Written evidence submitted by the Disabilities Trust [ASC 048]

 

We are a charity that works alongside people with an acquired brain injury, autism, and/or learning or physical disabilities to help them live as independently as possible. Our high-quality services across the UK support people to move forward with their lives. These include: assessment and rehabilitation centres, hospitals, care homes, supported living accommodation, care in people’s homes and a school. www.thedtgroup.org

 

Introduction:

This year, 2021, has been designated the year for social care reform1 and following the release of the Department of Health and Social Care (DHSC)’s white paper and the promise of a Social Care Bill by the end of the year, The Disabilities Trust is keen to see long-term, dedicated funding to address the chronic underfunding the sector has struggled with. Widely recognised even before the Covid-19 pandemic1, for over ten years, the social care sector has struggled to grow, with providers struggling to invest without a clear funding strategy provided by the DHSC2.

The Disabilities Trust calls for:

Long-term funding is an essential part of much needed social care reform:

Successive Governments have talked about the need to reform the social care sector with 7 out of 10 UK voters agreeing failure to deliver social care reform would be a breach of trust1. An essential part of reform is funding. Despite a trend of more spending on social care, starting from 2015/16, and in spite of increasing demand for care, with 1.9 million requests for care from new clients in 2018/19, the current level is still below what is was in 2010/113.

Long-term social care funding, must work for both older adults, but also working-aged disabled adults:

Whilst emphasis on social care reform tends to focus on our ageing population, with an extra 8.6 million UK residents aged 65 years and over predicted by the year 2066, the majority of these requests came from working-age disabled adults3. As such, we are keen to see a long-term funding plan which takes into account the needs of working-aged adults, including long-term care packages the funding of which has otherwise remained static. The House of Lord’s Economic Committee argued the adult social care system required £8 billion a year in order to “restore care quality and access to 2009/2010 standards… addressing the increased pressure on unpaid carers and local authorities and the unmet need that has developed since then4.”

Long-term funding is crucial to ensure providers can continue to provide high-quality care and meet the care needs of individuals:

Without consideration of long-term and dedicated funding for the social care sector, the Trust is concerned current reductions in spending will affect the ability of social care providers to deliver the high-quality care individuals desire. For example, the Trust undertook a spending audit, benchmarking service user fees with a nationally recognised benchmarking tool. We determined that assessed needs were 57% higher than the commissioned level of support. We found that in order to continue to produce the level of care needed, the Trust was required to ‘top-up’ local authority funding using charitable resources.

The problem of insufficient pay has been noted across the sector, with analysis by the King’s Fund (2021) showing many local authorities pay providers less than the cost to deliver care5. Short-term funding is necessary to alleviate these pressures; we hope to see plans for long-term funding, which compliments wider reform in the social care system, including improved integration with the NHS, improve how social care markets operate, and promote and protects its workforce. In light of these concerns, we responded to both of the Health and Social Care Committee’s inquiries on ‘social care funding and its workforce’ and ‘workforce burnout and resilience’ expressing similar concerns and calling for funding which addresses the short, medium and long-term challenges faced by the sector

The Trust’s CEO, Irene Sobowale, also lent her voice to a report analysing social care challenges, which coincided with the Spending Review announced by Chancellor at the end of 2020. She raised concerns that the funding outlined fell short of what is required to meet the needs of those we support, their families and carers, let alone to reform the system. In agreement with the report, we called for a longer-term funding model which recognised and rewarded our workforce and ensured health and social care was properly integrated and barriers between services broken down to meet the needs of our communities6.

Long-term funding will also alleviate a workforce crisis:

Even though the Covid-19 pandemic has highlighted the value of both our health and social care workforce, our current system does not adequately remunerate people for the essential, rewarding, challenging and skilled work they do. The Disabilities Trust pays its front-line workforce above the national minimum wage, however, our ability to adequately reward our staff and retain skilled employees is limited by the systemic under funding of the sector. There are an estimated 110,000 vacancies in adult social care, which has been exacerbated by the Covid-19 pandemic and whilst we know that for many of our staff, pay is not the main reason why they choose to work in the health and social care sectors, long-term and adequate funding would undoubtedly impact the attraction of working in the sector and help retain highly skilled and dedicated staff.

 

 

In conclusion:

We are keen to see long-term funding, which not only takes into account the needs of older adults, but also working-aged disabled adults. This funding, in conjunction with wider social care reform, including planned integration with the NHS, recognition and support for the social care workforce and local care markets will ensure the needs of individuals are met across the UK.

References:

1 Care Support Alliance. (2021). A Cry for Help: Why 2021 must be the year for social care reform. Available at: http://careandsupportalliance.com/wp-content/uploads/2021/03/CSA_A_Cry_for_Hope_Survey_2021.pdf

2 Disability Rights UK. (2021). NAO report lays bare shortfalls in adult social care. Available at: https://www.disabilityrightsuk.org/news/2021/march/nao-report-lays-bare-shortfalls-adult-social-care

3 King’s Fund. (2020). Social Care 360. Available at: https://www.kingsfund.org.uk/publications/social-care-360

4 House of Lord’s Economic Committee. (2019). Social Care Funding: Time to End a National Scandal. Available at: https://publications.parliament.uk/pa/ld201719/ldselect/ldeconaf/392/39203.htm

5 King’s Fund. (2021). Adult social care funding and eligibility: our position. Available at: https://www.kingsfund.org.uk/projects/positions/adult-social-care-funding-and-eligibility

6 Dac Beachcroft. (2020). Social Care – 2020 and Beyond. Available at: https://www.thedtgroup.org/media/163944/social-care-2020-and-beyond.pdf

 

 

April 2021