Written evidence submitted by Papworth Trust [ASC 047]


About Papworth Trust 


1.      Papworth Trust is a disability charity and registered social housing provider, whose aim is for disabled people to have equality, choice and independence. Papworth Trust helps over 5,000 people every year through a wide range of services including housing, work and care


2.      Papworth Trust believes that every disabled person should be able to live their life independently, with control and with choice. Receiving the right level of care and support is a central component of achieving these outcomes. We want to see disabled people receive a high quality service that is based on their need and where possible acts as a prevention against further deterioration in their health and subsequent admission into hospital care settings. 


Effects of the coronavirus pandemic

3.      As a vital, statutory service, Papworth Trust maintained delivery of care to all of our customers throughout the pandemic, often working in inventive and flexible ways to ensure the safety of customers and staff. 


4.      The Trust has had to incur significant additional expenditure in 2020/21, in terms of PPE, increased hygiene measures, back-filling shielding staff and increasing staff sick pay benefits, in order to ensure that staff remain safe and healthy. With social care services already significantly under-funded, it was important that the sector received funding in the form of the adult social care action plan and Infection Control Fund, which went some way to mitigate these additional costs.


5.      We are also thankful for the support of local corporate partners, the NHS and Suffolk County Council, who provided important equipment including hand sanitisers and gloves.


6.      The pandemic undoubtedly shone a spotlight on the social care sector. It elevated the status of our social care workforce, and both national and local Government provided useful short-term funding pots to boost support for the sector during a time of national crisis. It is important as we move forward that this elevated status and learning are not lost, and the discussions around the longer-term sustainability of the sector are addressed


7.      Despite the challenging external environment, the demand for high quality care and support has not diminished. In fact, it has become even more critical, as disabled people have found themselves cut off from their usual support networks. We continue to work closely with our commissioners to support the long-term costs of providing social care to our customers and we anticipate commissioners continuing to fund the cost of inflation for services, which is largely driven by increases in the National Living Wage rate, which is in turn reflected in the pay of Care staff. 


The Care Crisis

8.      The statistics are stark. The Health and Social Care Select Committee found a funding gap in adult social care of between 1.4 billion and £12.2 billion per annum[1]. This did not take into account any effects of the coronavirus pandemic, but was instead impacted by an increasing population of disabled and older people who require a social care service. It is not only damaging to people who need but are not receiving social care, but the cost of a lack of long-term investment in social care has serious effects on the NHS. The lack of an integrated approach between the NHS and social care is not politically, culturally and economically sustainable.


9.      It is important to note that the population’s needs are changing and social care and health providers increasingly support people who have 2 or more conditions occurring at once. This creates problems when health and social care are funded from different budgets and are not strategically linked. For instance, we know of examples where individuals who have multiple conditions, such as addictions combined with mental health issues/ learning disabilities, are often left vulnerable and unsupported while health professionals argue over where the greater issue is, in terms of deciding which budget support will be funded from; and what levels of funding are applicable. 


10.  With austerity cuts, Local Government budgets have been hit hard. Constraints on funding have led to Councils providing care and support to fewer people and concentrating on those with the highest needs.


11.  As a result of Local Government cuts to funding, we have seen worrying situations whereby social care providers are unable to sign contracts with Local Authorities or having to hand back contracts midway due to the low fees that they are able to pay for services. This is due to increasing staffing costs to the provider, compounded by a much slower inflationary increase from Local Authorities. National Living Wage increased by 11.4% from 2018 to 2020, yet inflationary fee rises over this two-year period only increased the income the Trust received by 6.4%.


12.  Providers have been forced to carry most of the financial risk, but they simply don’t have the capacity to carry this. As organisations, we work hard to ensure the cuts in funding do not reduce the quality of service we provide. This has been demanding, not least because the regulatory requirements for the sector have never been higher. We need to maintain a high level of standard, at the same time as our income is becoming more compressed. 


Social Care workforce

13.  As an employer, Papworth Trust is currently a middle-rate payer within the social care sector and pay our staff at or above the minimum wage. Our biggest concern is around pay and recruitment of care staff; currently over 80% of our total care expenditure is on staff salaries. We offer excellent support and training to our employees, but in comparison to other industries pay is low and the demands of the job are high. Recruiting good quality staff in the social care sector is always a challenge and this remains the case, despite rising levels of unemployment, due to the perceived attractiveness of the work and concerns over health risks due to the pandemic.


14.  We find that we are in direct competition with the retail sector, which is seen as a more attractive field of employment. We have experienced staff leaving to pursue careers outside of the social care sector for better pay and less responsibility, combined with a reducing pool of new employees because we are  in direct competition with the retail industry and others. A shortage of good staff means we have to rely on costly agency staff to fill gaps. This approach is clearly more expensive and far from ideal in terms of consistency of delivery for our customers. The living wage increases (which we will cover more in the next section) may help staff to feel more valued in their work and so improve recruitment and retention, but at the same time we need

funders to recognise the increase in costs associated with this through fees that reflect the actual cost of service delivery. We anticipate this rising to £10.50 by 2024 and therefore wage increases in Care being ahead of the wider inflation rates assumed.


The vital role of informal carers

15.  As of 2020, Carers UK estimates there are around 13.6 million people caring through the pandemic. There are many issues for informal carers that occur due to a lack of societal recognition and support for their caring role. It has been estimated that carers’ contributions value £132 billion[2], but they are not given either the financial or social status that they deserve. Over 3 million people juggle care with work, but the significant demands of caring mean that 600 people give up work every day to care for an older or disabled relative[3]. Educational barriers occur around access to education or continuing in education. Carers suffer with related problems, or such health needs being left untreated for too long. Financial concerns over lower earnings, a lack of pension savings and other costs such as travel, household expenditure, and on additional accommodation are common.


16.  1.3 million carers are in fact over 65 (with half of carers over 85 providing 50 hours or more of care a week)[4] and in need of some level of care themselves, but this factor is not considered, as the burden for social care is increasingly passed from the public sector on to these individuals. 


17.  Papworth Trust believes the Government must invest more and give a higher priority to providing appropriate respite, care and support. If we don’t invest enough, we increase people’s vulnerability. If there is too much pushed onto the Third sector, or too much reliance on family and communities, Papworth Trust considers that the whole Social Care sector is at risk of tipping over. Instead we should better support informal care by investing in our community and carer support networks. 

Conclusions and recommendations

We want every disabled person and their carers to get the support they need, when they need it. This will mean disabled people are able to live independent lives with control and choice. 

         The Government should publish a longer-term funding plan for social care to cover all social care needs, not simply for older people. 

         The cost of a lack of long-term investment in social care has serious effects on the NHS. The lack of strategic planning and well-structured service delivery between the NHS and Social Care commissioners/ providers is not politically, culturally and economically sustainable.

         There must be more central Government funding for the Social Care system to ensure the needs of all disabled people can be met. 

         Provider organisations cannot continue to be sustainable and provide good quality Social Care within the current climate. Good smaller providers are not able to sustain and are having to exit the market for financial reasons, leaving a monopoly for those who are left. 

         Funding is not adequate enough to support prevention and proactive innovations in Social Care. If we wish to address the needs rather than just the crises of future generations, then a new definition of Social Care is required. This should be focused around independence and prevention rather than a means-tested, welfare based definition of social care.

         As an industry that relies upon National Minimum Wage staff, future rises in National Minimum Wage must be clearly linked to and covered in full by increases in social care funding passed from central to local Government. Failure to achieve this will either lead to greater numbers of providers leaving the market or a reduction in standards and safety of care.

         The pressure on Social Care budgets and increasing financial risk for provider organisations, and therefore handback of contracts, means that the expectation of informal carers to cope is growing. This has a number of hidden costs not just to the individual, but to society as a whole. These are not adequately being addressed and Government (central and local) must do more to recognise the vital role that informal carers play. 


April 2021


[1] Health and Social Care Select Committee, Adult Social Care Funding and Workforce, 2020 

[2] Carers UK, Facts and Figures.

[3] Carers UK, Facts and Figures.              

[4] Carers UK, Facts and Figures.