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Warning over social care cuts

Deep cuts in spending on social care are being implemented in spite of “extreme” public concern over recent scandals in care homes, a senior figure has warned.

David Pearson, president of the Association of Directors of Adult Social Services (Adass), said Britain, as one of the richest nations in the world, needed to consider how much it valued the care that it provides for the most vulnerable.

He said local authority social care budgets have been forced to make savings of 26% over the last four years and were facing £266 million of cuts this financial year in spite of growing numbers of elderly and people with complex disabilities.

He said squeezed budgets meant less money for training, reductions in the number of people who receive care and continual review of the levels of care already received by individuals.

“Much of the publicity over the last year has indicated that there is extreme public concern about the quality of care that people receive and we have seen some horrendous examples of quality of care,” he said.

“Of course money does not excuse poor or unacceptable practice by individuals, it does not excuse that at all.

“However what that does show is that the public are extremely concerned that people who are most in need in this country should receive appropriate levels of care and it should be properly funded.

“That doesn’t mean to say that there is not scope for more creativity, that in some cases there is not scope for volunteers.

“But many of these people need properly trained staff who have skills and expertise to deliver appropriate levels of care. This is a national issue about how much we, as one of the richest nations in the world, value the care that we provide for people most vulnerable in our community.”

Mr Pearson said a “downward drive” on fees paid to social care providers had prompted concerns about whether providers would go out of business. There were also concerns about the levels of pay for care workers, and fears that the number of legal challenges facing local authorities could increase in the face of reduced budgets.

“It is fair to say that directors are extremely worried about the impact of future reductions on the people who use or need services and their carers,” he said.

He added that he would be “extremely disappointed” if the “largely protected” NHS – currently under financial pressures – received more funding but social care budgets, which pay for residential care and care in the home such as help with bathing and dressing, do not.

Mr Pearson was speaking as Adass unveiled research into 144 councils showing cash invested in adult social care will reduce by a further 1.9%, or £266 million, this financial year to £13.68 billion.

The association said it was the third year of continuing cash reductions and the fifth year of real terms reductions in spending.

A separate survey of 152 councils showed three quarters, or 75%, reported using 15-minute visits, with 15% of visits for this length of time. The visits were recently criticised in a survey by the Leonard Cheshire Disability charity as forcing many elderly people to choose between going to the lavatory or going thirsty because of a lack of time.

The vast majority, or 90%, of 15-minute visits were for checking up on an individual or whether they have taken their medication and “few would argue that this was inappropriate”, the association noted.
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“It is however of greater concern when more active care tasks are required to be completed, such as toileting, help with dressing, getting up and or washing and bathing,” the report said.

“For some people, such a time allocation may be appropriate, but councils need to reassure themselves that this is the case in all instances.”

The association said 8.6% of residential and nursing home providers and nearly 6% of home care providers were reported as being subject to “enhanced monitoring” by councils due to concerns about quality.

The association noted: “If quality is about getting it right the first time and every time, then there are too many providers demonstrating that quality of care provision currently falls short of that standard.”

Caroline Abrahams, charity director at Age UK, described the Adass survey as “profoundly worrying.”

“It is fundamentally wrong that so many older people who need care to continue living at home with dignity can’t get it unless they can afford to buy it in privately,” she said.

“We should be doing so much better as a society than leaving hundreds of thousands of older people who struggle with dressing, or washing, or going to the toilet or preparing food, to sink or swim alone.

“Integrating health and care is the right approach but it isn’t a substitute for filling the social care funding gap. Politicians in every party need to recognise this and commit to increased investment in social care as an urgent priority.”

A Department of Health spokeswoman said: ” We have given an extra £1.1 billion to councils to help protect social care services this year – that’s on top of significant additional funding in recent years.

“Councils are ultimately responsible for deciding how to spend their budgets but we agree that we all need to work differently to respond to the challenge of our growing ageing population – the Care Act and the Better Care Fund will focus resources on helping people to live independently, which can save money and prevent people from needing more support.”

Janet Morrison, chief executive of the charity Independent Age, said: ” This survey presents a deeply worrying picture of continued decline in social care funding.

“The Government’s flagship Care Act may become obsolete before the ink is even dry, simply because there is not enough money to fund it properly. We estimate that residential care alone is underfunded by £700 million.

“Increasingly, those in need of care, and their relatives, are being left to pick up the tab in this desperately underfunded system.”

Richard Kramer, deputy chief executive of Sense, the deafblind charity, said: ” The Adass survey reveals that over the last four years spending on adult social care had been cut by 26%.

“These cuts to funding are already unsustainable and mean that increasing numbers of people in desperate need of support are going without.

“We need a stronger settlement for social care.”

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