Social care – How can we turn it around?

Social Care Providers have left themselves wide open to systematic financial abuse from Local Authorities. The public are picking up the bill and enduring poor care as care providers struggle to balance the books and deliver the best care that they can. How can we change this ongoing situation?

Jeremy Hunt’s proposed cap on care has received much press coverage and criticism over the last couple of weeks. Generally it is considered that not enough has been done, and that most people will continue to fund their care in some way. Perhaps Jeremy Hunt is not keen to pour money into a social care system that has fundamental issues?

I read some very valid tweets and comments this week from some of the prominent people within the industry. Directly or indirectly they all refer to a single problem, the relationship between care providers and the Local Authorities - a problem that affects both the cost and quality of social care.

“The Care and Support Minister Norman Lamb has criticised Local Authority Commissioning Practice and said he wants this to change.” @eccaofficial

“LA’s able to pay lower care fees than private individuals because of greater purchasing power.”  @colintwangel

“People who are self funding effectively subsidise people who are state funded”. @MelanieHenwood from her article for @GdnSocialCare

“Providers and commissioners must work together and fight for more resources for home care to achieve 100% satisfaction rating.” @Mike_Padgham

The economics of supply and demand dictates purchasing power. Care providers have enjoyed a great relationship with local authorities (LA’s) in the past, which in times of plenty has worked very well for them.  It has also worked well for people receiving the care provided.

Now that we are in recession the Government is naturally looking to make savings and one area where they are able to do this effectively and easily is in social care. Social care providers form a very dependent supply base, with few options other than to accept the prices offered them by their local authorities.

Cost, quality and delivery are inextricably linked, if you affect one it will have a knock on effect to the others. To combat this we might look for efficiencies, but the return on effort diminishes quickly, that is why any care provider who has the option looks to recover any shortfall via their already fee paying residents.

So less money from local authorities is universally affecting the quality, delivery and cost of care throughout the UK. Hardly surprising that Norman Lamb wants to see some changes.

We could wait for Norman Lamb to effect these changes but we have waited 20 years for the government to solve the funding issues and we’re not universally happy with the outcome. Perhaps the industry could look to help itself?

As mentioned previously, the economics of supply and demand dictates purchasing power. While there is abundant demand on the LA’s to care for people at the rates offered, the LA’s will continue to supply that demand. The LA’s will assume that everybody is profitable and able to provide quality care at the rates being paid. While they enjoy a robust demand they will continue to have purchasing power - they will therefore continue to exercise that power and further reduce the amounts they pay to their demanding suppliers. The only way to stop this cycle is to break the chain – stop the demand!

The LA’s know very well what they are doing, it has been pointed out to them time and time again, but ultimately the care providers do have a choice. If care providers hope to break this cycle they must look to find their service users from other sources, but that brings a new set of problems. There has been little need for providers to advertise in the past, and few providers have any idea how to engage effectively with the internet. 85% of care homes are owned by people with 3 care homes or less, and their priorities or skills have not always included marketing.

I think Norman Lamb will struggle to find more money for the LA’s to pour into social care without that money providing positive sustainable change for the future. Perhaps he would have more luck providing practical help and support for care providers wanting to develop their businesses and overcome the dependency they have upon the LA’s? This would result in a more buoyant industry able to deliver care of a higher quality at a generally more competitive price across the board.

Innovations such as the forthcoming PQP are fantastic foundation blocks for the industry to build on, but the industry will need to address their own mindset if they are to engage with the online world to maximise this opportunity.

Comment by Springhill Care


"A very solid and sensible blog Mark. I concur that neither Government nor Local Authorities will solve the under funding problem in the care sector. They are hoping that by tightening criteria for public funding, the increased wealth of the next generation of older people equaling more private payers, they can maintain the squeeze on social care.

Dilnot is to my mind a diversion and is a sop to the middle class with assets who want to pass some on to their children. It will not solve the under funding of LA care fees, indeed it could make it worse as Dilnot will not be fully funded by Government and LAs will be left to sort out the mess. With a £75,000 cap for care plus cost of hotel services on top, this scheme will not lead to many more people saving their assets - but it is a good election ploy. It amazes me that as a country we can find £30 odd billion for a trident replacement yet will not put £2-3 billion into the care of the most vulnerable people.

As always the problem of under funding of care fees and hence a reduction in quality, will be swept into the long grass as politicians have a very short time frame. It will only come to the fore again if enough scandals break in the care sector and then providers will be blamed for their failings!!"

Mark Sadler

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