Help older people to live independently for longer
"Funding care is undoubtedly one of the biggest challenges we face and it is vital that the government is not put off by the costs involved in delivering a sustainable system."
By Laura Bradley, researcher, IPPR
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‘Home care in London’
July’s report on social care clearly set out a route to dealing with the financial pressures facing the social care system, recommending individuals pay up to £35,000 of their care costs with the government stepping in to cover additional expense.
As a proportion of the government’s overall expenditure the proposed costs to the public purse are relatively small and therefore affordable. While questions of finance have dominated recent debates, it is important that we also focus on the quality of care.
Firstly, greater clarity and consistency needs to be brought into care provision. The Dilnot report (pdf) points to vast variation of care standards and eligibility across the 152 local authorities, particularly for home care services.
The recent Law Commission report (pdf) confirmed these issues, providing evidence of a system which is out of date, confusing for those needing care and delivers very different levels of care quality across the country. This inconsistency impacts the extent to which older people are supported to live independently – something which ultimately saves the costs of care in either hospital or residential care.
IPPR research has highlighted the inequity of care in London; for example, only 6.2 per cent of older people in Waltham Forest are supported to live independently, whereas in Westminster 17.1 per cent receive this support.
Secondly, workforce issues need addressing urgently – something that is dependent on both investment and reform. This is flagged as a problem by Dilnot but was seen as being outside the scope of his inquiry.
Research by IPPR has warned of a potential crisis in the ability of the care workforce to meet growing demand, with the sector needing to attract up to 1.5 million additional recruits by 2025. But social care is not currently an attractive career for many – workers are mostly poorly paid and their ability to provide quality care is extremely limited because of tightly scheduled care visits and inconsistency of care workers.
The recent findings from the EHRC commission into social care found 15-minute home care visits were common and a case where one woman received personal care by 32 workers in one week.
It is clear that funding is only one side of the coin in securing a system that is ‘fit for purpose’. We need to harmonise eligibility criteria and bring about greater transparency to a very complex system. The market needs greater financial as well as quality regulation if we are to ensure older people aren’t let down by private providers.
We also need to raise the status of carers and ensure they are provided with the necessary skills to deliver increasingly complex care.
This could be achieved by pooling health and care budgets to fund ‘super carers’ who are trained to provide elements of both services and given opportunities for development. It could also be supported by giving social care workers greater voice and career support through a single professional body.
Stories such as that of Southern Cross, which tell of a care system hitting crisis point, show us the risks we take by ignoring the wider issues faced by the social care sector.