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By Debbie le Quesne

Archive for the ‘learning disabled’ Category

CQC: More companies are pulling out of contracts with councils

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Private sector care providers are ditching home care services, the Care Quality Commission (CQC) says.

And the regulator adds companies are pulling out of contracts with councils as they are no longer ‘profitable.’ A national trend, it’s now happening across the West Midlands, but the real crunch will come in April when we see the next increment in the National Living Wage.

According to the Commission the crisis in social care funding means authorities can only afford to pay firms very low rates.

How long has West Midlands Care Association been warning this will happen? Err, years.

David Behan, chief executive of the CQC, was reported in the media as saying several major companies, including Care UK, had pulled out of local home care contracts.

Giving evidence to MPs at the Health Select Committee, he said firms were unable to ‘deliver the quality of care and the volumes of care at the price being offered’.

Association of Directors of Adult Social Services figures show that 57 per cent of councils have reported home care businesses giving up their contracts in the past six months.

The research estimates that this had involved 10,800 elderly and vulnerable residents.

Some 400,000 people in the UK receive council-funded home care.

Quote: “Mr Behan told MPs that companies were ‘leaving the market’ and replacements were ‘not coming in.’ The vast majority of contracts handed back in our experience have been domiciliary care contracts where providers are saying:

‘We can’t deliver the quality of care and the volumes of care at the price being offered.’

The news has drawn comment from Caroline Abrahams, Charity Director at Age UK, who says ‘It’s worrying to hear that some care providers are giving up trying to make existing contracts work as their costs rise but funding fails to keep pace, and if these organisations are losing confidence in the sustainability of the care sector how on earth are older people and their families supposed to put their trust in it?’

Significantly she adds: ‘No care provider would ever walk away unless they felt they had no choice and the fact some are now doing so says a lot about the parlous state of the market at present.’

Very true. Austerity measures have had a catastrophic effect on care and ultimately the economies of council-funded packages don’t stack up with the inevitable failure to release bed-blocking at hospitals.

Estimates suggest that the number of those aged 85 and over will have almost doubled by 2030.

 

Snapshot on social care: Could it get any worse?

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Following the collapse of Southern Cross in 2011, we all though it couldn’t get much worse. The then UK’s biggest care home operator was in utter shambles and the lives of residents in turmoil.

No other big players have folded to date, but smaller firms aplenty are failing across the country. And there’s evidence too of major players in the region feeling economically uncomfortable . . . Four Season have closed in Birmingham and HC one have sold many of their Midland Homes.

The Guardian revealed last year a staggering 380 care homes have been declared insolvent since 2010 (Insolvency Service figures).

The number of failures each year has risen sharply since 2010, when 32 businesses failed. In 2015, 74 were declared insolvent, while another 34 failed in the first six months of 2016.

Large companies are also hurting. Four Seasons, the biggest care home operator in the country with more than 400 properties, is the most at risk, recording a pre-tax loss of £28m in the three months to the end of September 2016, the Guardian announced.

Robbie Barr, the chairman of Four Seasons, warns the industry is “struggling at tipping point” with the company juggling its own challenges.

On the issue of increased council taxes, he says it’s essential that councils use the powers they have been given to raise the social care precept and pass it on to frontline elderly social care services to help offset the additional costs of the national living wage increase and avoid further pressures on a sector.

The national living wage is scheduled to rise by 4.2% in April to £7.50, which is larger than the proposed 3% increase in council tax.

The Local Government Association estimates there will be a £2.6bn funding gap in adult social care by 2020.

A study by the Health Foundation, the King’s Fund and Nuffield Trust estimate the gap would be £1.9bn this year.

The LGA, reported: “The care provider market cannot carry on as it is and there is a real danger of more widespread market failure.”

And CQC . . . the industry regulator warned that adult social care is “approaching a tipping point”.

 

Time for a holiday, or more chocolate biscuits, please. . .

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

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.

 

How social care takes the lead in prevention

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If anyone should ever doubt the value of social care, I suggest they read an online article in Care Talk by Debbie Sorkin, whom I met recently at a Care Alliance meeting in London.

Her theme is simple – prevention is better than cure. Always better.

It is, as she points out, the cornerstone of recent health and social care policy. This is all about keeping people healthy and independent in their own homes – a “defining principle of the 2014 Care Act.”

She makes the point that “It means encouraging people to take more control of their own health and wellbeing: a move that is being supported, if slowly and patchily, through the introduction of Personal Health Budgets.”

But it’s also about supporting people, whether in their own homes or in residential care.

A great concept, this initiative is a pillar of NHS England’s Five Year Forward View – but, as Sorkin says “it should be clear that it’s also been the settled practice of social care for many years.”

But there is a problem. If we want preventative care (and we do). if we want to keep the elderly and frail out of A&E departments, if we want them healthy in body and mind . . . it costs money.

While I applaud Sorkin’s positive approach, she does point to a major cloud of foreboding.

She says: “ . . . Keeping people well, or nipping problems in the bud – is getting harder to do, particularly in relation to older people, where the social care system is struggling to cope.”

Let me quote a little more from her feature: “Six consecutive years of local authority budget cuts have seen 26 per cent fewer people getting help, and no-one has a full picture of what has happened to those older people – around a million strong according to Care UK – who are no longer entitled to publicly funded care. The human and financial costs to them and those who care for them are mounting.”

On the issue of district nurses providing community-based health services that are essential to keeping people with chronic, complex conditions well enough to live independently –there was a 28 per cent reduction in their numbers between 2009 and 2014, despite increased demands.

Sorkin begs the question what our response should be and points to leadership, well, system leadership (new sound bite) as an answer.

She mentions “doing what you can with the resources available.” What resources. Have my members any left?

She also promotes the Leadership Qualities Framework (LQF) for Adult Social Care “central to the section on Managing Resources, using resources effectively and minimising waste.”

All the right words and phrases are there . . . innovation, encouraging improvement, and creating a climate of continuous service.

Successful examples are cited in the West Midlands: New Outlook, a small care provider, teaming up with Nehemiah Housing Association to place a greater emphasis on wellbeing amongst residents and service users.

Results, she says, for the programme that has been running for only about a year, show emergency ambulance calls from the sites where the programme is operating dropped by 66 per cent between 2014 and 2015.

I don’t doubt good practice will always turn in good results and that Sorkin is right to point out the benefits of such management programmes. See http://www.caretalk.co.uk/how-social-care-takes-the-lead-in-prevention/ for the full list of improvements.

But for many care providers they’re well passed this rescue point. As someone said: “You can’t use an umbrella in a typhoon.”

Great leadership, hard choices, programmes of smart thinking, so many of my members have been there, done that, got the T-shirt and are still drowning.

Ultimately, all business needs the oil of finance – proper, fair rates for a proper job. Local authorities don’t want to, or can’t pay it; in many of the poorer areas (like mine) self-funders are thin on the ground and without the necessary viscosity of money the engines of care seize.

 

 

Care cuts ‘leave frail elderly fending for themselves’

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Frail old people in England are being left to fend for themselves because government-funded care is being scaled back, a review suggests.

That’s the news that recently greeted me care of the BBC.

The number of over-65s being helped by councils had fallen by a quarter in the four years to 2014, the joint King’s Fund and Nuffield Trust report claims.

Wait a minute, I’ve already read this report, I thought. But then I became aware that because of the information overload, I’d missed this crucial point.

Despite more people needing help because of the ageing population, we’re helping less and less it seems.

The BBC assured that Ministers were “taking measures to address the problems.”

The reality – highlighted in the report – means there are growing numbers left with no care or having to pay for support themselves.

The report was released on the day the BBC published an online guide to care, which details the costs people face wherever they live in the UK.

Care is means-tested, with only the poorest getting help to pay for services.

 

The Beeb reported (quote):

  • The numbers getting help from their council with care had fallen by 26% to 850,000 in the four years to 2014
  • Spending on care by councils had fallen by 25% in real terms in the five years to 2015, to £5.1bn
  • Additional money from the NHS and increased contributions from individuals had topped this up to £7.2bn, but that still represented a cut of 9%
  • Over 40% of money paid to care homes came from people paying for themselves
  • One million people with care needs now receive no formal or informal help – a rise of 10% in a year

 

The report also warned that the cuts by councils were a risk to the future of the market. I’d say so. It was noted that providers had walked away from council contracts in 59 local authority areas.

I’m not shocked – providers have walked away from contracts in all the West Midlands regions

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.

 

Why this boss is handing contracts back to the LA

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Alan Long is executive director of Mears Group PLC and in the last few months, has taken the “agonising” decisions to hand back a number of homecare contracts to local authorities, especially in the north of England.

In a Guardian article he explains why he felt it necessary to take such action.

The sense of desperation and frustration is tangible. It’s an argument you’ll have heard before . . . currently being considered by our providers in Birmingham and other Midlands areas.

This is what Mr Long writes: “As painful as this has been for the people we have been providing care for – and for our care workers – we hope others will follow our lead and help to end commissioning practices that should have no place in 21st-century Britain.

“Exiting contracts in this way is always the last resort and follows many months of trying to develop a different solution with a commissioner. But, ultimately, it may be the only means to drive the essential change in services that are life-critical to our most vulnerable citizens.

“We are not happy with the disruption this creates, but we feel that we have to take a stand to lead positive change in the absence of leadership from elsewhere.

“The contracts we have exited are those where simple mathematics shows that the charge rate a council wants to pay will result in a provider either not meeting the requirements of the “national living wage” for care staff, or not delivering the service needed by the user.

“In the homecare world, generally, councils only pay for “contact time” – the time a care worker spends with a service user. They don’t pay for the time it takes the worker to get to the property or move on to the next. They don’t pay for any of the time the worker must spend on training, or for the worker’s “on-costs” to ensure they are looked after if they fall sick. Nor do they help pay into their pensions.

“In recent years, councils have also shortened call lengths in order to cut costs, and many people have lost a service altogether.”

Could this be written about any area of the West Midlands and especially in Birmingham where most of our members have already withdrawn their services from the City? I think so.

Business are getting progressively militant it seems as they are driven into impossible corners. I started this post thinking of using just a few comments, but the article makes compelling reading without embellishes from myself.

Mr Long continues: “The “national living wage” is, of course, the bare minimum we need to pay – and rightly so. Being a care worker is an increasingly skilled job, requiring staff who can provide highly intimate personal care as well as support with medication. It is not for the faint-hearted and requires talent, dedication and strength.

“It is no surprise then that there is a national shortage of care staff. In the last 12 months alone, a lack of homecare capacity in the community has caused delayed discharges from hospitals to increase by 40 per cent.

“At a time when the NHS is creaking at the seams, there is an inherent short-sightedness in a system that focuses on cutting support for individuals, reducing call lengths and keeping charge rates for providers below sustainable levels.

“Unfortunately, many care providers still choose to accept very low charge rates from councils. This could be due to a lack of understanding of the minimum wage law, but is often simply caused by local businesses feeling they have no choice but to accept the terms offered, or risk going under. These businesses are often small and rely on a single contract just to exist.

“I have huge sympathy for councils on this issue, especially as many have been forced to cut other services to protect social care budgets. However, there is no excuse for setting charge rates that will almost certainly lead to breaches of the minimum wage or poor service.

“The last few governments have talked about reconsidering how we, as a society, fund social care – but nothing material has happened. Ultimately, this means we are failing to examine how we want to look after older and vulnerable people who need our support. All demographics point to an increasingly elderly population over the next 10 to 20 years, many of whom will be living with multiple long-term conditions. Surely it is a measure of a good society that we provide proper care for those people, at a time when they need it most?”

Mr Long suggests: “If we had given even 1 per cent of the time spent discussing Brexit on trying to reach a solution to the social care crisis, we might have one by now” and majors on the importance of having a sustainable care system.

Mears Group PLC is a major care industry player. Sadly, many of my members are independent, small businesses that do not have the wherewithal to join such a protest.

I fear for our future if we fail to move the hand of this government. I hope sincerely that Mrs May, a self-confessed champion of fairness, gets the message the care sector is sending out and administers fairly over our current needs.