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By Debbie le Quesne

Archive for the ‘Budget impact on care’ Category

As the Red Cross intervene with the NHS, what will it take force a social care lifeline?

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The other Saturday I watched the television news with a stunned sense of disbelief as the chief executive of the British Red Cross announced the NHS was in the middle of a “humanitarian crisis”.

I’d never thought of the Red Cross intervening in UK affairs in such a way – don’t the images of this worthy, brave orgaisation invade our news from far flung places where there’s famine and the ravages of conflict? Not any more it seems.

To hear its top man, Mike Adamson, explaining exactly what defines a humanitarian crisis and that it’s is now in England, stopped me in my tracks.

His definition was along the lines of . . .

“It affects many people over a prolonged period of time, something of threat to their health or wellbeing. Just think about the situation of someone, for example, waiting on a trolley in and A&E department for several hours, perhaps with no family around them after a fall, probably quite frightened. . . .”

The warning came as it emerged two patients died in the same A&E department within a week during “extremely busy” periods.

In December A&E department shut their doors 140 times and now cancer ops are being cancelled, I read in the newspapers.

Mr Adamson added extra cash was needed for health and social care to make the system sustainable.

What was that? Extra cash for social care. Indeed!

Sadly, at the root of the NHS crisis is a failing social care . . . and we have warned for years that it was terribly broken. They would not listen, and I’m not convinced they are listening now.

The official response from the NHS is predictable: What crisis? And this still remains the official line.

I find it odd that hospitals like Russells Hall, Dudley, is allegedly paying a company to try to help sort out their funding, either by pressurising care homes to drop their fees, or getting patients’ families to become fiscally involved. Surely this could never catch on after the government’s stalled attempt to get the public to invest in care insurance policies. The elephant in the room, of course, is a properly functioning social care system. Everyone knows it. The government, however, steadfastly refuses to acknowledge it.

Mr Adamson explained: “The British Red Cross is on the front line, responding to the humanitarian crisis in our hospital and ambulance services across the country.

“We have been called in to support the NHS and help get people home from hospital and free up much needed beds.” Called in by whom? I suspect the Department of Health.

Shadow health secretary Jonathan Ashworth said it was “staggering” that the Red Cross had been drafted in to help. I think so too, though I would add that his Government did precious little to grasp the nettle of social care during its term.

Of course, there’s much politicking to be had over this development in the care saga so we need to focus on facts.

Just about a year ago bed blocking was costing the NHS about £820 million per year.

Last summer the National Audit Office said delays in discharging patients from hospitals in England had risen by nearly a third over two years. Delayed transfers (bed blocking) have not improved and there’s a resigned approach that’s punching through that deeply disturbs me.

Across England, the audit office found that for every 100 beds, three days of use were taken by patients who no longer needed to be in hospital between March 2015 and February 2016.

Quite what 2017 analytics will deliver terrifies me, because it is in direct correlation to the ability of social care to unblock beds – something it can no longer do. And we all know the reasons why.

The question now is this: Exactly what will it take for the Government to intervene? Will it deliver the much-needed financial lifeline to social care, which could not only rescue struggling care providers, but also our hospitals and . . . dare I say, those people who need either one or both of those services,

 

 

Autumn Statement: My utter disbelief

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Like millions of others, I listened to the Chancellor’s Autumn Statement in a stunned disbelief that after unprecedented pressure he failed to deliver on social care.

Secretly, I’d been hopeful that, as ITV put it, this vital area of funding would be Philip Hammond’s “rabbit out of the hat.”

But the man, who is privileged to represent the constituents of one of the wealthiest areas in the UK, said absolutely nothing on the issue so many of us were pinning our hopes on.

As the Prime Minister pointed out in PMQ’s, local authorities have been allowed to raise council tax by 2% to help plug the funding gap. But, especially in poorer areas where council tax receipts are low, the “social care precept” has barely touched the sides.

The irony of it all I find was in the closing comment calling it a plan that “provides help to those who need it now.”

On what plant does this Chancellor live?

It was no surprise that leader of the opposition Jeremy Corbyn chose to focus on health and social care as he took on the Prime Minister in the Commons before the Autumn Statement.

But is set a stage of clear demarcation – between reality and Cloud Cuckoo Land.

Love him or hate him, Corbyn urged the Government to plug the gap and address the “stress and fear” it causes.

Unremittingly bleak, social care providers have done an amazing job in recent years without the central funding to sustain long-term credible business models.

Local authorities have also been forced to pare provision back, to in the opinion of many, dangerous levels.

For six years there have been unprecedented cuts to LA budgets, with figures suggesting those people eligible for council-funded care falling by 25 per cent.

Teresa May’s almost apologetic herald for the mini-budget of gloom was found in her comment: “We can only afford to pay for the NHS and social care if we have a strong economy”.

My life! This is another George Osborne in this key role.

Well, Mr Hammond, may I congratulate you on your sheer brilliance in ignoring perhaps the most pressing social dilemma since the introduction of the Three-day Week in 1974.

Predictions of “looming chaos” were rejected by the Chancellor.

Philip Hammond said a previously announced NHS funding commitment was in line with what its leaders had wanted.

Health and social care leaders are reeling and unanimous in their condemnation.

Now the Treasury has made its stand, with Mr Hammond confirming that ministers would be sticking with departmental spending announced last year, the official unraveling of social care can begin.

In a new briefing published ahead of the Autumn Statement on 23 November, the Health Foundation, The King’s Fund and the Nuffield Trust analysed the state of health and social care finances, concluding that cuts and rising demand will leave adult social care facing a £1.9 billion funding gap next year.

What a cynical approach to well-founded information in the care sector we have witnessed. Is this bordering on criminal neglect . . . interesting thought.

And finally (for now): For once I am in a position to sympathise with the local authorities in the West Midlands and particularly Birmingham which is £50million in the red already this year.

No lifeline, the extra burden of the living wage  . .  and effectively an abandonment of responsibility for those in need and their care providers. In the industrial West Midlands  there simply are not enough self-funders to keep the sector afloat and bolster the care of those people funded by their local councils.

A budget for the JAM people (just about managing), Mr Hammond. Not in my world, Sir.

 

 

 

 

– Debbie LeQuesne CEO

At last, the embattled social care sector is making the headlines it needs

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Billions of pounds are needed to avoid the NHS and social care crisis – that’s the message which has been sent to Secretary of State for Health, Jeremy Hunt.

According to the Daily Mirror, leaders in the care sector have alerted Mr Hunt after three health areas revealed they face a combined shortfall of more than £2.4billion by the end of the decade

As we broke into November, the dire warning outlined that without extra money they will struggle to meet waiting time targets, provide enough hospital beds and basic levels of social care.

Sounds familiar, doesn’t it, and it’s right on our doorstep.

The Mirror reports: “The verdict is contained in the newly published Sustainability and Transformation Plans (STPs) for Birmingham and Solihull, North Central London and South West London.

Sustainability and Transformation Plans were ordered by NHS England boss Simon Stephens in December 2015 and charged 44 regions in England to come up with a five-year programme for providing health and social care in their areas.

I’m not a lover of red-top journalism, but this report is exactly what’s needed.

And it adds: “Of the three reports published so far Birmingham and Solihull warns it faces a £712million shortfall by 2020, South West London £828million and North Central London £876million.”

For the record, West Midlands Care Association is working very closely with Birmingham City Council and assessing the impact throughout the neighbouring Black Country region.

The shortfall will doubtless impact on areas already struggling like Sandwell, Walsall and Dudley.

Mark Rogers, the chief executive of Birmingham Council, says in the piece both health and social care face “huge challenges”. According to Mirror “this includes the need for at least 430 more hospital beds in the region.”

Personally, I’m struggling to find a creative way forward. All the cuts in social care have already been made and I fear the duty of care caveat is lost somewhere in the ether.

Budgets are not just shrinking, they are vanishing and the demand for care is astronomic.

Mr Hunt, I fear lives in a bubble as MP for South West Surrey, and as we all know the social care financial map is very different in his constituency.

There is a laudable push to get people out of hospital and back into their own homes with social care support. But it is catastrophically failing.

Let me quote the Mirror again: The North Central London STP says it is not “able to deliver universally for everyone to the standards we would like.

“Our analysis tells us that too many people stay longer in hospital than is medically necessary. There are challenges with meeting acute standards, as well as issues workforce sustainability.

“Some of our estates aren’t fit for purpose. Additionally, we face a financial challenge of £876million across health commissioners and providers by 20/21 if we do nothing,” the STP is reported as saying.

This could have been written of any number of LAs throughout the UK.

Chancellor Philip Hammond has a chance to help next week with his mini Budget on November 23.

In the light of bleak analysis, I truly hope he will understand his responsibilities towards care providers and those receiving care.

WE are working with Birmingham to look at the consequences for Domicilairy and Care Homes. The shortfall in Birmingham has impact on the Black Country with many people being placed in Sandwell Walsall and Dudley

‘Billions’ needed to avoid social care meltdown

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Billions of pounds are needed to avoid the NHS and social care crisis – that’s the message which has been sent to Secretary of State for Health, Jeremy Hunt.

According to the Daily Mirror, leaders in the care sector have alerted Mr Hunt after three health areas revealed they face a combined shortfall of more than £2.4billion by the end of the decade

As we broke into November, the dire warning outlined that without extra money they will struggle to meet waiting time targets, provide enough hospital beds and basic levels of social care.

Sounds familiar, doesn’t it, and it’s right on our doorstep.

The Mirror reports: “The verdict is contained in the newly published Sustainability and Transformation Plans (STPs) for Birmingham and Solihull, North Central London and South West London.

Sustainability and Transformation Plans were ordered by NHS England boss Simon Stephens in December 2015 and charged 44 regions in England to come up with a five-year programme for providing health and social care in their areas.

I’m not a lover of red-top journalism, but this report is exactly what’s needed.

And it adds: “Of the three reports published so far Birmingham and Solihull warns it faces a £712million shortfall by 2020, South West London £828million and North Central London £876million.”

For the record, West Midlands Care Association is working very closely with Birmingham City Council and assessing the impact throughout the neighbouring Black Country region.

The shortfall will doubtless impact on areas already struggling like Sandwell, Walsall and Dudley.

Mark Rogers, the chief executive of Birmingham Council, says in the piece both health and social care face “huge challenges”. According to Mirror “this includes the need for at least 430 more hospital beds in the region.”

Personally, I’m struggling to find a creative way forward. All the cuts in social care have already been made and I fear the duty of care caveat is lost somewhere in the ether.

Budgets are not just shrinking, they are vanishing and the demand for care is astronomic.

Mr Hunt, I fear lives in a bubble as MP for South West Surrey, and as we all know the social care financial map is very different in his constituency.

There is a laudable push to get people out of hospital and back into their own homes with social care support. But it is catastrophically failing.

Let me quote the Mirror again: The North Central London STP says it is not “able to deliver universally for everyone to the standards we would like.

“Our analysis tells us that too many people stay longer in hospital than is medically necessary. There are challenges with meeting acute standards, as well as issues workforce sustainability.

“Some of our estates aren’t fit for purpose. Additionally, we face a financial challenge of £876million across health commissioners and providers by 20/21 if we do nothing,” the STP is reported as saying.

This could have been written of any number of LAs throughout the UK.

Chancellor Philip Hammond has a chance to help next week with his mini Budget on November 23.

In the light of bleak analysis, I truly hope he will understand his responsibilities towards care providers and those receiving care.

WE are working with Birmingham to look at the consequences for Domicilairy and Care Homes. The shortfall in Birmingham has impact on the Black Country with many people being placed in Sandwell Walsall and Dudley

Pressure mounts on Chancellor for more cash

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Last month Theresa May’s claims that the government is putting £10bn extra into health was challenged by five MPs. led by the Conservative Dr Sarah Wollaston, the chair of the Commons health select committee.

The impact of not enough money for hospitals and access to social care are written for all to see in rising demand for A&E and missed waiting time targets.

Clearly there are complex reasons that, according to some sources, delayed transfer of care lost 192,000 hospital bed days. But the downgrading of social care in government agendas must be a primary cause.

I am led to understand some NHS number-crunchers believe the real number of people in hospital who should be being cared for in the community is probably four times as many as represented the figures here.

The pressure really is on Mr Hammond to deliver in his Autumn Statement.

Rising costs, the ageing population, difficulties recruiting staff and years of central government reducing its grant have left the service in crisis, the Local Government Association claims.

Surely, there is an unprecedented agreement that social care should be at the very top of the list of Mr Hammond’s priorities for urgent extra funding.

The triple whammy of shrinking budgets, rising demand and the cost of paying the national living wage to care workers has left many councils paring back more and more on care costs.

I’m led to believe that in Walsall last week there were 138 people waiting to leave hospital. There is enough capacity in the region to take them all, but . . . there is not the money to start the funding of new packages.

Before winter pressures kick in we understand discharge managers are looking to get all those people back in the community and free  100 beds for winter. Sadly, if all of those perceived admissions required care in the community or step-down residential beds we’re in trouble. There simply is not the capacity.

Mr Hammond is being urged by senior Tories to give the crumbling care system a double boost in his autumn statement, amid growing alarm that social care and the NHS will be unable to cope with demand this winter.

Rumours suggest that Mr Hammond is examining a plan to plough between £700m and £1.5bn extra into social care services from April to help reduce numbers of older people being admitted to hospital.

Apparently, he is also considering letting councils raise the amount they can add to council tax bills to fund social care through a precept introduced in April, currently capped at two percent.

We’ll see . . .

The LGA has made known that years of cuts to town-hall budgets have left the sector in crisis, with fewer people getting help with basics such as washing and eating at a time when need is rising.

Also, care homes are closing, partly because councils cannot afford high enough fees to allow operators – whose costs have risen because of the national living wage – to make a profit.

Putting further funds into social care, will I’m sure, indirectly relieve some of the difficulties being encountered by the NHS; not lest helping to facilitate a more efficient discharge of patients.

 

Council leaders call for more investment in social care

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I’m cautiously hopeful that the Daily Mail may be onside with out campaign for more social care funding.

Recently I stumbled across a story where Local Government Association (LGA) were warning  that money is being diverted away from road repairs, leisure centres and local bus routes in order to maintain the struggling social care sector. Really!

Propping up funding caps in care can seriously damage your car or compromise public travel seems to be the message here, but the message hopefully will help our cause.

The LGA also reported that the current funding gap in the social care system is hampering councils’ ability to support the nation’s most vulnerable adults.

This is good for us, isn’t it?

The LGA said that councils spend around 35 per cent of their budgets on adult social care and increasingly have to divert money away from other services to plug gaps.

Adult social care services face a potential funding gap of at least £2.6 billion, according to a new report from the LGA.

The news broke as charity Leonard Cheshire warned that as a result to cuts in care, many people are left without the help they need or are being left trapped in their homes for “days on end without vital support and human contact”.

Leonard Cheshire’s chief executive Neil Heslop was reported as saying: “It is a national scandal that thousands of disabled and older people do not have the support to do everyday tasks such as washing and dressing, and even more shockingly, no support to eat.

In the foreword to the new LGA report, Councillor Izzi Seccombe, chairwoman of the LGA’s community wellbeing board, says: “For too long the service has too often been seen by decision-makers as an adjunct to the NHS, rather than a service of equal importance.

“A lack of recognition in terms of profile has combined with a lack of recognition in terms of funding to place our care and support system under enormous pressure.

“The situation now is critical and it is no exaggeration to say that our care and support system is in crisis.”

It’s interesting to note too that the LGA is saying that councils have long argued it is a false economy to pump money into the NHS but leave social care so chronically underfunded.

Locally, a West Midlands Care Association survey of those providing residential care brought the crisis into pin-sharp focus when 50 per cent of those polled warned they could face closure or have to sell if things didn’t improve.

The Mail also quoted The King’s Fund as saying spending cuts have left social care in a “perilous state”.

Not a single provider wants to read this kind of news, but it seems to have taken us six years to get to the point of having the Press onside.

There ought to be a public outcry and if this were happing in France or Italy, I’m sure there would be. But we’re all so British – measured and at times frustratingly dispassionate as we ‘get the job done’.

It may be premature to thank the media for . . . eventually . . . responding to our plight.

Please keep it up Daily Mail. We need all the help we can muster to survive this care crisis, and critically, so do our elderly, frail, disabled and marginalised.

 

The masterplan for Cumbria . .. and elsewhere?

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I’d never head of the News & Star, but for those who are interested it’s a newspaper. Recently it broke a story of a masterplan for care in Cumbria County Council ‘s area.

It said the council was to carry out its own separate consultation on the future of care homes in Carlisle and Copeland.

Interesting. It also said the Success Regime’s long-term aim is to reduce hospital beds and care for more people at home but can social care cope?

The council wants to close a total of seven homes and replace them with a new £6 million home in each district, focusing on caring for those with the most specialist needs such as dementia. Overall its care beds would reduce, with more people instead being looked after at home.

I accept that a local authority run care homes are not viable as their carers have to be paid the same rate as refuse operatives. My question: How will this new venture be funded and at what cost to the general public?

Have I heard this one before?

How foolish I am, I genuinely though that health and social care were supposed to be working hand in glove, but this plan has all the makings of pushing more people into care in the community and that service is already stretched to the limit.

How desperate is this measure and how shortsighted.

I love the fact that people can remain independent longer, but for that to happen we need well-funded social care going into people’s homes.

Defending their position, Cumbria County Council says although the plans will see beds reduce none of those homes affected have high occupancy rates.

There’s a pledge on jobs too, with staff from the existing homes being transferred alongside current residents to the new centres.

This will make an interesting consultation period I’m sure. Already a

county councillor fears the overhaul of north and west Cumbria’s NHS will put extra pressure o care services.

Whitehaven councilor, Christine Wharrier, who previously worked in the NHS, called for more joined-up thinking.

The Success Regime’s long-term aim is to reduce hospital beds and care for more people at home, but Mrs Wharrier is worried social care will not be able to cope.

Of course, we do need larger care homes, but we don’t want factories or a mentality that views transfers of residents and staff like personnel being offered relocation deals after plant closures.

 

Older people’s care: It’s where you live that counts and . . . if you’re rich

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Did anyone catch the BBC headlines that said older people are paying the price for cuts to social care?

And the faithful old Beeb added (what so many of us already know), the care and support older people receive increasingly depends on where they live and how much money they have rather than their needs,

Last month a new report by The King’s Fund and the Nuffield Trust laid the facts bare.

Six consecutive years of cuts to local authority budgets, rising demand for services and shortages of staff have left the social care system increasingly unable to meet the needs of the older people who depend on it.

Sadly, the findings also highlight the plight of unpaid carers, saying an unacceptable burden was placed on them. According to the BBC this leaves “rising numbers of older people who have difficulty with the basic activities of daily living – such as washing, dressing and getting out of bed – without any support at all.”

What is happening to us as a society? Mrs Thatcher’s infamous “there is no such thing as society” quote is ringing in my ears.

Evidence is presented that reductions in fees paid by local authorities and other cost pressures such as the National Living Wage are squeezing the incomes of residential and home care providers.

And you’ll never guess . . . it warns that an increasing number of providers are likely to leave the market or go out of business as a result.”

A West Midlands Care Association survey showed that some 50 per cent of home owners were considering selling or closing their businesses. And the picture was not much brighter with the dom-care market with commissioners recognizing there is indded a shortage of community caring.

How have we arrived at this crisis point? I’ll tell you how: Because successive governments have failed to listen to our warnings, and it appears they’re still not listening.

The sum total of what colloquially is known in the Midlands as ‘cocking a deaf ‘un’ is leaving our older citizens without the care they depend on.

The squeeze on the budgets of care providers is also prompting some providers in affluent areas to step back from providing care for people funded by local authorities, leaving those who depend on council funding reliant on an increasingly threadbare safety net.

We have to realise that nearly all private sector providers are running businesses, though it’s my experience that many have charitable hearts and subsequently are managing loss-making care enterprises.

The Beeb also noted: “At the same time, more people are having to pay for their own care as a result of cuts to local authority services.”

Indeed they are.

I cannot recall how many times I’ve spoken of the funding gap between the cost of adequate care and what is paid to my members by local authorities, but catch this . . . “The report highlights a growing funding gap within the existing, inadequate system which will reach at least £2.8 billion by 2019/20 as public spending on adult social care shrinks to less than 1 per cent of GDP. “

There’s a call for the government to be honest, to tell it how it is and if it is unwilling to properly fund and expand the current system, should say so.

Richard Humphries, Assistant Director of Policy at The King’s Fund said is reported online by the BBC as saying: ‘‘The failure of successive governments to reform social care has resulted in a failing system that leaves older people, their families and carers to pick up the pieces. “Putting this right will be a key test of the Prime Minister’s promise of a more equal country that works for everyone – there is no more burning injustice in Britain today than older people being denied the care they need to live with independence and dignity.”

I couldn’t agree more.

 

‘Leak’ reveals a savings solution. Is this really the best we can do?

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My recent weekend off had an annoying surprise. Scanning the newspapers to check essential TV viewing, I find a story about a leaked document that allegedly reveals the government is up for motivating people to save for their care in old age.

Just great. How is that going to help us now?

The leaked memo warns of a looming crisis. Looming? Wake up, it’s already here!

Sir Andrew Dilnot offered his solutions and they’ve been shelved. It appears our current elderly population is being somewhat overlooked in these new proposals (if they’re true).

Observer policy editor Daniel Boffey writes: “Ideas include Isa-style savings accounts – known as “care Isas” – with preferential interest rates for a pot of up to £75,000, which you would be able to withdraw to fund your social care or leave, tax-free, in a will. Another plan is that tax incentives could be offered if people wished to take from their pensions to meet social care costs.”

He goes on to say the memo was written last May by the then pensions minister Baroness Altmann in which it’s claimed she says the crisis has been left too long.

Let me quote some more . . . The memo also warns of huge political risks of allowing the crisis to unfold. “There is no money set aside for social care spending by individuals or by local authorities – needs have to be funded as they arise, and if the money is not there the quality and availability of care is compromised, causing scandals and misery that could potentially rebound on policymakers at some point,” it says.

Word has it the Dilnot proposals are dead in the water and I suspect the care industry as we have known it is too.

A savings solution is for too simplistic in my opinion. Would tax breaks encourage it to work? Only for the well off, I suspect.

Newcomers, who are younger . . . would they buy into it? I doubt it. My friends’ kids are too busy surviving the present and trying to get on the property ladder to have disposable income for their care that appears to them light years away.

If this ‘leak’ is the best offering, I think I need stress counseling or maybe anger management therapy . . .

 

Osborne’s social care cash ‘used to balance books’

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In any other scenario, you’d expect legal exchanges and the Press to be shouting ‘scandal’ from front pages.

But this is the care sector – often unde-gunned and always under-funded.

It’s incredulous, but has been claimed by reliable sources, that funds being raised by Dudley Council to shore up the costs of social care are to be used to help balance the books on the previous year’s overspend.

Under Chancellor George Osborne’s plan to fund care sector needs, he sanctioned a two per cent hike in council taxes during the Spending Review last November.

But it emerged at an emergency members’ meeting of the West Midlands Care Association, which represents private and charitable care providers, the new monies will have no impact on the current industry crisis that has seen 1,000 social care beds lost across the country since January.

Neither will there be any new monies generated for social care from Mr Osborne’s 2016 Budget proposals.

Hopes that he would heed calls by the Directors of Adult Social Services (ADASS) to bring forward £700m of social care funding never materialised.

Sadly, the outlook can only get worse as care providers struggle to make ends meet.

The West Midlands Care Association understands 50 per cent of the public in Dudley agree with the Chancellor’s precept of two per cent in the belief that it will help adults requiring social care packages to continue to receive them in a sustainable way.

But the truth is that the two per cent is just not enough and is being directed towards last year’s accounts shortfall.

How can they get away with this?

There are no provision margins from such funding for the current financial year.

A packed meeting at the Quality Hotel, Dudley, delegates from across the Midlands, heard the next three to four years would be “critical to the survival of social care as we know it.”

For the last nine years fees have fallen below the viable cost of running a care home.

Figures from Industry analysts LaingBuisson reveal English councils pay on average £91 a week less than what is needed to provide fully compliant care.

I’m sure the survival rate will tumble very soon as the living wage outlays start to hit home and the number of private funders, who shore up the shortfalls on the cost of care being paid for by local authorities, remain static.

At best, I believe, we have three to four years before the landscape of care changes beyond recognition and there will be no way back to the required bed levels our ageing population needs to provide some kind of fluid service to hospital discharge managers wanting to avoid bed blocking.

In a desperate attempt to secure a funding lifeline to the industry, MPs, councillors, local authority officers and Clinical Commissioning Groups (CCGs) have been asked to meet with us to discuss ring-fenced funding for social care. It’s the only way we’ll ever see any monies decanted from Government.

The vast majority of Black Country care businesses rely on placements paid for by councils as a primary income generator. More than 26,300 people across the region are receiving residential care. A similar number have care at home.

In September last year my association revealed Dudley Social services had given rises totalling 8.9 per cent over a five year period while, the Consumer Prices Index was at 11.6 per cent, the Retail Price Index at 15 per cent and wage rises hitting 12.3 per cent.

I’m wholly persuaded our local authorities understand the dilemma, but are working under a Government that is hopelessly adrift of reality.