Written evidence submitted by Care Rights UK (ASC0081)

Health and Social Care Select Committee Inquiry:

The cost of inaction on social care

Care Rights UK response

Introduction

Care Rights UK is your care champion, the charity focused on promoting the rights of people in care. We want people to know their rights and how to use them. We offer information, advice and support to empower people using care services, and their relatives and friends. As a community of families and experts, we fight for better lives for people in care. We challenge poor care, highlight good practice and demand a better system.

Our adviceline supports people who are impacted by the failing social care system, leading to poor care, safeguarding concerns, exclusions from care planning, unfair charges, restrictions and evictions. Our expert advisors have worked in the sector for over 20 years and have never seen it this bad.

Running the national advice service for older people needing care gives us invaluable insights into how inaction on social care reform impacts people every day on the ground. We hope sharing the experiences of people relying on care services will help bring about change and a better system for everyone.

What is the cost of inaction to individuals and how might people’s lives change with action on adult social care reform? 

For the people we support, inaction on social care reform has a huge impact on their lives, and on the lives of the relatives and friends who support them. Continual poor care because of inadequate systems also comes at a financial cost to the individual and to bodies like the local authorities. We support people who are impacted by inaction through having unmet needs, and through failed attempts to meet their needs.

With current inaction on social care reform, there is a lack of provision of quality care, from the initial stages of assessing care needs to the provision of care. Often people find themselves having to get back in touch with the local authority and needing the social worker to come back out for further assessments due to inadequate initial assessments and care packages failing to meet their needs, costing local authority resources.

We hear of instances of care commissioned following poor care needs assessments leading to safeguarding issues. Where there is poor oversight of these care packages, these safeguarding issues can be found late, as many older people needing care, particularly those with communication challenges, are unable to raise the alarm themselves. Commissioning poor care can require people to move care settings, meaning the local authority time is replicated having to find a new placement. This is also incredibly stressful and distressing for the individual and their chosen representatives. It can cause a deterioration in the person’s wellbeing and an increase in their care needs, and therefore expense.

The system can fail to meet people’s care needs in various ways. For example, we supported someone whose needs warranted homecare which they preferred, but due to lack of availability, they were moved into a care home. This can cause long-term issues, result in loss of life skills and premature entry into a care home on a permanent basis. It often causes people to split from their partner or other important relationships, creating huge distress.

Equally, sometimes being in a care home is the right option but again, due to lack of available provision or poor needs assessments recognising the extent of their needs or their carer’s needs, people end up in an unsuitable place. This can put their dignity at risk. We supported someone who experienced a deterioration in her health, and she was planned to be discharged home, despite her son who had been caring for her being no longer able to cope. She was also afraid to live alone. She was moved into supported living instead of a care home, meaning she was often left unattended for long periods without the personal care needed to live with dignity after her health incident.

Sometimes needs aren’t met through poor application and understanding of the Care Act’s principle of providing quality care. We often support people who have to move between care settings, which can cause deterioration in health conditions like dementia. Or people who are placed in care settings that are not able to meet their needs, particularly those relating to dementia. Often there is a lack of consideration given to the importance of supporting important relationships, despite being an eligible need under the Care Act. As a result, people are often moved considerable distances from their loved ones. The lack of proper application of care laws and regulations under the current social care system means staff don’t appreciate the impact isolation can have.

We supported someone through our adviceline who became very isolated due to her partner and all of her friends passing away. Both her and her son wanted her to be moved closer to him, they needed additional support and guidance from our advisers to ensure the authority appreciated the cost to her of isolation and used this as a factor when assessing her needs.

There is also a cost on relatives and friends when people’s care needs go unmet. Delays in getting needs assessments means that carers go longer without getting support, often past the limits of their capabilities. Especially for older spouses, this can create a great deal of anxiety and risk. Often people have to take immediate long-term leave from jobs, coming at a financial cost and also having a disruptive impact on their lives.

Sometimes this can be too much for family carers. Our advice service supported a family when the partner (and carer) had to leave the home in exhaustion, having not received appropriate support from the local authority. This led to other family members needing to raise a safeguarding referral to get urgent support for the disabled person left at home. These instances can mean people go into care earlier than they need to, and it can impact loved ones’ ability to continue to be involved in someone’s care, meaning the care provision becomes fragmented and breaks down.

Often the delays in carrying out needs assessments can lead to safeguarding incidents as above. It can mean that there are no safety nets for either the person needing care or the carer, should a crisis or even a planned event happen. For instance, if someone’s spouse or family member who is acting as their carer due to someone waiting on a needs assessment is then hospitalised or dies, the individual becomes suddenly at crisis point. This can result in them being forced into the system via safeguarding. This invariably leads to an emergency placement with no care plan, and often having to move again, once their needs have been assessed, causing disruption and distress.

We would be happy to meet with the Committee to provide further information on any of the issues we have raised.

December 2024