Last Updated on November 18, 2022
The Care Provider Alliance (CPA) published a new report this week, detailing the current state of social care in England.
The CPA briefing, The State of the Social Care and Support Provision in England, highlights the key issues currently afflicting the social care sector. These issues include, but are not limited to:
The rising cost-of-living.
The announcement of the Energy Bill Relief Scheme, while offering much-needed short-term stability to care providers, does not represent the long-term strategy needed to support the sector through a sustained energy crisis.
In August 2022, before its announcement, care home providers were facing gas and electricity costs of £5,166 per bed per annum. This represented a 600% increase on 12 months prior at a total cost of circa £2.2bn per annum across the sector, threatening providers’ financial viability and further jeopardising the sustainability of the sector.
The Government support package reduces that total impact to just under £1bn per annum, which, while welcome, still represents a three-to-four-fold increase on August 2021 prices and even higher for providers exiting long-term deals over 2-3 years prior.
There are a range of nuances that have been seemingly overlooked in the Governments’ Energy Bill Relief Scheme for businesses, such as the failure to account for shipping and transportation charges or risk premiums, which are additional to the cap and have increased by between 50-100% over recent months.
The sector also remains subject to 5% VAT, which, given the increase in wholesale rates, has yielded HMRC more than a fourfold increase in collections. Additionally, care home providers are being asked to provide security deposits of up to three months in advance by energy suppliers and are faced with contracting for energy without knowing what Government support will be due to the energy discount being published in arrears.
High fuel costs are having a significant impact on the homecare sector. In the UK, an estimated 1.5 billion miles are driven in a year for homecare visit. The effect of the increase in fuel prices on the sector is made even more acute by the fact that 87% of care workers use either their own vehicles or company vehicles (whether powered by petrol or diesel), with more than four-fifths (82%) alone driving their own vehicles.
Lack of funding to local authorities to adequately raise fee rates for social care
Whilst £600m has been provisioned for the Fair Cost of Care Reform from April 2023, this only equates to around a 5% uplift in fees. The local government funding settlement is currently unknown but unlikely to be set as high as inflation, given Local Authorities have already been asked to find efficiencies. There is £500m provisioned as part of the Our Plan for Patients guidance which will be split between Local Authorities and the NHS to help with hospital discharges this winter and to support staff retention, although how this will be funded and disseminated remains unclear.
Impact of financial pressures and uncertainty
The CQC’s State of Care Report 2021/22 highlights the challenges services now face are due to historical underinvestment. The report recommends that the focus must now be on long-term planning and sustainable investment. Ensuring the future sustainability of the social care sector through appropriate investment is of fundamental importance for the sector itself, but also England's society and economy in broader terms.
Action is required to prevent widespread market collapse and to help commence the journey towards a sustainable future for the sector, given that 45% of providers in the Southeast are considering exiting the market according to the SESCA survey. This statistic has been further validated nationally, with a Care England survey suggesting that the percentage had increased to over 50%.
Unmet need is unacceptably high and rising
There are significant implications for service users, with 540,000 people waiting for either an adult social care assessment, a care or a direct payment to begin, or for a review of their care. Councils are receiving an average 5,400 new requests for help every day.
The CPA calls on the Government to make clear today that there will be no delay to the planned timetable for reform, and that rather than kick the reform can further down the road, they grasp the urgency of this fiscal event and escalate it to the top of the table.
CPA Chair, Nadra Ahmed said, ‘The plans as they stand are not sufficient to create the kind of step change that people are calling for, however, doing nothing and this delay will only accelerate the pain, further exacerbating the structural instability across the sector. The delay impact on us all, including the NHS who will also bear the brunt of our unfunded social care system.’
Kathy Roberts, Chief Executive of the Association of Mental Health Providers (AMHP) said, ‘Any reform needs to be inclusive of all service providers; the social care landscape must be viewed from a much wider lens, to include mental health, and also learning disabilities and autism service providers.’
She goes on to say "We believe there needs to be a greater emphasis on the prevention in relation to the right support at the right time to prevent worsening mental health and relapse."
Professor Martin Green, Chief Executive of Care England, said, ‘We require a 1948 moment for adult social care to establish a long-term and sustainable future that will be to the benefit of all citizens and the economy. It is clear that the reforms introduced under the Johnson administration are a starting point but are by no means going to ‘fix social care’ and the current reform proposals may well be kicked into the long grass again. The sector stands ready and willing to support the delivery of a much-needed reform agenda that will deliver a clear funding strategy for social care, whilst also developing a range of careers and opportunities that will provide high-quality care and support local economic development. The health of the UK economy cannot be separated from the health of the social care sector, the two are fundamentally linked.’
Visit the Care Provider Alliance website to read the CPA briefing report in full.
In other news, ADASS published its Autumn Survey 2022 this week, which reveals that almost all directors of adult social services across England say there is neither enough funding nor enough care workers to meet the support needs of older and disabled people this winter.