DHSC publishes ten-year vision for adult social care

December 1, 2021

The Department of Health and Social Care (DHSC) published its White Paper today, which sets out its ten-year vision for adult social care in England.

As part of the White Paper, the Government is today setting out further details on how over £1bn for system reform will be spent over the next three years to improve the lives of those who receive care – as well as their families and carers.

The publication of the social care White Paper has been welcomed by care leaders as a ‘foundation stone’ upon which to build modern care and support choices for older and disabled people and all those at risk of social exclusion. The White Paper, People at the Heart of Care, should be seen as a first but highly significant step on a journey of transformation, according to the Association of Directors of Adult Social Services (ADASS).

Professor Martin Green OBE, Chief Executive of Care England, says, ‘This top level visionary White Paper sets out the Government’s direction of travel for the reform of adult social care. Care England stands ready to help the Government deliver this strategy by identifying and dismantling some of the barriers standing in the way of delivering this vision.’

The DHSC said the funding will help pay for the range and amount of new supported housing to be increased through £300m in housing investment, to help local authorities offer greater choice, care and support, alongside a new practical service to make repairs and changes in people’s homes to help them remain safe and either stay with their families or live independently in accordance with their wishes.

Michael Voges, Executive Director of ARCO, said the White Paper ‘clearly recognises the key role which specialist housing such as Integrated Retirement Communities should play in our future social care system.’

Other funding areas include:

  • New technology and digitisation is to be backed by at least £150m to improve care quality and safety, support independent living and allow staff to provide focused care where it is needed. For example, acoustic sensors which monitor movement will help residents to sleep uninterrupted and allow carers to monitor them safely and be alerted if needed. Digital care records will be updated to make sure all caregivers have the latest up-to-date details to provide the best support possible.
  • The 1.5 million-strong adult social care workforce will see £500m invested so they have the opportunity to progress in their careers with training and qualifications while providing an even better standard of care. This will help recognise their valued skills and prioritise their wellbeing, with greater support for their mental health.
  • Up to £25m will be provided to work with the sector to kickstart a change in the services provided to support unpaid carers, to boost support and increase access to respite services giving them much-needed support and a break.
  • A new national website will provide easily accessible information for the public on social care and at least £5m will be given to pilot new ways to help people understand and access the care and support available.

Provider reaction 

James Rycroft, Managing Director at specialist dementia care provider Vida Healthcare, shared his reactions with CMM, ‘I’m disappointed by the Government’s long-anticipated plans to reform social care today. The amount of investment into social care hasn’t changed and only £5.4billion (15%) of the total fund will come to our sector over the next three years with the remaining 85% going to the NHS.

He added, ‘Once again care homes and the sector as a whole has been neglected in favour of the NHS, and this will not only negatively impact the sector and the people who work in it, but our population as a whole. This is simply not good enough as social care needs funding immediately. We are left paying more tax for very little return and it highlights that the cost of care is clearly not understood by the Government. If it was, a larger proportion of the fund would have been allocated.'

‘An appetite for change’

Vic Rayner OBE, CEO of The National Care Forum (NCF), said the White Paper ‘rightly centres its attention on people who receive care and support, unpaid carers and the incredibly valuable workforce’ and that it’s a vision that many will feel represents ‘the social care that we want for the future’.

Commenting on the Government’s commitment to implementing change in the future, Vic Rayner OBE said, ‘It is clear that there is an appetite for change based on shared principles, and an understanding that investment in social care is critical to facilitating that change.’

But does it go far enough?

‘No …’ Vic Rayner responded. ‘… However, it is definitely a narrative that the not-for-profit care and housing sector can support. It does create a different vision for care that starts from the perspective of people who receive care and support. It will help people who know little about care and support to understand the truly transformational potential of social care. The funding allocated for social care reform as part of the social care and health levy payments is absolutely insufficient, and drastically out of line with the ambitions outlined here.’

Care workforce

As part of the ‘reforms’, £500m will be invested in the social care workforce. The DHSC outlines that this will enable the care workforce to ‘have the opportunity to progress in their careers with training and qualifications while providing an even better standard of care.’

Skills for Care CEO Oonagh Smyth said, ‘Much of the workforce elements in the White Paper are measures we and others have been asking for. The commitment to invest in our workforce’s professional development, and in our key leaders like registered managers, is something we have been talking about for some time, and I am sure will be welcomed by employers and those who work for them.’

The Care Workers’ Charity is pleased that the Government recognises the need for reform but the Charity says it cannot help but feel disappointed in many respects.

Karolina Gerlich - CEO of The Care Workers Charity said, ‘To discuss care workers’ rate of pay increase in terms of The National Living Wage increase is saddening as we believe that care workers should never be placed in this category of pay and expect to feel valued. This also diminishes the value that the Government places on those who draw on social care by undervaluing those who provide this service.

‘We are also disappointed to see no forward steps in the parity of esteem between social care and health care despite a notable move in the public’s opinion of how well the sector has coped under pressure during the pandemic with very little government support. Programmes such as Channel 4’s “Help” and Ed Ball’s “Inside the Care Crisis” have shown the true heroic nature of our Social Care sector and yet this seems to have yet again fallen on deaf ears within our parliament. This is again shown with the very disappointing amount of MP’s who turned up for the unveiling of the white paper today.’

Does it address the current crisis affecting the social care sector – particularly in relation to workforce shortage and how that is impacting on people who need or receive care and support?

Vic Rayner, CEO of NCF, replied, ‘No.’

She added, ’For the vision to succeed, we need the Government to urgently go further. The reform paper says nothing about how we go from the here and now to the future. Bridging this risk-filled chasm must be a priority over the next four months. People who need care right now are being left either in hospital or at home without the support they require. Staff who have worked in care for years are leaving in their droves through exhaustion, stress and the ability to be paid better in other sectors that can flex and change their wages. Organisations who have delivered care as a vital part of communities are closing their doors, unable to continue in the face of unsustainable pressures. If the Government does not take urgent action, then this admirable vision will remain a distant dream. People in communities across all parts of the country need this; social care matters to us all.’

Mental Health and Wellbeing

The White Paper document covers many key aspects such as housing, technology, digitisation, data, and innovation, but does it cover mental health social care adequately?

The Association of Mental Health Providers welcomes the inclusion of Isaac Samuel’s experience of how quality social care has helped him to recover from mental illness and maintain his mental health and wellbeing –  the Association said it is a compelling example of the essential value of social care and added that stories such as these, from people directly accessing care and support, highlight the impact the social care sector has on choice, control, and independence within people’s lives.

Responding to the publication, Association of Mental Health Provider’s Chief Executive, Kathy Roberts, said, ‘It has taken a long time for us to get to this point and it is to be commended that the role of mental health social care in improving the lives of people with mental health needs and mental illness has been acknowledged. Beyond this recognition, mental health social care is relatively absent from the White Paper. There appears to be an absence of valuing people who need to draw on care and support to maximise their independence and to live in communities. The lack of parity is a concern.’

Home care

Lucy Campbell, Chief Operating Officer of Right at Home UK, responded to the publication of the White Paper and said, ‘There were some glimmers of hope in today’s announcement – including the confirmation of the personal care cap; the renewed focus on helping people to live independently, in their own homes, for longer; and the commitment to fund staff training and wellbeing support.

‘With home care colleagues from multiple care providers up and down the country being forced to turn clients away due to a lack of available caregivers, we are disappointed that the White Paper fails to tackle the ongoing recruitment crisis, despite vocal calls from providers, staff and clients across the country. People are being left without care now. Solutions cannot wait until tomorrow.’

Local authority funding

The reform programme also includes:

  • £70m to assist local authorities and improve the delivery and standard of care.
  • An increase to the upper limit of the Disabled Facilities Grant for home adaptations such as stairlifts, wet rooms and home technologies to allow people to live where they want to and increase the options for care.

Cllr Martin Tett, Adult Social Care Spokesperson for the County Councils Network (CNN), said, ‘While CCN supports many of today’s proposals, we remain concerned that the amount of funding committed so far falls short of the ambitions laid out. In particular, there remains little detail on how the Government will implement a “fair price for care” and new duties for self-funders to access council-arranged care and their rates. This policy alone could cost £761m a year in county areas, so it is vital that the Government fully funds this aspect of the reform package and works with local authorities and providers on its implementation to ensure it does not unintentionally destabilise care markets in the short term or lead to unsustainable costs for councils.’

Person-centred 

‘Invest in our people’Dr Rhidian Hughes, Chief Executive of the Voluntary Organisations Disability Group (VODG), said in reaction to the White Paper today.

Dr Rhidian Hughes commented in his response, ‘We stand for a society where disabled people can flourish, drawing on care and support services, to enable independent and fulfilling lives. We thank the Minister of State for Care for publishing People at the Heart of Care and it is encouraging that the vision for care is one that we can all support. Everyday staff within our members’ services are delivering care and support underpinned by these shared values.

‘The intention behind today’s publication is admirable but what we need from Government is reassurance that further financial investment will be forthcoming to alleviate the immediate pressures being harshly felt today. The reality of underfunding has been increasingly highlighted in recent weeks. It’s clear that funding from central to local government is insufficient to cover the costs of providing high quality care and support and the tragic result is people are losing out on support. The new initiatives that the White Paper will introduce, such as digitisation and housing investment, are to be applauded but we are left searching for the immediate and tangible plans for change, with the funding behind it, that disabled people and their families, and the workforce supporting them, can genuinely get behind today.’

The VODG Chief Executive said 'Now is the time for the Minister to strengthen engagement with people who draw on social care, and the services and organisations behind them.’

Turning Point, a leading health and social care social enterprise, which supports people affected by drug and alcohol misuse, mental health problems and people with a learning disability is pleased the Government has honoured its commitment to publishing a White Paper by the end of the year. However, Turning Point is concerned that these proposals will not ‘fix social care’ as Boris Johnson promised.

Julie Bass, Chief Executive at Turning Point, said, ‘It’s good to see the Government’s ambition to develop more person-centred services, increase the range of supported housing options available, improve the opportunities for employment for people with a disability and recognition of the significant part of the sector that supports working-age adults, for example people with a learning disability.

‘The LGA has estimated that the sector needs an additional £2.6bn each year to stabilise the market. This is to account for increasing demand, inflation and increases to the national living wage. The money raised from the new health and care levy which has been allocated to social care reform will not meet this test.’

Visit the Government website to download The White Paper, People at the Heart of Care, in full.

In other news, The Association of Directors of Adult Social Services (ADASS) has published its latest Home Care and Workforce Rapid Survey. The survey was undertaken between 2 November and 18 November.


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