Last month, I became Co-Chair of a coalition of providers set up to deliver a clear message to the Government: care for people with learning disabilities is in crisis, and we need to safeguard our frontline services. This coincided with the launch of our Care Crisis Manifesto, which makes clear policy recommendations concerning our funding, our workforce and, most importantly, our ability to provide high-quality care.
The coalition, Learning Disability Voices brings together charities, not-for-profit and independent companies that provide services across the UK. Representing 20% of the total learning disability sector, we provide highly-specialist care services to some of the UK’s most vulnerable people.
Supporting people with learning disabilities is one of the most complex and specialist areas of social care. As providers, we carry out an essential service, day and night, to people that rely on our support; for many individuals, their lives depend on it. Yet providers operate in an increasingly challenging market; one that is at risk of collapse. The provider sector has faced huge cuts, around 40% since 2010. The situation is exacerbated, potentially to crisis point, by the introduction of the new National Living Wage, with costs set to increase year on year. In a world where local authorities contract out care and support on an hourly rate, it is not difficult to see that when costs go up and funding does not, something has got to give.
We all recognise the budgetary constraints that local authorities are operating under, and we’ve worked together to drive efficiencies and make difficult savings wherever possible. But now, when many authorities are telling us that there will be no increase in fees, despite our increased costs, the situation is getting desperate. With the Government effectively our sole customer, there are little or no genuine self-funders, so, unlike other areas of social care, we are unable to cross-subsidise to generate private fees.
The services we provide to local authorities are directly and hugely impacted by central spending decisions. Whilst we contract locally, the funding that authorities receive in the core revenue support grant from Whitehall has decreased dramatically. Although central Government has ensured that funding can be raised locally through the 2% social care precept, this is nowhere near enough.
The Government also promises support via the centrally-managed Better Care Fund, yet no money will be available until 2017. That could be too late. Many providers have already had to leave the sector; the others that remain are facing an enormous financial challenge to their ability to provide high-quality services.
Alongside this, there has, thankfully, been progress in policies that are designed to support people with learning disabilities. Since the Winterbourne View scandal in 2011, we have seen initiatives such as Transforming Care that are striving to place community care at the heart of service provision. Yet without proper funding of providers, these initiatives will fail.
As a coalition of providers, we know that we join a chorus of organisations, pressure groups and campaign voices in calling on the Government for more funding in every aspect of public services. However, our Manifesto advances some constructive recommendations about how we can address the growing funding gap.
A starting point would be to use the Better Care Fund more effectively, to shore-up the sector with a £700m cash injection this year, rather than holding it back until 2017. These funds urgently need to be released to local authorities, in order to support learning disability services, as opposed to being used simply as a safety net to reduce pressure on the NHS. In the longer term, local authorities also need to be empowered to raise the precept to a level that ensures that they are better able to fund services.
We also urge Government to address our rising workforce costs. Whilst the National Living Wage is undoubtedly a tremendous step forward in rewarding our staff, we urgently need clarity on what should now be regarded as ‘working time’. Many of our employees work on ‘sleep-in’ shifts, which see them available to provide care, should it be needed, at night. This arrangement has been in place for decades, but classifying these shifts as ‘working time’ for the purposes of the National Living Wage will hit us particularly hard.
We have successfully worked in partnership with our one and only customer, the Government, for decades, and we want to continue doing so. Now, with a looming crisis in the funding of learning disability care, we desperately need it to step in before it is too late.
Diane Lightfoot is Co-Chair of Learning Disability Voices and Director of Policy and Communications at United Response.
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