Hard to believe, perhaps, but 10 years ago there was a lot of optimism around social care. The passing of the 2014 Care Act was widely welcomed as a new dawn because of the exemplary way it had been drawn up and agreed, its vision and values and its clear programme of action to address the sector’s challenges. The period since has been ‘a decade of disappointment’ in the words of Melanie Williams, new President of the Association of Directors of Adult Social Services (ADASS).
The brave new world envisaged by the legislation has failed to materialise thanks to relentless cuts in real-terms funding and postponement – perhaps now permanent shelving – of phase two of the Act which included reforms to relieve families of the terror of catastrophic care costs.
Missed opportunity
As we anticipate a general election and, judging by the polls and local election results in May, the likelihood of a change of government, will it be possible to recapture that optimism and even sense of excitement that so many people shared 10 years ago? Let’s recall those days. The Act was the product of careful and inclusive consultation that was widely praised and held up as a textbook model for future law-making.
Its focus on promoting wellbeing and prevention, its recognition of the vital role of unpaid carers and their own support needs, its acknowledgement of the potential of ‘asset-based’ work in communities, drawing on their strengths, and its placing of adult safeguarding on a statutory footing – these were all seen as hallmarks of a new era in care and support.
The 2014 ADASS President, David (now Sir David) Pearson, who by coincidence was Williams’ predecessor as Director of Adult Social Care and Health for Nottinghamshire, hailed the legislation as ‘fantastic’ and a ‘great platform’ for care and support for the next 20 to 30 years.
Then dismay. There was to be no reversal of the austerity spending cuts made by the 2010 coalition Government in response to the banking crisis two years previously – and certainly not the investment needed to fund the Act’s implementation. The departure of the Liberal Democrats from government in 2015 significantly reduced pressure on the Conservatives to follow through.
By 2019, against a backdrop of £7.7bn savings by adult social care departments in England since 2009 and two postponements of the Act’s phase two, it was becoming painfully clear that the grand vision was not going to be realised. As that year’s ADASS President, Julie Ogley, remarked, ‘The reality of the current situation remains a distant stretch from the one imagined by the legislation.’
Cautiously optimistic
And there, by and large, we remain. Funding constraints continue to be so severe that only 6% of social services directors say they can be fully confident of meeting all their statutory duties under part one of the Act.
As for part two, enshrining a version of the individual spending cap and other reforms recommended by the Dilnot review in 2011, let’s just say there is technically a plan finally to implement it next year. But don’t bet on it.
So, will it be possible for people to start believing again? Labour’s vision of a National Care Service is intended as a rallying cry, but currently lacks detail and colour and would anyway take another 10 years to bring about.
In a new briefing ahead of the general election, the Nuffield Trust thinktank has sought to sketch in some of the particulars and has identified eight essential factors, ranging from parity with the NHS to workforce reform and fair fees for care providers. ‘At its best,’ it says, ‘social care gives people of all ages choice and control over where and how they live, underpinned by principles of wellbeing, prevention and dignity.’
Words and sentiments which could have come straight out of the 2014 Care Act. The tragedy is that for too many people, in too many parts of the country, they remain an aspiration.
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David Brindle is a social care commentator and Chair of Ambient Support.
Email: [email protected] X: DavidJ_Brindle