Social care in Somerset must stop being 'the poor relation of the NHS' as MPs call for extra funding

By Daniel Mumby - Local Democracy Reporter

12th Aug 2022 | Local News

Mel Lock, Interim Director Of Adult Services At Somerset County Council. CREDIT: Daniel Mumby.
Mel Lock, Interim Director Of Adult Services At Somerset County Council. CREDIT: Daniel Mumby.

Social care in Somerset must stop being seen as "the poor relation to the NHS" if recruitment issues and the cost of care are to be tackled, according to the county council.

The levelling up, housing and communities select committee has published a report calling for a drastic increase in funding for adult social care across the UK to offset inflationary pressures and tackle recruitment issues.

Somerset County Council has backed the calls for extra funding and a more long-term vision which would allow it to plan how funding is allocated over several years.

Here's what you need to know:

What has the government done so far on adult social care?

Since Boris Johnson became prime minister in 2019, a number of reforms have been introduced to the social care system in a bid to make it more affordable for residents and address financial shortfalls elsewhere.

These included capping the amount people would pay for their personal care at £86,000, and making means-testing for state-funded care "more generous".

Under the Care Act 2014, people who receive care in a care home can now access the same, usually lower, fees paid by their local authority.

The government has also introduce the health and social care levy, ring-fencing £5.4bn over three years to fund social care.

But even with the mitigating circumstances of the coronavirus pandemic, the select committee does not believe these changes go far enough.

What did the report say?

The committee's report was critical of the level of funding that social care was receiving, arguing that difficulties in recruiting and retaining staff were being worsened by rises in inflation and the national minimum wage.

While the health and social care levy has raised funding, most of the money has been going to the NHS instead of social care – and what has been allocated there is paying for the reforms, not tackling immediate cost pressures.

To remedy this, the committee has recommended additional funding of at least £7bn be allocated to social care immediately to offset inflationary pressures and allow local authorities to plan their care provision more than 12 months in advance.

The committee has also warned that the "increasing reliance" on funding social care through council tax receipts does not strike "the right balance" between local and central government.

Clive Betts MP, who chairs the committee, said: "As prime minister, Boris Johnson said he would fix the crisis in social care once and for all.

"The government deserves credit for attempting reform and for acting to try to prevent the unpredictable and catastrophic costs which can be inflicted upon people for their care.

"However, the government should be under no illusions that it has come close to rescuing social care and it needs to be open with the public that there is a long way to go.

"Ultimately, whether it relates to immediate cost pressures or on wider structural issues in the sector, the fundamental problem is that there continues to be a large funding gap in adult social care which needs filling. Those who need care, their loved ones, and care workers deserve better."

The committee has also called on the government to publish a ten-year plan for reforming social care, including measures to retain and grow the workforce and to ensure pay parity with NHS staff.

Mr Betts added: "The NHS and adult social care provision should not be pit against one another. The two systems are interdependent and each needs to be adequately funded to reduce pressure on the other.

"Wherever the money comes from- from allocating a higher proportion of levy proceeds to social care, or from central government grants – the government urgently needs to allocate more funding to adult social care in the order of several billions each year."

How has the council responded?

Somerset County Council is currently responsible for adult social care, with these services transferring to the new unitary Somerset Council on April 1, 2023.

Councillor Heather Shearer, portfolio holder for adult social care, said: "The select committee's report reflects the national reality that social care desperately needs long-term sustainable funding, and urgent financial support is required in order to meet current unmet and under-met need across the sector. I would argue that we have yet to see the national political will to do so.

"But it isn't just about funding, it's also about parity of esteem with the NHS. For too long, social care has been treated as the poor relation to the NHS, and government urgently needs to address the disparity in pay and terms and conditions between health and care workers in order to attract vital staff to the care workforce.

"Until that parity is in place it will be immensely challenging to keep a skilled workforce in the field. Providing high quality care to our most vulnerable residents should be the measure of us as a society.

"We should pay staff properly for the valuable work they do. They should not be able to earn more stacking shelves."

Mel Lock, the council's director of adult social care, said the care market in Somerset remains fragile as a result of ongoing staff shortages and the cost of living crisis.

She said: "We are already working closely with our care provider market in addition to the NHS and community and voluntary sector to manage the challenges we're facing, but there is a workforce shortage.

"This, alongside the cost-of-living challenges, is causing fragility in the market nationally and in Somerset.

"Upcoming changes to the way care is funded will continue placing additional demands on this workforce."

The council has taken numerous steps over the last few years to highlight the issues surrounding adult social care – including a central role in the BBC Panorama investigation 'Crisis in Care', which was broadcast in 2019.

Ms Shearer said: "We do not shy away from telling difficult stories in Somerset, and we'll continue to make our point, lobbying for appropriate funding through the Local Government Association and the Association of Directors of Adult Social Services in England.

"We have had no steer at all over the local government settlement for the coming year, other than Michael Gove indicating that he was keen on a two-year settlement. Obviously, with a leadership election going on, all bets are off."

Ms Lock said Somerset had "unique challenges" in light of its ageing population and predominantly rural character – with local solutions such as micro-providers only being able to go so far in meeting patients' needs.

She said: "Somerset's ageing population is a bonus in many ways, as people continue to volunteer in their communities and keep that vibrant community support.

"As we all live longer, the ageing process affects us all. This, alongside the rural nature of Somerset, presents us with unique challenges, but social care is an absolute priority for the council.

"Events of the last two years have resulted in a perfect storm of pressures – reduced workforce capacity across the sector (including recruitment of social workers and occupational therapists), increased complexity and a rising demand for care, cost of living pressures, and challenges in the private market such as home closures.

"This is why our relationships with the NHS and community and voluntary sector are absolutely critical in helping us manage system pressures and respond to changing demand."

How do the care operators feel?

Dimensions, which provides services for adults with learning disabilities, has been working in partnership with the council since 2017 under the 'Discovery' banner.

Chief executive Rachael Dodgson said the government needed to act quickly to ensure sufficient funding was in place to "meet immediate pressures" and ensure all staff were properly paid.

She said: "We recently published our 'workforce manifesto' which aligns closely to the findings of the select committee's report, calling for this additional investment and parity of funding with the NHS for front-line workers.

"Pay is the key issue in this staffing crisis and social care workers should be paid at a level that reflects their contribution to society and the skill set required to perform their role.

"It is not just about providing personal care, it is about supporting individuals in all areas of life, from their health to finances to social relationships.

"The government should heed the report and grant providers more resource to address these issues, which have been allowed to fester for far too long. A well-staffed, motivated social care workforce is one of the best methods to reduce pressure on the NHS.

"We know that local authorities and commissioners are struggling to meet demands for assessment and that there are significant gaps in resource nationwide that make the delivery of reforms incredibly challenging for local government.

"These problems are exacerbated by a shortfall in funding that makes it difficult for councils to meet providers' pay requirements. This creates significant risk for some of the most vulnerable people in our society.

"How many more reports are necessary to make the same fundamental points? Investment in social care is needed now. Lives depend on it."

     

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