By Debbie le Quesne

Posts Tagged ‘funding for care

Crumbs of comfort welcome, but the problem is still not fixed    

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I have concluded that a good barometer for the condition of the care sector can be the number of reports that land on my desk and the time I DON’T have to read newspapers.

Thank goodness for online material where I can catch up.

I picked up on piece by Paul Burstow in the Guardian where the former Minister of Sate for Care Services was reminding us what Jeremy Hunt, the Secretary of State for Health, told a local government audience.

It went along the lines that families should take more responsibility of caring for the loved-ones. Hunt then called for a national debate about caring for the elderly.

The comment at Local Government Association’s conference rattled more than a few boxes.

It’s easy to see why in the recent Carers UK State of Caring report which outlines the huge price that is paid, physically, psychologically and financially

What will happen to those without children? Ageing Without Children highlighted that as many as one in five over 50 have not had children.

Burstow, who I met in London at the Care Alliance meeting, poses the question: Will there be enough good quality care to support those without families in their old age? Will it meet their needs and lifestyles?

He goes on to write that there are fears that “a major provider the care home sector” will collapse, reasserting the gloom-laden forecast he made earlier in the year. Let’s not go there.

Certainly the news – especially for providers aligned to the West Midlands Care Association – has been bleak.

Perhaps one of the most telling bits of news was from Radio 4’s You and Yours programme where it was stated that around 5,600 care homes could go bust within three years. That’s one in four.

With other care providers, associations and representatives, we have lobbied the Department of Health about the continued squeeze on fees and delivered strong messages about the implications of the living wage.

In practical terms the only monies that have been generated are from the introduction of the adult social care precept, but in many areas it’s balancing the books for a previous year’s provision.

Let me quote Burstow’s piece, published at the end of May: “The trouble is that the precept yields its best returns in the areas where the care home market is more buoyant because of the higher rates of occupancy by self-funders. Those areas most dependent on the precept will raise the least and still be dependent on state funding.”

In fairness, Burstow does temper the misery with a heartening story about registered manager Blesson Thomas, who steered a care home to an outstanding CQC rating.

Key to the success was his approach to his staff, setting up career paths, and allowing them opportunity to showcase talents. As Burstow puts it, Thomas unleashed the potential in the care workforce.

We take comfort in every success story, but as Burstow rightly points out the Government still needs to find a plan that will work for the sector.


Written by debbielq

July 4, 2016 at 11:51 am

Co-operatives: Is this really the way forward?

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Not to be confused with The Co-op, Co-operatives UK is a national body that campaigns for co-operation and works to promote, develop and unite enterprises.

And it’s just possible it might have come up with a trump card in these times of care funding austerity and at the same time help restore public confidence in the sector. We’ll have to see when all the cards are on the table . . .

Published in a national newspaper, Pat Conaty, a research associate at Co-operatives UK, tables this question: “Could the active membership and co-operative ownership of workers, service users, volunteers and family members rebuild public trust in services and put an end to cruelty and neglect through a socially inclusive solution where the system of care is owned by the recipients?”

This week also saw the launch of the UK and Wales co-operatives research report Social Co-operatives, a Democratic Co-Production Agenda for Care Services in the UK.

With austerity measures aplenty, the publication identifies opportunities for co-operative approaches to deliver social care across the UK. It’s a brave agenda, but the logistics of management and accountability worry me.

So many stories of bad caring have dogged the industry and more recently the Winterbourne View scandal and the Southern Cross crisis have served to erode public confidence even further.

But what if there was a democratically accountable ownership model for health and care services, asks Conaty.

In a growing number of countries, from Europe to Canada and Japan, social care co-operative models are being rolled out.

Conaty believes these approaches can develop in the UK and would directly empower the people receiving care. Personally. I’m cautious. I have spent time studying care in Europe and there is a strong embedded culture of wives giving up work to care for elderly parents of in-laws. True, things are changing, but slowly. It’s important that people don’t think the co-operative approach is the default setting in Europe.

She adds: “We have researched social co-operative approaches extensively and the Italian co-operative movement provides a good example. The movement has been at the forefront of innovation in the provision of social and health care services.

“During the fiscal crisis of the late 1970s it pioneered a social solidarity system that enabled workers, volunteers, service users, family members and providers of co-operative capital to become member stakeholders in the governance and ownership of care services.“

Pretty radical, I think, but it’s still functioning. Most Italian social co-operatives have fewer than 30 worker-owners and less than 100 other stakeholder members.

Development in the UK has been slower but some co-operatives in the UK are now delivering home care.

Conaty says that in Wales, co-operative approaches to care delivery are specifically advocated in the Social Services and Well Being (Wales) Act which received royal assent at the beginning of May. Whatever may develop in the UK, be assured I’ll be fighting the corner for the private sector to be fully engaged. I don’t believe co-operatives can be a substitute for what we already have in place, but working alongside them seems a possible way forward. Watch this space. . .


‘Zombie’ comment on care plans reveal true divide

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Care minister Norman Lamb is not happy. Indeed he appears to be furious after his £5bn plan to join up social care and NHS funding was likened by a doctor to “zombie” that needed putting out of its misery.

The care and support chief was speaking at the School for Social Care Research conference and had told delegates that “great chunks” of NHS cash was going over to personal health budgets for people living with long-term conditions.

A question from the floor reminded him that at another event a show of hands revealed that overwhelmingly most health professionals were against the idea, with one medic likening the plan to an “intellectual zombie”, an “ideologically-driven dead idea still moving” that needed putting out of its misery.

Lamb’s response was brisk: “It demonstrates the cultural change that’s needed,” he snapped. “The idea that the clinician knows best has to be stopped.”

It’s a brave stance by anyone’s reckoning and though I welcome the promise of more funds, we must find a common ground with the NHS and be able to work together.

And may I add that all NHS staff are not the same. With West Midlands Care Association I have fostered some great working relationships with NHS-led care colleagues.

Lamb’s angry retort reveals the real tension over his plans, something I have mentioned many times in my blogs. If I’m honest, I can really see any movement to scrap the plan.

The coalition’s Better Care Fund (BCF) will mark a significant step forward.

According to the national media: “Lamb has confirmed that the fund, set up with a pooled £3.8bn of existing funding, mostly from the NHS, will in fact kick off next year with at least £5bn available to develop integrated care services, thanks to more than 50 local areas electing to chip in extra to that required.”

Sadly, there has always been a chasm between health and social care and the enthusiasm to join the two together I fear is only skin deep.

I quote yesterday’s Guardian: “A few months ago, when there were fears of a winter crisis in the NHS, Care England, representing private care providers, approached Downing Street to offer help. Encouraged by officials, it emailed health trusts and CCGs, among others, to make beds available in care homes for less acutely ill patients so that pressure on hospital wards might be eased.

“According to Care England, barely 10 per cent of its emails were even opened. Still fewer prompted any response. As long as such narrow thinking persists, the health and care system is doomed to remain disunited – and to fail.”

I’m afraid Mr Lamb will need more than a sticking plaster approach to fix this problem.

‘Eight million hours of care time lost to subsidising drinks industry’

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Councils could have paid for eight million hours of home care visits and filled almost three million potholes with money they have been forced to spend settling a £1.5 million monthly bill subsidising the drinks industry.

Can this be true? Yes it can and I am fuming!

The facts have benn released by the The Local Government Association, which represents more than 370 councils in England and Wales and quite rightly it is calling for an end to nationally-set licensing fees as part of its Autumn Statement submission.

The Home Office has not made any progress on its commitment to introduce locally-set fees, set out in the 2011’s Police Reform and Social Responsibility Act, the LGA says.

In simple terms it means that town halls remain unable to recover the actual costs of applications from pubs, nightclubs and off-licences. These include paying for site visits, public consultation, liaising with police, committee hearings and investigating and taking action on breaches.

It is costing councils almost £1.5 million a month with the current bill at £150 million since the system began in 2005.

LGA analysis reveals this money could have:

Provided 8.9 million hours of home care or 24.8 million Meals on Wheels.

Filled 2.8 million potholes or paid for one fifth of total council spending on street cleaning.

Funded the annual running costs of 520 libraries.

Paid for 8,430 care workers or 11,290 lollipop men and women.

Reported in the Care Industry Neews online magazine, Councillor Mehboob Khan, Chair of the LGA’s Safer and Stronger Communities Board, says: “With council budgets, on average 43 per cent less than they were, councils are having to find £20 billion worth of savings. At a time when councils need every penny for vital services, it is totally unacceptable that councils are being forced to subsidise the drinks industry to the tune of £1.5 million a month.

“With our road network crumbling and social care budgets being stretched to breaking point, this ever-rising bill would already fill millions of potholes and help councils provide more than eight million hours of home care.

“The Government must act now to reform the system so councils are able to recover the actual costs of applications from pubs, nightclubs and off-licences and not divert taxpayers’ money in such a needless way.”

Come one, Mr Cameron, this may even be an election platform worth standing on.

Tricky questions on the care capping issue

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There’s a million-dollar question that’s forever being asked about the funding of care regarding just how the new £72,000 capping level is going to be rolled out by April 2016.

It’s a gigantic job and the logistics are complex.

The principle of introducing a capped cost was outlined in the Care Bill with the aim to provide financial help for people currently facing catastrophic care costs.

The government’s intention is to assess all the self-funders already receiving care who ask to have their costs applied towards the cap.

An assessment framework is within the Bill and all eligible people will have a personal care account which will monitor their progress towards the cap.

The Guardian online, with the help of Laing & Buisson and Nick Kirwan, director of ILC-UK Care Funding Advice Network, poses the burning question of how this will be be implemented before April 2016.

It’s not a lightweight piece, but care providers will be in the vanguard of this change, so it’s well worth the read. Care managers will be the ones quizzed over the details of this self-funding ceiling, believe me.

According to Laing & Buisson, there were 175,000 people in residential care (43.4 per cent) in 2012 who paid the full cost without support from their local authority.

Issues raised in the piece include:

  • How many will apply to have their care costs accrue towards the cap and what will be the demand on local authority resources?
  • Fears that this exercise could have an adverse effect on the care sector.
  • How will the facts and the process be communicated, so that people are clear about whether or not to apply?
  • What about people who lack mental capacity?
  • What of the so-call ‘accommodation cots’ not counting towards care?
  • Self-funders should be assessed immediately before April 2016 so that they don’t miss out on any qualifying costs. Could this create a traffic jam in the system in March 2016?
  • How will the queuing system work?

Just for good measure there’s a bunch of other Pandora’s Box questions too. I’m dreading 2016 unless the government really gets its act together.

Full article: http://www.guardian.co.uk/social-care-network/2013/may/28/how-to-implement-care-bill