What, in your view, are the greatest challenges affecting the adult social care services sector at the moment?
I think the biggest thing right now is the workforce; people leaving and the challenge of recruiting new staff to come and work within the sector. I think there are a lot of other things that are around trying to understand how, when the rest of the country is going back to something approaching normal, how do care organisations continue to navigate within a quite strongly controlled environment around protection, prevention, control and testing and vaccination obviously as well?
I think there's something about understanding what the model of care will look like going forward. So people trying to work through that as well. And I mean I think there are ongoing problems for organisations in terms of funding which is exacerbated by trying to think about how to pay people appropriate levels for their skills and expertise.
Is the Chancellor’s commitment of £4.8 billion in new grant funding for local councils, on top of the new social care levy, enough in your view to stave off the crisis that the sector is facing at the moment?
No. The extra £4.8 billion for councils is not ring fenced for social care. Local authorities have wide-ranging responsibilities across all sorts of areas that need funding with that money
We've had additional funding in the last year through infection control funding, recruitment and retention funding and testing funds, but we don’t anticipate a repeat of this funding.
Along with the shortfall there, we also have to deal with:
Anticipated inflation of around 5 per cent
Energy bills in home care
Increases in fuel costs for travel
Wage inflation - if people's costs go up 5 per cent, then they're going to need to see their salaries compensating for that.
In April 2022, I don't think the care sector will see any of the money from the proposed health and social care levy. It may see some training and development funding, but I think any other monies that come out of that levy will end up being absorbed into the local authority system.
How is the sector addressing the current labour shortages in the short term?
Currently, three coping strategies are on show. The first is handing back care contracts or not taking new admissions. The second is asking staff to work large amounts of overtime, and the third is the increasing use of agency staff, whose exponential cost increases are completely unsustainable for providers.
The Government has to take some action because individual providers can't carry on. They can't raise prices, and they can’t raise staff salaries because they don't have any additional money coming in.
Without the further abilities to raise self-funded fees (owing to Competition and Market Authority rules) or get more money from local authorities due to inflexibility of contracts, the only real way to address some of this is three things we've been asking for:
Government pays all care workers a retention bonus.
Government announces an increase in all care staff's pay
Reinstating ‘care workers’ on the shortage occupation list, so that we can look to hire fantastic, talented staff from all over the globe.
What will happen if the sector’s skills shortage is not resolved?
I think what will happen is that we will be finding that organisations have had to take some very drastic steps to protect the staff group that they have.
People in communities will be unable to access the care that they need, putting pressure on unpaid carers and family members and people themselves.
I don't think the care sector will see any of the money from the proposed health and social care levy
Alternatively, you'll have people in hospital who can't get back into their own home or into a care home. So much evidence shows if you are medically fit to be discharged from hospital then staying in hospital is the worst possible place for you to be. I think we're seeing that already and we will see more of that. In that context, you've got people with a statutory right to care which is not able to be delivered.
With longevity increasing and demands for social care services forecast to grow over the coming years, how can this increased demand be met in the long term?
Looking ahead, we have to put in place a professionalisation agenda that means people are paid properly for their skills and that establishes career pathways with fixed points of salary. Without that we are going to be yo-yoing between feast and famine as the wider job market changes.
The second thing is we absolutely need to get our investment right in digital solutions.
Recent data says that we're going to need an additional half a million workers. But greater longevity means fewer working age people, not just more people needing care.
A shrunken workforce reduces care's ability to attract those half a million extra workers. We desperately need digital solutions to meet people’s care needs, be that robots, be that more intuitive care planning systems which allow you to choose when you need services. But we cannot just invest; we need a proper digital strategy that says what we think care will look like and how people will experience it and how that will be underpinned by a digital offering. Otherwise, we will fail fast.