Government policy


3. Invest in people, not profit Social care delivers public good, and much of it is funded by the public purse. Not- for-profit care provision ensures that all the funding from either government or citizens is directed towards the delivery of care, so that money remains in the sector and is reinvested into the workforce and improvement of quality of care – rather than leaking out of services. Not-for-profit organisations place a strong emphasis on the long-term sustainability of their care and support services in their communities, often having deep roots due to their origins and history in local areas, alongside their focus on person-centred care. As such, many are able to offer specialist provision for people with specific needs, such as people from different faith traditions, veterans, and the LGBTQ+ community.


Many not-for-profit care and support organisations are charities or social housing providers, so are not just accountable to the CQC but also the Charity Commission and the Social Housing Regulator. As a result, the organisations we represent, have a very strong culture of accountability, transparency, governance, diversity and person-centeredness.


We are calling on any new government to introduce measures to help not-for-profit care provision grow. This should include: n Putting people before profit through the strategic commissioning and funding of not-for-profit care.


n Developing a pathway to enable more care organisations to adopt a not-for- profit care model.


n Ensuring that regulation has a focus on financial transparency to ensure confidence and accountability.


4. Create an economic growth strategy for adult social care Social care is a large employer contributing £55.7bn to the English economy, making it an essential part of the national infrastructure.


Social care services are anchor institutions for their local communities, generating spending which remains within the community in which they exist and support a much wider ecosystem of local services and businesses. Collectively, these services are some of the biggest employers across the country, and Skills for Care estimate they contribute £55.7bn gross value added per annum to the English economy.7


For every extra £1bn in social 16


People should be at the heart of their own care and empowered to shape the development of care services


care spending, 50,000 more jobs are created across England, particularly in the North East and North West.8 Furthermore, the very nature of social care is enabling to people as it improves population health and wellbeing, creates new jobs, enables some people in receipt of care and, crucially, their unpaid carers (often women) to join or return to work and is also a powerful tool in addressing inequalities. To maximise these benefits adult social


care needs proper investment to enable sustainability, digital transformation and new models of care to meet changing demographics. We also need investment in housing and technology enabled care to ensure people are able to remain in the community and independent for longer. We want to see the development of an industrial strategy for social care which includes: n A capital investment fund to enable not- for-profit providers to develop and create new services and build new models of care, environmental sustainability and the introduction of new technologies.


n A funded national framework for the price of registered and unregistered care which ensures good quality, sustainable care wherever you live and removes the catastrophic costs providers, individuals and families are being expected to pay to subsidise the state.


n A ‘Greener Social Care’ strategy to help the sector meet net zero and environmental sustainability targets.


n Zero-rated VAT for not-for-profit adult social care providers to enable VAT on operating expenses to be reclaimed.


n New data infrastructures and a minimum data set for adult social care which allows care insights to be harnessed, co-produced with the sector and people, and it must balance data burden with data benefit and clarity on data ownership and access. Data is not free, so any strategy must ensure that it meets the costs of increased data reporting requirements.


n A new duty for CQC to promote innovation, improvement and economic development of social care services


which considers the role of LA and ICS commissioning.


5. Enshrine rights, fairness, and choice for people in a National Care Covenant If we want a system which enshrines rights, fairness, and choice for people, we need to give those with the biggest stake in the system working more power. People should be at the heart of their own care and empowered to shape the development of care services with commissioners and providers. To use the language of the Archbishops’ Commission on Reimagining Care, we need a ‘social covenant’ that sets out the role and contribution of people, communities and government and clear expectations of what support should be available.9


This support should be


universally accessible, not rationed by the postcode lottery of funding and resources. It will also require a shift towards prevention and anticipatory care which ensures that resources and funding are in place to enable people to get care and support when they need it, where they need it. The underfunding of care and support has led to a reactive approach with the eligibility threshold to access support getting increasingly higher. This must be reversed. The dignity, independence and wellbeing


of people and their families should be paramount. We need to see a situation in which people who draw on care and support have the same choice and control over their life as everyone else – a ‘gloriously ordinary life’ to borrow the language of the House of Lords Adult Social Care Committee.10 People should be enabled to live in a place they call home with the people and things they love, in communities that look out for one another, doing the things that matter to them.11 Policymakers currently assume that families will ‘step up’ to provide unpaid care which is deeply unfair on both parties and creates physically, emotionally and financially exhausted carers and robs people receiving care of an ordinary relationship with friends and family. Meanwhile, people ageing without children or other family to care for them are disregarded. We are calling on a future government to:


n Develop a National Care Covenant, as outlined in the Archbishops’ report


n Commit to a strong role for central government to guarantee universal access to care and support, security against the costs of care, and upholding people’s rights.


www.thecarehomeenvironment.com January 2024


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