Government policy
10.6 million people. For care providers, they must be confident that the commissioning and funding environment can sustain their aim to continue to deliver high quality, people centred services that need proper funding. The efforts to understand the local costs
of providing care were made during 2022-23 in the ‘fair cost of care’ exercise. However, despite providers offering evidence-based cost data in good faith, there continues to be very significant gaps between what the state pays and the actual cost of providing care. Having commissioned and managed the process, the government is now distancing itself from the results, making a mockery of the commitment towards addressing fairness, and raising huge anxieties about the longer-term implications around the planned implementation of the funding reform in 2025. With elections on the horizon, it is vital that the urgency of social care reform does not return to the wilderness. The National Care Forum has worked extensively with our not-for-profit and charitable members to amplify their voice as well as the voices of people they support and employ. These voices are at the heart of our work and our must haves for the next government.1
1. Think social care first We need to ensure that people care about social care like they do the NHS and understand its central role in joined up health and care for people. Policymakers must consider the impact on or possible contributions of social care when developing relevant policy. We want to see an approach to adult social care which recognises how important the availability of and access to a diverse range of adult social care services is to the wellbeing and overall health of communities and enabling people to live their lives to the full. This must involve greater collaboration from other
local services that people depend on. The sector offers a diverse range of care services – not just care homes – which form an ecosystem of care and support for many communities. This includes housing with care options as well as home care, befriending services, day services, personal assistants, employment help, addiction and rehabilitation services, and services which overlap with housing and mental health, as well as the wider voluntary, community, and social enterprises sector. All too often, the voice of adult social care
providers and of people who access care and support are overlooked. Any new government’s policy agenda must include: n A commitment to beginning reform within the first parliament of any new government.
n A campaign to make social care transparent, accessible, and intelligible to the general public.
n Creation of a clear, public identity for adult social care, as recognisable as the NHS in the public’s mind which explains the diversity of provision for all ages, together with funded roles to enable the representation of adult social care providers on the membership of every Integrated Care Partnership.
n The appointment of Adult Social Care Leads on all Integrated Care Boards to ensure accountability and good governance, as well as correcting a tendency for systems to see everything through a healthcare lens alone.
n Regular analysis of current and future requirements for social care for adults of all ages, regardless of whether they fund their own care or not, which is used to inform future policy on funding, workforce, innovation, and commissioning practice to ensure we build the social care capacity we need, and that people want.
2. Improve the pay, terms, and conditions of the workforce Care work is intrinsically skilled and valuable and must be remunerated to reflect this. Currently, the skills, knowledge, and expertise of social care workers are not reflected by the level of pay that they receive: 80 per cent of jobs in the wider economy pay more than jobs in social care. Compare this to NHS roles and there is a significant difference; pay for the average care worker is £1 less per hour than a healthcare assistant in the NHS who is new to their role. At present, experience is also undervalued, Skills for Care data indicates that, on average, care workers with five years’ (or more) experience in the sector are only paid 7p per hour more than a care worker with less than one year experience.2 Accordingly, recruitment and retention is one of the biggest challenges for adult social care and is contributing to unmet and under-met need across England. There are currently 1.635m filled posts but 152,000 vacancies in the sector.3
Unmet
and under-met need are growing, there are now 5 million unpaid carers4
and requests
for care are expected to exceed 2 million in 2022/2023.5
It is likely we will need 440,000
new social care posts to keep pace with demographic changes by 2035 on top of the current shortfalls.6
This pressure is largely being driven by the failure of successive governments to bring forward a workforce plan for social care or properly fund providers to improve workforce pay, terms and conditions. We are calling on a future government
to: n Improve care workers pay to reflect their skills and competencies determined by an independent review body, aligned, at the very least, with NHS Agenda for Change Pay Bands. This must be fully funded via local or central government funding models.
n Develop a long-term workforce plan which models future workforce requirements and seeks to diversify the types of roles available and develop career structures and qualifications. This should be aligned with NHS workforce planning to enable a joined-up workforce and to enhance the quality of care provided by both the NHS and social care.
n Introduce professional registration for all adult social care workers and establish a professional body to represent them. This must be fully funded by the state.
January 2024
www.thecarehomeenvironment.com 15
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