Just 33% of the public are satisfied with social care services, according to the recently released British Social Attitude survey, and this fell to just 18% of those that had actually had direct contact with the services.
The survey, which has just reported the lowest ever level of satisfaction with the NHS, also asked what people thought about social care services, and for the first time included those provided by local authorities and private companies.
Almost half (49%) of those surveyed were dissatisfied with social care services, but dissatisfaction rose to 66% of those that had actually had contact with social care.
The conditions for those who work in social care are one of the major reasons people said they were dissatisfied; with 59% dissatisfied because the pay, working conditions and training for social care staff are bad. The same number of people (59%) felt that people don’t get all the social care they need, 44% said they were dissatisfied because social care is not affordable to those who need it, and 43% were dissatisfied because of a lack of support for unpaid carers.
Social care has suffered due to the pandemic, but just like the NHS, the problems began many years ago. Promises to reform social care have been made time and time again, but successive governments have always kicked any idea of reform into the long-grass. The latest plans unveiled in December 2021 in the House of Commons, the White Paper on adult social care was greeted with little enthusiasm by leading stakeholders.
The lack of satisfaction with social care services is not surprising. Social Care services have had years of underfunding and an ongoing workforce crisis due to low pay and poor conditions, which has been exacerbated by Brexit. Skilled carers can earn more working in supermarkets or Amazon warehouses. At the end of 2021 there was a record number of adult social care vacancies across England of around 100,000.
The National Audit Office noted in 2021 that local authority spending on care reached its highest ever cash level in 2019-20, at £16.5bn, but this was 4% lower in real terms than in 2010-11.
The NAO also found that almost all English councils were planning to slash budgets in the wake of Covid-19, including through reviewing adult care packages, reducing staffing levels, and increasing service user charges.
The government has been urged to help social care via the new health and social care levy, however, most of the £12bn a year from the levy, and a related dividend tax rise, will go towards the NHS, particularly in 2022-23 and 2023-24.
At the end of 2021 ADASS published the results of a snap survey, which showed long waits for an initial assessment, around 400,000 people waiting for an assessment of their needs or for service provision, plus more than 1.5m hours of commissioned home care could not be provided between August and October 2021 because of a lack of staff.
Social care services are soon to receive another blow when the government implements a section of the Care Act 2014 in full. This section requires councils to arrange care in a care home for self-funders who request it at council rates. Good for the individuals concerned, but it will mean a massive drop in income for many care homes; self-funders on average paid 40% more than the council rates and it was well known that self-funders made up the shortfall in funding from councils.
There have been warnings this week that if the councils don’t increase their rates there could be widespread care home closures. The government has provided some funding to councils (£1.4bn from 2022-25) to cope with the increase in cost to enable them to pay providers a “fair cost of care”, but a study by the County Councils Network (CCN) carried out by LaingBuisson, indicates that the government is ‘seriously underestimating’ the costs of its proposals by at least £854m a year.
CCN says it supports the premise of making private and council fees fairer, but warns that local authorities will be ‘left between a rock and hard place’ unless the government commits more funding. Councils that are already facing severe financial pressures, would have to cut other services or significantly increase council tax to fund the increases to avoid large numbers of care home closures in their areas.
Martin Green the CEO of Care England, the organisation representing private care home providers, said that if the government’s figures “were not immediately revised this could lead to catastrophic financial failure to be experienced by providers, leading to home closures, and an inability to invest in services for some of the most vulnerable members of society now and into the future”.
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