Social Care: From Crisis to Catastrophe

Stuart Weir, 2015 Sep 07
Holding hands
It’s Happening Everywhere in England

Read the report: Social Care: From Crisis to Catastrophe

Order a hard copy here.

Our Fairness Review for September 2015 is a meticulous investigation into the social care services for vulnerable residents in Cambridge and Cambridgeshire, ‘Social Care: From Crisis to Catastrophe‘. It concludes that the crisis in social care in Cambridgeshire has become a catastrophe for local people “to which no end is in sight”.

The author, David Plank, is a respected former local government chief executive and director of social services. His review of Cambridgeshire County Council’s spending on social care from 2013 to 2020 shows that escalating government cuts to the authority’s budget over the period are imposing devastating cash limits and “savings” on care services not only for older people, but for children, the disabled and other vulnerable groups as well.

David Plank says: “The effects of the cuts are devastating. Older people in residential care and at home are having their incontinence pads changed  less frequently and are at increased risk of distressing incontinence; adults with learning disabilities receive crisis care only and are less able to live independently; people with mental ill-health have greater difficulty getting a much needed place in residential care; children in care are at greater risk of abuse, mental health issues, homelessness and prison; even support to disabled children and their families has been reduced; and huge strain is being placed on the army of informal carers upon who we rely most to care for these people, many of whom are also on low incomes, in poor living conditions and harmed by benefits reductions.

“This is all happening at a time of a huge rise in urgent need from older people and the young. More resources are urgently required.  Instead resources to meet their needs are being cut and cut again – and no end is in sight. This is the hidden side of the austerity programme. And of all people, our most vulnerable fellow citizens  bear the brunt of it. This is a matter of political choice not economic inevitability. If we really are all in it together, the government will right this wrong now. It has the opportunity to do so in this November’s Spending Review announcement and the promised review of social care spending.”

It’s Happening Everywhere in England

David warns that central government’s cumulative funding cuts are creating a catastrophe in care across the whole of England.  He cites a National Audit Office report in 2014 on the government’s reckless cuts in local authority spending and also the recent warning by Andrea Sutcliffe, the nation’s chief inspector of adult social care, that the social care sector is broken.

The NAO report provides sold support for his warning that catastrophe across England awaits in a section of his report, “It’s happening everywhere”. Government cuts apply to all authorities in England, not just Cambridgeshire; social care makes up roughly the same proportion of other social care authorities’ total budgets as Cambridgeshire’s; and the NAO’s concern about the ability of these local authorities to make the savings required and the impact of financial stress on services applies to England as a whole.

Background

David Plank’s report follows on from the recent Cambridge Fairness Review, ‘Cambridge: Wealth and Want‘, also published by Cambridge Commons, which examined the effects of inequality and austerity on poverty, housing, care services, state benefits, hunger and distress in this iconic city.

Nationally, the National Audit Office (NAO) has identified a real terms reduction of 37% in that funding for local authorities since 2010. This is a reduction of one quarter in local authorities’ total income. As the NAO acknowledges, most local authorities have sought to protect social care. But the funding cut is so great that this became impossible some years ago.

In the last two years, the social care services in Cambridgeshire have had to make “savings”aa totalling nearly £58 million a year. By 2019/20 this increases to nearly £126 million a year when it is anticipated that the government’s Revenue Support Grant to the County Council will have ceased altogether. These massive sums are required to keep the County Council in the black and to meet some of the pressures arising from population change and additional statutory responsibilities such as the new duty towards informal carers.

And this at a time when high priority demand is going up – particularly amongst the very old but also among disabled people of all ages as birth survival and longevity have improved. In Cambridgeshire, for example, the number of people aged 85 or over, whose individual needs are greater and more complex, is projected to increase by 49 per cent between 2011 and 2021. At the very time when resources for social care should be going up they are in fact going down – and massively so.

The effects at the receiving end are devastating. The most vulnerable children, young people, disabled adults, older people and their informal carers are having the services – upon which they rely for a minimally reasonable life – cut and cut again; many of who are on low incomes, in poor living conditions and adversely affected by benefits reductions.

Yet even bigger cuts are to come. Despite the political rhetoric from government,  David says, with all his experience, “no amount of ‘service transformation’ and improved working methods can bridge this huge gap. Service cuts are happening up and down the country way over and above savings from better practice and improved cost efficiency.”

Therefore, he says, it is no surprise whatsoever that the Care Quality Commission is receiving even more allegations of abuse. The state relies not only on hard-pressed, poorly paid staff but also, and much more so, on the army of informal carers made up of often frail elderly spouses, parents, brothers, sisters and many others. Cuts in support to those they care for and to themselves are pushing some informal carers way beyond their tether.

Read the report: Social Care: From Crisis to Catastrophe

Order a hard copy here.