'New Deal' for social care call

The scale of the adult social care funding crisis in England was revealed today (September 7) in a new analysis from the TUC, which shows that annual spending on adult social care is still £600m lower than in 2010.

The research found that in the vast majority of local authorities in England – 112 out of 150 – social care spending per head was lower than it was a decade ago, with an average of an 8 per cent spending reduction since 2010 in England overall.

Some areas have seen steeper spending reductions than others, with spending per head in London 18 per cent less than in 2010. Both the North East and the West Midlands experienced spending reductions of more than 10 per cent over the same time period. The South West was the only region that saw a marginal spending increase on adult social care per head over the last decade.

Such substantial falls in adult social care spending, under a system where local authorities’ budgets have been cut to the bone, comes amid a rapidly ageing population who have increasingly more complex care needs.

Unmet care needs

Many local authorities have been forced to respond to budget cuts by tightening eligibility for social care, so that only those with very serious care needs or have assets valued below certain thresholds receive state-funded care.

Between 2010 and 2014, 400,000 people stopped accessing state-supported care because they no longer qualified, and now it is estimated that a shocking 1.5m older people have an unmet care need.

As fewer people are able to access social care, the demand for such care will only continue to increase in the years to come – by 2030, the number of people aged 85 or over is set to double.

With so many older people with unmet care needs, the pressure on unpaid carers such as partners and adult children continues to grow. It is estimated that the value of this unpaid army of carers totals up to a £100bn each year.

Recruitment and retention crisis

Above all, the TUC highlighted the retention and recruitment crisis as the single biggest challenge in adult social care. At any given time, there are more than 120,000 vacancies in adult social care, and in England the turnover rate exceeds 30 per cent. This means more than 400,000 care workers have left the vocation in the last 12 months alone.

Poor pay and insecure work is endemic in the sector – the vast majority, 70 per cent, of care workers earn under £10 an hour, with very little room for pay progression and a quarter of the workforce on zero-hours contracts.

The TUC noted in its analysis that there “is evidence of a link between the wellbeing of workers and the quality of care that people receive”.

“Due to slashed budgets, councils are forced to resort to short-term, lowest cost commissioning, which suppresses wages and means care services are focused on a production line of task-to-time slots rather than what the cared for person needs, and the true labour costs to deliver this,” the report went on to say.  

The TUC also highlighted the damage that privatisation of the sector has caused. At present, the vast majority of care homes are run for-profit. This means that any increase in funding for local authorities does not necessarily translate into more money for adult social care provision or increased wages for staff.

“It’s time to fix a broken system”

The TUC has put forward a number of recommendations which Unite welcomed, including a new long-term funding settlement; a national sectoral care body representing the government, trade unions, employers and commissioners; fair pay and terms and conditions for the social care workforce, including the introduction of sectoral collective bargaining; and a limit on private sector involvement.

The TUC said that it should be the UK’s long-term ambition to have a universal, fully-funded social care service, free at the point of use for all, and paid for by general taxation.

Commenting on today’s report, TUC general secretary Frances O’Grady said, “When the country needed them, social care workers stepped up. Care workers looked after older and disabled people in the midst of a pandemic, often without the right PPE, and often for low wages and no sick pay.

“Now it’s time to fix the broken system. Social care is badly underfunded. Pay and conditions for care workers are dreadful, and families can’t be sure of high-quality, affordable care a family member needs it,” she added.

“As we face mass unemployment, ministers should act to unlock the 120,000 existing social care vacancies right now, and they should put investment in social care at the heart of our national recovery plan.

“Social care jobs should be decent jobs on fair pay, at the heart of every community.

“Ministers can’t spend another decade hiding from the social care crisis.”

Unite assistant general secretary Gail Cartmail agreed.

“The government and, society more generally, can no longer turn a blind eye to the enormity of the social care crisis in England,” she said.

“Unite strongly supports the TUC report and we would like to see a once-in-a-generation New Deal for social care that gives the elderly, vulnerable and disabled the fully-resourced support they need, and which also properly rewards and respects the contribution of social care staff.

“This crisis has been coming down the track for several decades, however, it was the pandemic that shone a very painful spotlight on the situation in care homes that politicians have ignored for too long,” Cartmail added.

“Throughout the pandemic our members in social care have contacted us with heart-breaking experiences. Many have suffered in silence, fearful of speaking out against their private sector employers.

“Many have put their lives at risk because they lacked the basic PPE. Testing of these key workers was inadequate and many did not have proper sick pay if and when they had to isolate,” she went on to say.

“There can be no justification for continued underfunding and the rampant commercialisation of the sector – how can you factor in profit margins for someone’s health and care?

“Boris Johnson and his ministers need to act now and stop kicking this issue into the long grass – they should swiftly implement the TUC’s recommendations.”

By Hajera Blagg