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Adult social care – workforce web forum

Levelling Up, Housing and Communities Committee

  • What works and what doesn’t work about the current system?
  • Are you able to provide the services people need?
  • Is there sufficient funding available for adult social care?
  • Have you come across any successful alternative approaches for financing and providing care?
  • What has been the impact of recent policies, like the 'social care precept' on council tax and the new national living wage?

Return to the adult social care inquiry

23 Contributions (since 11 August 2016)
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Total results 23 (page 1 of 3)

Tony Dailide

02 September 2016 at 12:37

In my experience the cuts to social care budgets have undermined the progress on personalisation and the hopes contained within the care act. With less money and fewer staff local authorities are unable to invest the extra time to get support right first time. Pressure makes staff take a line of least resistance and put in place quick fixes. Centralisation and reductions in back office support while protecting the front line removes essential infrastructure and front line managers spend more time on administrative tasks. Cuts to voluntary sector grants mean less available community support at a time when there is a greater push for prevention and early intervention to reduce or delay the need for social care. This contradicts the spirit and practice in applying the Care Act. Local authorities are reluctant to publicise services for fear of demand they cannot afford to meet. Corporately adult care is little understood and remains the biggest financial risk. The precept has been unfair in raising large sums in affluent areas and small sums from the Least well off council tax payers in poor areas. It has not even covered the national living wage rise and providers are beginning to pull out of the market. Finding home care packages is becoming more difficult leading to delays in hospital discharges among other things.

Patricia Patterson

01 September 2016 at 15:55

I am a manager and work for a local authority. We provide a range of supported living, day services, employment support and residential respite. I personally rank our service highly. We have staff consistency with many staff knowing clients from a young age and understanding their needs , good training and the service expects a high standard of care from all our support staff and the emphasis is on outcomes and prevention. The quality and governance procedures have been much improved and safeguarding issues are flagged early and followed up. There has been a move away from local authority provided services. I believe in some cases this has been very beneficial for clients and as a service we have supported individuals to progress by moving into situations that enable them to be more independent ie housing, jobs and volunteer work. There are also a large number who really benefit from the knowledge, relationships and support that they receive from a service who knows them well. As long as the focus is on outcomes and continual person centred support in terms of moving people forward to situations that help them develop, a lot can be achieved for an individual if the staffing is consistent and knowledgeable about the person. As a social care provider, we do rely on sufficient funding to provide a good quality service to the individuals we support. My particular area of concern regarding costs and funding streams is regarding the continual work and benefit related reassessments of individuals with learning disabilities who receive adult social care funding. The face to face assessments are costly and very distressing to individuals and their carers and due to the lifelong conditions of individuals, the results of the assessments provide very little change to the persons circumstances or financial situation. The costs of these could be redirected to support long term job coaching for individuals who have the capability to work or volunteer but need a lot more support to maintain and carry out a job. Many of our clients require long term supported permitted work and there are very few agencies that provide this. The existing assessments for things like ESA and PIP do not allow for the correct assessment of people with mental health conditions and LD as they focus mostly on task related activity rather than cognitive ability. There is also an inconsistency in approach of workers when clients are attending their work capability meetings and this needs to be addressed through training and effective communication with all departments. We have had several instances of needing to appeal for people with autism, mental health conditions or learning disability as their assessments have not reflected the reasons the individual is within the adult social care service. More emphasis on customer co-production, co-operatives and social enterprises could help to move people from services into situations where they have much more control about the outcomes they achieve. We have had a number of individuals who have supported permitted work support and the national minimum wage increase has impacted on their ability to work more hours due to the ceiling on income related benefits.

Rob Gready

01 September 2016 at 15:06

We are Home Care Providers and we have a good working relationship with the Local Authorities and CCG's. It is the mantra of the moment to have integrated services across Health and Social care, but it is still not working well enough. Our view is that trusted Providers should be able to more easily move clients up and down the Care sector according to their need, so called step up and step down. This should be controlled by those closest to the client or else the service is simply not responsive enough and therefore normally lands up costing more as the intervention takes place at too late a stage. We are able to largely provide the service people need but over the last years the level of need clients have when we first get commissioned is far higher than used to be the case, this impacts on quality of life and most likely overall cost. If the whole Home Care sector is to move to Outcomes driven payments and commissioning there is a very large cultural gap to fill in that clients believe they have certain entitlement and Caregivers feel the same. This is a very considerable issue and will take a considerable time to change. The impact of the National Living Wage has been immense and there was already and now is an even bigger funding gap. Even with the Social Care Precept there is very significant underfunding which has driven down the wages we are able to pay which in turn impacts recruitment and retention. It is likely the current approach to commissioning will lead to significant numbers of Providers either ceasing to offer services or being in a position where compliance with NMW regulations is unlikely. There are far too many providers in the sector, although small can sometimes be excellent, overall it simply does not work we need very profesional providers who are able to invest in support, training IT, excellent recruitment retention and HR systems, in other words providers with really good management systems and in the homecare sector there really is much work to be done.

Mary Anson

01 September 2016 at 15:00

I am a care provider in Cornwall. We have virtually full employment locally and recruitment of those with the right values is extremely difficult, both in care homes and more so in Domiciliary care. Younger carers cannot do care at home because largely they are either non car drivers (public transport not possible) or their cars have restricted mileage for insurance purposes. Tax credits have created a climate where fulltime workers regularly reduce their hours to part-time in order to benefit from such benefits. Overtime pay (eg Christmas and bank holidays, triple time paid) resulted in staff losing housing benefit. Changing family groupings with fluctuating partners results in a lack of informal childcare for weekend or evening support, so too few carers are available to support vulnerable clients at times required to meet their needs. Too many staff work only to tax credit thresholds. Too many staff work part time. Shortage of carers, shortage of cooks; we have tried apprenticeships but lack of 'work readiness' amongst school leavers who wish to socialise on Fridays and Saturdays making them unfit or unwilling to work on Saturdays or Sundays. I am a governor of a local secondary academy and do my best to identify suitable school leavers to offer training, and so far most leave for various reasons linked to work that allows for social lives that fit better with their friends. Pregnancy is seen as a route to lots of money without having to work (much) for it, eg new employee taken on last month informed us after commencing employment that she was pregnant, at 19, with her third child. No partner so not much childcare. Family friendly policies are great-I'd have welcomed some myself! But they do not fit well with a career in social care. Years ago as a staff nurse myself, women in a relationship who had a family considered they were lucky to have a career that enabled them to work, for example, for two split nights per week so they could manage their own children and still have a reasonable sleep pattern. In Cornwall (I can't speak for other parts of the country) we need to recruit into the county from elsewhere, but would benefit from personnel who come to a fixed job role tied to an immigration permit, and who cannot immediately move onto family tax credits (I have a European worker, with a teenage daughter, who within a year was using the NHS to a considerable degree, the education system, tax credits and reduced hours to a tax credit threshold.I have provided accommodation-a two-bed flat not tied to the job-but am not allowed by government regulation to charge enough to cover my costs as I can only charge the 'accommodation offset allowance' of less than £6 per day, despite no bills to her and her daughter, other than food.I purchased further facilities to provide a house in multiple occupation for singles to share in order to recruit sufficient staff to safely care for people in the community, but cannot afford to do so just for the accommodation offset allowance, which I didn't realise prior to purchase. I have had to rent it out on the open market and not to employees; social care is not benefiting from my attempts to create an environment which might entice foreign or local workers to enter the social care workforce. The standard of English and maths amongst our own school leavers has definitely deteriorated in the years I have been a care provider, and now CQC regulate on the quality of documentation which some very good carers lack; the Key Skills training required for some of the qualifications we support does not compensate for deficiencies in their early years education. For this I do not believe the education system itself is to blame, but the change in parental attitudes to schooling, where education (here anyway) is not seen as important. My daughter in law attended a parents evening when my granddaughter started school where the purpose was for teachers to show parents the current teaching systems so they can help their child at home. 12 parents attended out of an intake of 90 children. Care as a career is too often denigrated. A secondary teacher has said 'if you don't work a bit harder you will end up a carer'. Another, primary child, responding to a discussion about future careers, said she wanted to look after people, and the teacher said,'what, not OLD people? You can do better than this, you could be a doctor'. The children were seven years old, and not everyone can be a doctor, no matter how admirable such aspirations might be; NO careers should be trashed in this way. This is the climate that social care struggles to survive in, and higher wages than stacking shelves in a supermarket, no matter what the Living Wage might offer, have to be available. And publically funded social care does not make this(or a quality service) possible. A supermarket is too often seen as a much more attractive way of working-if you have to work at all, that is! We have some wonderful staff; but the local workforce is ageing and not being replaced. [Edited to remove abbreviations]

Mike Frizzell

01 September 2016 at 12:53

We are continually frustrated by Governments promising to do things such as capping costs and then realising it is unaffordable. The previous Labour government spent years kicking the issue into the long grass. The introduction of the Care Act has done little to change anything as there has been no funding for it. I can say that the "social care precept" is just another way of taxing us to see no difference on the ground. Home ownership should not be burdened with this tax. The national living wage has put up prices for Private Funders but is just further cross subsidising the Local Authority who have not put funding up. The current system is plainly failing because of people wanting things for free when they have not made any provision at all for their future. If the care cap had been introduced then insurance products would have been introduced to enable people to cover these costs. There has been talk of using technology with Telecare and Telehealth but in reality we see little happening to change the need for one-on-one care. I personally do not understand why Social Care is left with Local Authorities where the Senior Managers do not come from a Health Care background and councillors are unlikely to be aware of the issues. We need to hand our Care system over to people who have a background in Care. The Local Authority often take a bureaucratic view where we get tied into recording hours of work, we have difficulty being paid and more senior people are totally oblivious. We need a totally separate organisation that has a remit for prevention, the application of technology and is innovative in its approach. It deals with the welfare of people separate from the NHS obsession with being good at dealing with us once we are ill and dishing out a high level of medicines that cost the NHS a fortune. I could go on but do not expect anything to change.

Joseph Schneider

01 September 2016 at 12:01

I would also add that I am currently researching and trying to move forwards with starting a Cooperative Support Agency but the resources for this approach are not available. I believe a cooperative could be an excellent alternative to the current problems of hierarchical and outdated agencies where the system is based on a command/punishment structure rather than on cooperation. This is, of course, the problem with politics at large. And the same reform that needs to happen on a constitutional level needs to happen on the level of care providers.

Joseph Schneider

01 September 2016 at 11:57

This is posted on behalf of members of The Care and Support Forum facebook group. “We as carers are the worst paid group of people ever. I've worked in both a care home setting at £7.20ph and also as a live in carer at £700 a week for being there 24/7. It's about time us carers were paid what we are worth and especially when my friend who works at a supermarket as a cashier is earning up to £10ph for just putting items through a till.” “I feel absolutely worthless at my place of employment. I have worked there for 14 years next month. I’ve worked hard been a loyal and trustworthy member of staff. I’ve hardly been off sick in the whole 14 years. I’ve had my nvq 3 since 2000 and always been a senior from the start. I’ve now had my pay cut, my extra weeks holiday taken i accrued over the years and my double time on bank holidays. I’m on just over the minimum wage now. How can they get away with treating staff like this and they are meant to be a caring industry. I feel so worthless I’m considering giving up care altogether.” “I think zero hour contracts should be abolished also, i have recently resigned from mine a few months ago. I worked for 3 years never knowing how much money i would bring home each week due to irregular hours. It was a case of who picked up the most calls and also if 'your face fits'. I'm now working for a different company, i have a contract and i am enjoying my work a lot more i know when im working and have regular hours.” “They should be abolished. Its nothing but a sidestep of workers rights and the gateway to the pseudo self employed status of workers in many jobs now. The flexibility is something the job should offer its staff, the flexibility of zero hours in my experience is essentially resigning and hoping that the boss will rehire you after the day away. Zero hours hands everything to the people that already had the power.” Joseph Schneider: I have worked as a support worker for people with learning disabilities for five years. I see a system underfunded and underesourced and under enormous pressure. Time and money constraints mean our jobs become far more stressful than they need to be making it an unsustainable job. Not to mention the now critical level of low pay that has the already lowest paid members of society take a in real terms 14% pay cut. Care and support staff are commonly working a more than 45-50 hour week to simply make ends meet. My gross full time salary is £15,170. I have had to drop out of my studies which I saw as a route to better paid work because I can't afford the fees. I love many aspects of the work and working in this sector has been transformative. And I would like to remain working in some way in the social care sector. And not just feel trapped in a job with no prospects. But there needs to be a series of changes to address the very serious problems. I see The Social Care Forum and my own initiative The Care and Support Forum as a very small step in the right direction. But more needs to be done to, in particular, address the concerns of care and support workers themselves. But the first step has to be to try and understand why they are not speaking up in the first place. A lack of confidence? Fear of reprisal from employers? A lack of confidence in trade unions? Whatever the reasons there needs to be a national campaign that places the voice of care and support workers and all that silences us, and all that might release and encourage our voices, at its centre. That is why I started the forum and why I will become a regional rep for the UK care and support workers association. My outspokenness is not particularly welcomed at my place of work. But I will continue to speak out. And to find a way to persuade others to join me. The government and employers needs to encourage this self-advocacy and self-care, not seeing it as a threat, but as the first step to care and support workers feeling more valued. And ultimately then giving more to their jobs. Kath Baker: I'd add that the companies I worked for fell short in what they provided for my people - pocket money, birthday cake, activity materials - when they were in the contracts. The only way to get them was for us staff to pay for them. In "fundraisers" such as raffles, fairs, crafts etc, staff not only donated most of the goods, we bought the tickets and those same goods back! So as well as having minimum wage we were effectively taxed to provide the materials for the care we were delivering..... [Edited to remove company name]

Joseph Schneider

01 September 2016 at 11:55

This is posted on behalf of members of The Care and Support Forum facebook group Janette Cross: Until the last 3 yrs I have always had office jobs... Most of which paid £9.50 or more per hour. I wanted a complete change and found myself in Domiciliary support work. I love the job but the pay is extremely poor in comparison to what you have to do... I've just recently completed an NVQ level 3 to better myself and yet there is no pay rise to recognise this.. If there was an issue that arose at a job and I was with a level 2 qualified colleague it would ultimately rest on me to make the decisions yet we are both paid the same. I find it very odd that this type of work is paid so poorly.. I can see the argument that anyone can do this job, qualified/unqualified… Experienced/unexperienced because it's that poorly paid there isn't going to be a long queue of people who want to get into this industry. At the end of the day the majority of carers do it for just that, they care. A lot of care workers are not too far away from being nurses.. We administer medication, peg feed, first aid, mental health, counselling, manual handling, personal care, risk assess, safeguard, chauffeurs, shoppers, finance & budgets, companions, advisors, activity buddies, we deal with death, trauma, violence, illness and so much more.. Written down in this way in black and white, it seems to me and I imagine a lot of care workers that this job should be paid accordingly and with a degree of common sense. We are carers who look after people who so badly need it, and without us the government would be faced with a quandary… Who is going to be responsible for these people who are unable to live independently and more pressing for them would be the question.. How much is it going to cost? This will never happen of course but if it did they would be forced to scrutinise what is required for this role and what sort of people it takes to do it. Rachel Ann Sullivan: I love this idea.... I wish we were listened to. Aside from being carers/ support workers... We have bills to pay and families of our own to look after. Our pay packets do not reflect the valuable and NECESSARY contribution we make to society. I do love my job but with it comes responsibility, unsociable working hours, & loads of training and working towards qualifications. We are undervalued... And often overlooked.... But the truth is: what would happen without US?! Niomi Giles Taylor: I love what I do but to be paid the hours I am actually in uniform and at work instead of just for the calls I do would be lovely! I don't know many other jobs that you work 14 hour split shifts but only earn 10 hours money. Also, as a home carer, a government allowance or some kind of 'bonus' at the end if the year towards wear and tear on our cars would be great! I do roughly 12000 miles a year for work......that's a set of tyres! Rachel Bridle-Evans: The jobs we do if dissected would read, carer, chef, confidant, counsellor, priest, life-coach etc. Many years ago family would look after our service users, there is no parity in what we give and what we receive. Our bosses earn more for less stressful work, the company owners holiday abroad three times a year, what do we get, job satisfaction but why not good pay for a job well done? Paul Featherstone: I agree with all of these comments BUT lets look at our vocation in the context of where we sit in the social care setting. We are the lowest tier, there are no formal educational requirements, anyone can become a carer, its more often or not a job of last resort, rather than a job of choice, the majority of tasks in a Dom care setting entail some form of personal care, that most people would balk at, we are not respected, valued or recognised, many of the established Health Care Professions have serious concerns that an unregulated and unqualified individual has the responsibility for providing ongoing care and support for a vulnerable person, so it stands to reason our pay is going to reflect all of these issues. Am I happy about, damn right I'm not! But unless and until the perception of our vocation is changed, our pay is not going up anytime soon. [Edited to remove reference to external campaign]

Michael Baines

01 September 2016 at 11:31

It is incredulous that all key stake holders within the health and social care sector including the Association of Directors of Adult Social Care, the Care Quality Commission, the UK Homecare Association and Clinical Commissioning Groups all acknowledge and concur that the social care system is in CRISIS resultant from continual financial austerity measures. This has been compounded by continually increasing demand from an ageing population which increases the pressure on the whole health & social care sector. Central Government policies imposed upon employers have led to an increase in operating costs including the introduction of the Living Wage (increasing in 2017), introduction of work place pensions (increased employer contributions 2017), and introduction of Apprenticeship Levy 2017. However, fees paid by Local Authorities have in many cases not been increased over a number of years and when they have been applied; they do not cover the aforementioned costs or inflation. The social care precept tax lead to increases being allocated by local authorities that did not even cover the Living Wage increase to front line care staff, let alone enable providers to maintain the differential between the carers pay and their managers which is resulting in a transience of highly skilled and experienced staff from the sector. Consequently, many providers have to evaluate if it is actually commercially viable to continue trading within this sector. There is an inherent danger that many large providers will diversify out of the sector which coupled with the current under provision of care will lead to a complete collapse of the system with the safeguarding issues resulting being unimaginable. The key decision makers within Central Government Have to address these issues now as a matter of urgency or a catastrophic failure of the current system will occur in the very near future. [Edited to remove abbreviations]

Christine Rowberry

01 September 2016 at 08:38

As an independent provider of complex care packages for 16 years I can honestly say the position has never been so desperate. As employers we aspire to achieve a vibrant workforce to support the vulnerable in our society . But funding is woefully inadequate onerous administration burdens imposed create back office administration costs and further dilution. The funding available for social care simply has to be increased so doing so enables support of the NHS . Integation is the key but this must be managed well and with all parties engaging and at the table. The independent sector should be respected as the professionals we are and enable growth and recruitment with adequate funding please.

Total results 23 (page 1 of 3)