bale out from us is immoral.
Hi Lucy, I’m not sure what your background is but I’m not sure your experience of care providers is entirely representative of the health and social care sector as a whole.
The CQC defines that a reasonable limit on profit for care providers to make is around 10% – that is, after costs, they can make around 10p out of every £1 spent. However, the reality is that most care providers do not come close to this, 2% is regularly seen within domiciliary care with around 4% being deemed “good” (around the average for care homes). If you expected on a good day to make 4p out of every £1, the ability to ‘stockpile’ reserves as you’ve suggested is minimal – it could take years, without even considering that PPE costs have risen by around 800% in the last month (private providers equally don’t have the negotiating or legislative power of the NHS behind them to tackle this huge cost increase – i.e. they can’t send their own personnel to the border to confiscate PPE on their behalf).
The NHS is funded by taxation however is also receiving donations hand over foot to deal with Covid-19 issues – at the time of writing NHS Charities Together is currently sat at £94,663,712.12.
I would consider that if taxes are already there to support the public sector, why campaign for additional donations as well. This seems unfair that private care providers have to ‘deal with it on their own’ when the NHS already has its own funding stream.
I also don’t think families of loved ones in private care would agree that it is solely up to the provider to deal with their own issues – I’m sure they would cry out for any support Authorities can give them to care for their loved ones – especially if they are already being funded by Local Authorities and can’t afford additional private funding for their families.
In my view the issue is the legacy of the new public management ideology that drove the creation of a market in health and social care and how this has shaped people’s consciousness, jobs and careers over the last 20 years.
Supportive as I am of local government someone needs to bite the bullet and put adult social care into the NHS and bring education back under local authority control.
While public health was viewed with cynicism by some clinicians when it was in the NHS is it really more effective in local government? Hard not to think that local public health teams are struggling with the same old system coordination issues that 20 years of spend on ‘transformation’ has struggled to address. How much PPE would that have bought?