The last 12 months have been possibly the toughest ever for the care sector; they have also been the ones with the greatest ever focus on social care. Providers and their amazing staff have been at the forefront of this dreadful pandemic and, out of all the misery, pain and destruction, I am determined to use the spotlight that has been shone on our sector to bring about something positive – namely, change.
We have heard whisperings that adult social care reform may well be included in this year’s Queen’s Speech. This is not a moment too soon and Care England will do all it can to ensure that such legislation will neither be too vague nor be kicked into the long grass. It needs to cut to the heart of the necessary reforms. Central to these reforms is the need for a 10-year plan for the adult social care workforce.
Our workforce is our best resource and we need to cherish it. Care needs to be a career of choice, not simply something that people fall into. It needs to be on a par with careers in the NHS, not just in terms of status but also in terms of access to training, resources and benefits. We have come a long way from the beginning of the pandemic when our workers found it impossible to be recognised as key workers and, ironically, now the vaccine centres are full of people claiming to be social care workers. How the pendulum has swung, and we need to harness that swing and push for a better deal for care workers.
Of course, none of this is possible without the financial resources. Until the Treasury realises the net worth of the sector and the fact it is a vital part of the national infrastructure, we will not have the necessary funding. I find it incredible that commissioners, some of whom have worked so closely and effectively with providers during the last year, are not only worryingly late with their fee offers but, when the fee rates are delivered, they are woefully low. How can a provider sustain their quality of care when offered such pitifully low rates?
The irony is that the Government has never been so generous to the sector; however, as providers will bear testament, much of these COVID-19 relief funds have simply not reached the front line. We have appealed to various Government departments not to distribute money via local authorities; a simple audit would show the huge inefficiencies and lack of direction. Reform needs to audit the delivery of these funds, as well as the impact they have. The bottom line is that everything needs to be commissioned for outcomes and we can measure these by the impact on the individual; success is about what the person experiences.
One of the unintended consequences of the plethora of guidance for the sector has meant, in some cases, a loss of confidence by providers. For example, the visiting guidance has had so many different permutations and been so contentious, that it has been hard to satisfy all parties involved. What we need is support from the Department of Health and Social Care, as well as our local Directors of Public Health, where we can work in tandem with them.
Last year, Care England produced its own statement of principles with regards to visiting. These principles will, we hope, form the basis of any future guidance; they set the parameters. They are also operative for all care settings, including those for people with learning disabilities who have been largely forgotten throughout this challenging time.
The impact of COVID-19 on people with learning disabilities, particularly since Christmas, has been appalling and this invisibility is another issue that needs to be addressed. For example, we had to fight incredibly hard to ensure that people with learning disabilities were a priority group for the vaccine, sadly too little too late. One can’t help wondering where the regulator was during this time of crisis. CQC has consulted on its new regulation and it is slightly disappointing that it took a pandemic to highlight some of the pitfalls associated with CQC’s regulatory model. It is important that this new regulatory approach is informed by a fair and proportionate framework, which gives providers the ability to speak up against inaccuracies and also to request timely reassessment.
Yet, despite the tragedy associated with this past year, I have been overwhelmed by the innovation and ingenuity amongst Care England’s very active membership. We need to hold on to the fact that reform could be within touching distance and we will do all that we can to ensure that providers are armed and equipped to move into the next phase.
Martin Green OBE is Chief Executive of Care England. Twitter: @ProfMartinGreen. Share your thoughts and feedback on Martin’s column below.