Care costs could close libraries, say councils - BBC

Care costs could close libraries, say councils

By James Gallagher Health and science reporter, BBC News

Care funding is "already over-stretched" says LGA.

A crisis in funding care for the elderly could lead to the closure of parks, libraries and public toilets, according to council leaders in England and Wales.

The Local Government Association has warned that funds will have to be diverted to "plug the gap in care funding".

It said an agreement was needed on how to pay for elderly care.

The LGA said it was "absolutely united" on the issue.

In 2011, an independent review recommended a cap of £35,000 on the amount people would have to pay for social care.

Council-funded home help and care home places are currently offered only to those with less than £23,250 of assets. The review said that threshold should rise to £100,000.

The report by Andrew Dilnot said those changes would cost at least an extra £1.7bn a year and would rise as more people retired.

The LGA, which represents around 400 councils, sent a letter to David Cameron, Nick Clegg and Ed Miliband.
'Over-stretched'
It stated the Dilnot recommendations were the "only real solution" to funding care and urged the leaders of the three main parties to be "courageous" and commit to reform.

Continue reading the main story

Social care in figures

• About 1.8m people get state-funded social care - a third adults with disabilities and two-thirds elderly
• Nearly 500,000 people are paying their own costs
• Another 800,000 are estimated to go without formal care despite being in need of help
• The average lifetime cost of care is £30,000, but for one in 10 it will total £100,000
• More than £14bn is spent on social care by councils
• But once inflation is taken into account funding has hardly changed in the past seven years

It said: "For too long we have toyed with adult social care reform and failure to act now may be the failure that tips the system over."

The letter argues the care system is "already over-stretched" and that inaction "will increasingly limit the availability of valuable local discretionary services as resources are drawn away to plug the gap in care funding".

The LGA's chairman Sir Merrick Cockell told the BBC: "It's unusual for local government to be able to absolutely be united and from our side of public services we're saying 'we have a common view and we really want to work with the national government on actually delivering that'.

"But we need some certainty and we think that the population of the country needs a simpler system, where they know what their liabilities are going to be, some certainty and that we join up the health and the adult care systems at a local level."

The care services minister Paul Burstow said: "We absolutely agree that the social care system is in urgent need of reform and we are working with a wide range of interested parties - including the LGA - to create a sustainable system that ensures people and their carers get the quality care that they want.

"We will publish our white paper on care and support shortly and are working hard to secure cross-party agreement to find a sustainable long-term solution on social care funding."

http://www.bbc.co.uk/news/health-17868598

Social Care Survey - Inclusion London

Please encourage your members to participate in the social care survey and forward this email onto other interested people.

Tell us what is happening to your social care…

Is funding is being cut?

Costs rising and eligibility tightened?

Are your needs being met?

Do you have choice and control over the support you get?

Follow this link to take the survey: Social Care Survey

We want to hear from disabled Londoners about your experiences of social care. What’s working for you and what’s not?

What changes are needed to your social care to give you greater choice, control and independence?

We also want to hear if you are experiencing cuts to your social care support, dealing with rising charges and whether it’s harder to get support because of changes in local eligibility criteria. Will you be affected by the closure of the Independent Living Fund? We would like to hear about this as well.

The information you give us will shape Inclusion London’s response to the Government’s white paper consultation on social care, expected later this spring. The Social Care Reform white paper is important because it will lay out government plans for the future of social care, including how care will be funded. It follows the Caring for our Future consultation and documents such as the A Vision for Adult Social Care: Capable Communities and Active Citizens the Commission on Funding of Care and Support report.

More information is available at:

http://www.insidegovernment.co.uk/health/social-care/

http://caringforourfuture.dh.gov.uk/about/

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121508

http://www.dilnotcommission.dh.gov.uk/our-report/

http://lawcommission.justice.gov.uk/publications/1460.htm

Best wishes,

Shelley Fannell

Temp Office Manager

Inclusion London

Can Mezzanine

49-51 East Road

London

N1 6AH

Tel: 020 7237 3181

SMS: 0771 839 4687

info@inclusionlondon.co.uk

www.inclusionlondon.co.uk

Twitter: @inclusionlondon

Inclusion London is a London-wide Deaf and disabled people’s organisation promoting equality for the capitals 1.4 million Deaf and disabled people and providing capacity building support to London’s Deaf and disabled people's organisations.

Skills for Care Personal Assistant Survey

Personal assistants surveySkills for Care is calling for personal assistants (PA) to complete a short survey to help us estimate the number of people that have more than one job in the adult social care sector.

As part of The size and structure of the adult social care sector and workforce in England report, Skills for Care requires an estimate of the number of jobs carried out by people in PA roles.

National Minimum Data Set for Social Care (NMDS-SC) data is used for the majority of the report however coverage of people who employ their own care and support staff (through direct payment or other means), and therefore PAs is still relatively low so cannot yet be used to accurately produce these estimates.

If you are a PA and would like to contribute to this important report, click on the link below. It should only take a few minutes to complete and will be open until 5pm on Friday 4 May 2012. Information gathered will not be used for any other purposes. http://www.surveymonkey.com/s/SfC_PAMultipleJobs

TLAP -edited version of Best Practice in DP support services

Think Local Act Personal have released an edited version of the Best Practice in DP support services guide. This can be found at http://www.thinklocalactpersonal.org.uk/_library/BPDPS.pdf

What service users want from social workers - Community Care Magazine

What service users want from social workers

Peter Beresford

Friday 27 April 2012 15:43

What do service users want from social workers? Social work academic and mental health service user Peter Beresford says that research points to four crucial qualities. He will be speaking about the future of adult social work at Community Care Live on 16 May.

The crucial importance of the social work relationship
Above all else the evidence highlights that service users value the relationship that they have with social workers. It is seen as the crucial starting point for getting help and support on equal terms; for working with rather than on people. Service users talk of relationships based on warmth, empathy reliability and respect. It is the antithesis of form-filling approaches to assessment, which reduce the contact between service users and practitioners to a formulaic and bureaucratic contact.
It is not surprising that service users sometimes talk of social work practitioners as ‘friends’, not because they confuse the professional relationship they have with them with an informal one, but because they associate it with all the best qualities they hope for from a trusted friend.
Good social work is social
Positive social work practice with adults, as its name makes explicit, comes from a social perspective. It is based on seeing people’s lives in the round, not just their problems, not just what they can’t do, but also what they can do.
Service users talk about the strengths of social workers who see them in their community, among their families and friends and who don’t just interpret their problems as their fault - as a matter of individual deficiency or pathology to be blamed - but rather take account of the broader barriers and difficulties they may face.
Offering practical as well as emotional support
Service users particularly value the fact that social workers can offer both practical and emotional support. They bring the qualities of a counsellor alongside the practical skills of a hands-on worker. They know how to negotiate the housing and benefits system, fill in forms and sort out practical problems from debt to infestation. But they also offer ‘talking therapy’ and a shoulder to cry on, and don’t treat psychological and emotional difficulties in isolation from people’s real worlds.
However, the modern history of the helping professions has been to separate practical and emotional support, creating assistant roles to handle more mundane practical tasks. What service users highlight though is that through such mundane tasks they can build the trust and confidence to confide in social workers and be in a position to gain emotional strength from their support.
Listening
Service users frequently report how much they value social workers ‘listening’ to them. This quality or skill of being able to listen is the basis for much else that service users value. It makes them feel that they are valued, that their viewpoint has merit. It is the starting point for an approach to practice based on ‘co-production’ – the social worker working with the service user to find out what will help – the basis for all good practice.
When they talk of social workers listening, service users also emphasise the sense of not being judged. The social worker is both well informed and anti-discriminatory. Listening is much more than a passive quality. It is the starting point for an empowering approach to practice.
Delivering what service users want
The rise of managerialism and the adoption of care management have undoubtedly created barriers in the way of social workers delivering these qualities in social work with adults in local authorities. But these aren’t inherent problems for statutory social work. After all, local authorities have a strong tradition of encouraging community work, which has supported local neighbourhoods, citizens and service users, and fostered empowerment and anti-discrimination.
This approach sometimes means taking their side against their employers and other state agencies. Despite the challenges this tension poses, this community-oriented tradition needs to be rediscovered and social workers supported to feel that their first loyalty as professionals must always be to the people they work with, not those they work for.

Peter Beresford is a long-term mental health service user, professor of social policy at Brunel University and chair of service user network Shaping Our Lives. This piece draws on research findings from Palliative Care, Social Work and Service Users; Making life possible (2007, Jessica Kingsley Publishers) and Supporting people: Towards a person-centred approach (2011, Policy Press) by Beresford and other authors.
http://www.communitycare.co.uk/Articles/27/04/2012/118171/What-service-users-want-from-social-workers.htm

Skills for Care tools for people employing Personal Assistants

Skills for Care tools for people employing Personal Assistants

A framework to support the involvement of people who use services, and carers, in education and training provision: guides education and training providers in involving service users and carers in the planning, design, delivery and assessment of training programmes.

A toolkit to help people employ their own personal assistants: A toolkit to help small employers deal with the basic issues and legalities of employing own staff. Topics include being a good employer, getting starting, sorting out problems etc. Contains relevant key questions, tasks, links to further resources and templates for useful paperwork.

Care training code: a guide for individuals buying in training for their own staff: gives an overview of the core values which should form the basis of social care training and development. Addresses questions and issues that should be thought about when purchasing training and development.

New Qualification Options – for those working as a personal assistant – level 3 diploma in health and social care (adults) for England (QCF). QT013

Social workers 'reluctant to refer clients to user organisations' - Community Care Magazine

Social workers 'reluctant to refer clients to user organisations'

Mithran Samuel

Tuesday 24 April 2012 14:04

Social workers are reluctant to refer clients to user-led organisations (ULOs) for support in using direct payments because of concerns the organisations will challenge practitioners’ decisions.
This issue appears to be holding back the development of support services of sufficient scale to meet government ambitions to significantly increase the number of people on direct payments. This was one of the messages from a guide to commissioning direct payment support services published last week by Think Local Act Personal, the sector-wide coalition responsible for supporting the implementation of personalisation.
ULOs are often commissioned by councils to provide direct payment support, such as helping service users recruit personal assistants and manage payroll systems, but also typically have an advocacy role as well in representing service users. In some cases, practitioners who referred clients to ULOs for direct payments support were having their decisions about the value of the direct payment challenged by the same organisation, council commissioners told the report’s authors.
“This has in turn led to reluctance on the part of practitioners to refer to external organisations,” said the report. “The resultant under utilisation of support services makes them appear very expensive and can render them unsustainable.” Support service providers also complained of low referral levels and poor communication with commissioners, the report said.
However, the report, by social care consultancy Groundswell, said that service users valued ULOs' advocacy role. Author Simon Stockton told Community Care that it was particularly so currently as some councils sought to make cuts to personal budgets.
The report said that it was right for ULOs to perform both advocacy and direct payment support roles, but added that they needed to clearly separate the two functions. However, it said tying ULOs into large contracts to provide direct payments support could compromise their independence and ability to advocate for service users.
As a solution, the report suggested that councils commission direct payments support from a diverse market of providers, including ULOs and larger charities that had the infrastructure to support large groups of people, limiting the size of user-led organisations' contracts.
It also said a "mixed economy" could tackle the lack of capacity in the support services market, which it said needed to grow substantially to meet the government's target of extending personal budgets to all council-funded users by April 2013, and making direct payments the preferred method of delivering them.
“The market as it stands is not well placed to meet the challenge of a step change in the number of people with direct payments," said the report
Despite a 15-year history, the market was "relatively small scale", with mainly local providers serving "small numbers of people" and striving to "stay afloat with decreasing staffing and budgets".
Stockton said tackling the problem would involve councils spending more on direct payment support, but he said money could be saved from other areas, for instance by reducing care managers' role in support planning for service users, with this being led instead by users and their families, with support from ULOs or peers.
The TLAP guide is a revised version of a report published last year for the London Joint Improvement Partnership.
http://www.communitycare.co.uk/Articles/24/04/2012/118160/social-workers-reluctant-to-refer-clients-to-user-organisations.htm 

Training social workers to spot telecare needs 'will cut costs' - Community Care magazine

Training social workers to spot telecare needs 'will cut costs'

Mithran Samuel

Monday 23 April 2012 11:02

 

Councils can generate big savings from telecare so long as they improve training for social workers in identifying appropriate options for clients during assessments, says a study.
Using telecare could generate an estimated £3m to £7.8m a year for the average council through reduced home care costs and delaying entry to residential care, said the report from assessment systems provider FACE Recording and Measurement Systems, funded by telecare provider Tunstall.
FACE reviewed a sample of 50 older people's assessments and identified where telecare could have been used instead of other forms of care.
The savings figure was identified by running the revised assessments through FACE's resource allocation system and comparing costs with and without telecare, which found package costs could be reduced by between 8.5% and 19%. Scaled up for an average local authority's older people's services, this translates into savings of between £3m and £7.8m a year.
The report said achieving the shift involved councils moving from considering telecare as an "add-on" activity to seeing it as a mainstream response to people, at the assessment stage. Currently, it said, "the emphasis remains strongly on either home care provision or the use of direct payments to employ a relative/friend to provide support".
"Staff training is critical," it added. "Frontline staff need to be made more aware of the specific benefits of different telecare solutions. This includes guidance on both which telecare solutions are appropriate to particular needs; and on the needs profiles of the types of clients who will typically benefit most from telecare."
Councils also needed to modify their assessment tools so that telecare was considered routinely at the assessment stage and care managers asked the right questions to identify the appropriate assistive technology.
It also called for a national outcomes monitoring system to test how well councils were doing in using telecare to make savings in their budgets, saying that currently provision of and outcomes from telecare were "somewhat of a postcode lottery".
The report was launched at last week's spring seminar held by the Association of Directors of Adult Social Services.
http://www.communitycare.co.uk/Articles/23/04/2012/118157/training-social-workers-to-spot-telecare-needs-will-cut-costs.htm

TLAP newsletter

Think Local Act Personal: April Newsletter

20/04/2012

Welcome to the Think Local, Act Personal bulletin providing you with updates on the work to transform adult social care through personalisation and community-based support.

How to commission really good direct payment support Direct payments lead to better outcomes than managed budgets. So said the POET survey published in June last year. Simon Stockton, Director of Groundswell Partnership, writes in this week's TLAP blog that this echoes the claims that many disability organisations have made for years that, put simply, direct payments work. A new guide, co-authored by Simon, Best Practice in Direct Payment Support: a guide for commissioners is based on work with people currently using direct payments, providers and commissioners. The guide was developed from an identified list of "must haves" for what an ideal support service, or range of support services, should be doing and delivering. To read the POET survey visit the TLAP website To read the latest TLAP blog visit the TLAP website To read Best Practice in Direct Payment Support: a guide for commissioners visit the TLAP website TLAP welcomes new ADASS president and SCIE Chief Executive The Social Care Institute for Excellence (SCIE) and the Association of Directors of Adult Social Services (ADASS) welcome a new Chief Executive and President. Andrea Sutcliffe, who was formerly the Chief Executive of the Appointments Commission, joined SCIE on the 10 April. Sarah Pickup is due to take up her role President of ADASS on 18 April. TLAP wish both luck in their new roles and look forward to working with them in 2012-13. ADASS elects new President for 2012/2013 SCIE's new Chief Executive TLAP Self-directed support forum The TLAP self-directed support forum will bring together people and organisations determined to make self-directed support work in social care and linked public services. Its membership will include people with both knowledge and insight into what is currently happening in implementation and with experience and ideas to aid improvement. This includes people using public services and those commissioning and providing them. Members will also include representatives of national and local government and of leading provider bodies. The forum will meet for the first time on the 24 April in London. Look out for a blog from the forum chair, Bridget Warr, Chief Executive of UK Home Care Association, next week Building community capacity through volunteering TLAP is pleased to be working with Skills for Care, ADASS and SCIE to set out the contribution volunteering can make to building community capacity. The joint report will be released in time for the forthcoming Department of Health adult social care White Paper. More details will be released on the TLAP website over the summer. For more information on building community capacity visit the TLAP website The National Market Development Forum - an update The National Market Development Forum is a work stream of the TLAP Partnership. The forum will act to facilitate many of the outcomes set out in Making it Real , the main challenge of the forum will be to promote a greater choice of affordable, locally available and responsive services that people want. The forum is due to launch resources which will advise on forming effective market relationships, promote open conversations and help providers, commissioners and people who use services to work together in finding answers locally. For more information on the work of the National market Development Forum, visit the TLAP website. What Makes Us Healthy? The What Makes Us Healthy? report will inspire and support those who want to look again at what they are doing to improve health and wellbeing and to tackle health inequalities. The report contains specially commissioned articles on the evidence for the beneficial effects of assets such as social relationships and networks on health and wellbeing. It includes many examples and ideas about how to put asset principles into practice, support with evaluation and how to assess whether the new ways of working are having an impact. To read the full report visit the TLAP website Join the conversation with our Friday blogs Our Friday blogs are a place for TLAP's members to share with others what they have tried, learned and wish for as they tackle challenges in making a difference to people's lives through personalisation and community-based support. Catch up with previous blogs and leave your comments on any of the issues raised by the blogs. View all of the blogs on the TLAP website Unlocking potential and innovation in local communities NESTA's latest guide Neighbourhood Challenge: Learning from innovative communities focuses on approaches that work in unlocking potential and innovation in local communities. The Neighbourhood Challenge project is developing new ways of supporting community-led innovation in order to release creative potential within local communities. The interim paper explores their two main insights so far - that communities, even those with low social capital, have the potential to generate their own solutions to their own priorities. The second is that funders and support agencies have an important role to play in creating the enabling conditions required for community-led innovation to flourish. To read the full guide view the TLAP website From the Partners The March 2012 edition of "Update", the personal health budgets information sheet, has been published. This edition includes: * Headline story: Personal health budgets toolkit * Understanding personal health budgets leaflet * Seeking personal health budgets stories * Peoplehub online forum for people with a budget * What's happening locally * In the news * Programme milestones Read more on the Department of Health website Join us on Twitter Follow us on Twitter to keep updated with the very latest news on personalisation, personal budgets, community based support, coproduction and building community capacity. TLAP on Twitter

Website Links Think Local, Act Personal

Think Local, Act Personal 5th Floor, 2-4 Cockspur street, London SW1Y 5BH Telephone: +44 (0)20 7089 6840 Email: thinklocalactpersonal@scie.org.uk Web: www.thinklocalactpersonal.org.uk To unsubscribe from future Think Local, Act personal emails please visit the address below. http://www.thinklocalactpersonal.org.uk/unsubscribe/

'Care gaps and funding gaps' - BBC

'Care gaps and funding gaps'

Comments (9)

By Dr Ian Donald British Geriatrics Society

Community projects 'try to fill the gap'

Older people are being failed by an under-funded social care system, according to Dr Ian Donald of the British Geriatrics Society.

With a white paper on social care imminent Dr Donald, who is working with Age UK, spells out in this week's Scrubbing Up how things need to change.

As a specialist for older people's health working on an acute elderly care ward in a district general hospital, I see around 1,500 patients a year.

Most are keen to return to their home, and their families are keen to resume caring for them.

Very many suffer from dementia, and most are frail, entering the last year or two of their lives.

We try to make it our practice to meet the families within a day or so of their admission to our ward - and so often we hear a story of how they are all struggling to cope.

Some have contacted social services for help and are on a waiting list because their needs are not yet judged to be urgent - sometimes it seems the only way to turn is to seek hospital admission, or more commonly wait for that crisis to occur which precipitates the emergency admission.

Sometimes that crisis was just a fall, or simple infection, but it uncovers the struggle being endured at home.

Other times the crisis is more serious - a pressure sore, fracture, or malnutrition - which could have been avoided if more timely assessment had been provided, with medical and social care working hand-in-hand.
'Keeping watch'
Many are already receiving home care, which ensures that basic personal needs are met, such as being helped up in the morning, washed and dressed.

Yet how does this support the muddled person who may well forget to drink the tea or eat the hot meal left for them?

I meet many families who are anxious about the time gaps between home visits from carers, and especially the long gap through the evening and night.

Continue reading the main story

“Start Quote

We need to find ways of not just meeting basic needs but improving wellbeing, reducing loneliness, and restoring some pleasure to their life”

End Quote

A fall or other incident can go unnoticed for hours, and soon a crisis such as immobility is created.

Some have suggested that the solution lies in technology - telecare with devices "keeping watch" for the unforeseen crisis or fall.

But this generation of older people grew up before the computer, and technology should be at most an adjunct to personal care. So many patients will stay in hospital longer than they need while we assess, review, and try to find more care to support them again.

None of this of course is to criticise social services - they have made it quite clear for some time that their resources are stretched too thinly to support the many frail or confused older people who wish to remain in their own homes.

Some may point the finger at families neglecting their duty, but my experience is that the family are usually doing all they can, often from a considerable distance away.

We need to find ways of not just meeting basic needs but improving wellbeing, reducing loneliness, and restoring some pleasure to their life.

This of course requires more time, and the development of friendship between carer and client, which is not possible in 15 minute segments of care.

Communities, churches and voluntary groups seek to fill the gap, but it is clear to all who have had personal experience of the system that social services is close to breaking point.

In addition, there are some extraordinary inequalities - one person will spend £35,000 each year, while another will receive the same care for free. This has also been described clearly by the Dilnot report.

It makes no sense to me as a doctor seeing the same considerable needs from the same devastating illnesses costing a person either nothing or their whole life savings.

I very much hope that we will find a new way of bringing more money and hence more compassionate care to the growing number of frail older people who want to end their lives at home, and I believe that most people in our society today agree with me.

http://www.bbc.co.uk/news/health-17705290

Support for carers must be central to social care white paper - Guardian

Support for carers must be central to social care white paper

Government's upcoming reforms must take the needs and contributions of unpaid carers into account, says Heléna Herklots

• Comments (7)

• Heléna Herklots
• Guardian Professional, Thursday 19 April 2012 09.37 BST
• Article history

Saul Wordsworth and his grandmother Miriam. Family structures are changing as more people juggle caring for their parents at home. Photograph: Eamonn Mccabe

We will all need care or provide care for loved ones at some point in our lives – it is an issue for all of society and all parts of government.

As care and support for older and disabled people rises up the political agenda, decision-makers and the public are confronted with an array of stark statistics on the rising demand for care – with the number of people over 80 to double by 2020, 11 million people alive today expected to live to 100, the number of adults with learning disabilities to rise by a third by 2030 and the number of carers by 50% in the next 25 years to 9 million.

But these statistics do little to shed light on what this care challenge means in practical terms or what solutions might look like. They also fail to truly reflect how demographic change is bringing about significant shifts in all of our lives – not just the lives of people using social care services.

Family structures are changing to meet multigenerational caring responsibilities as parents, grandparents and great-grandparents juggle childcare and 'eldercare' between them. Parents of disabled children are caring long into retirement, which can mean juggling support for grown-up children with caring for older parents. Workplaces are adjusting as increasing numbers of staff need to manage 'distance caring', often by phone and email, for older relatives who are at the other end of the motorway; more and more days off work are taken by staff taking partners with long-term conditions or older relatives to medical appointments, or having to provide care when care services let them down. Increasing numbers of people are suddenly finding themselves exposed to the challenges of navigating the benefits system, power of attorney, and getting community care assessments from local councils.

All these issues reflect how 'cross-cutting' the issue of care is, and how important it is to support families to care. Alongside the NHS and local authority social care services, the care challenge impacts on employers, the benefits system, pensions, childcare, transport, communications technology, the legal system … the list goes on. As a result, the solutions to the current crisis in care must involve stakeholders and government departments in all these areas, and the forthcoming social care white paper must reflect this.

A white paper that is supported across the government will also help to shift the debate away from the view that social care is about 'managing a demographic problem'. We need a bigger exploration of how public services, care providers, businesses and workplaces must adapt to fit around the changing shape of modern families. But we must also make the most of the opportunities changing demography presents – improving workforce participation by helping families to balance work and care, stimulating growth in the care market and innovation in care technologies.

However, without the contribution of the UK's 6.4 million unpaid carers health and social care services would simply collapse. As a result, supporting carers must be a central part of reforms.

Caring often comes as a shock, and the inability for many care services to get suitable support in place quickly leads to many carers caring round-the-clock without support; endangering their physical and mental health, personal relationships and often forcing them to give up work. And this isn't a small group of families; two million people take on caring responsibilities for an ill, frail or disabled friend or relative each year, and this means that around three in five of us will care at some point in our lives.

It's not easy to get information and advice on care, and we need comprehensive independent advice and information services – delivered nationally and locally, so that families always know where to go to get the information they need. We also need more certainty around the costs and levels of care, regardless of where we live. The current system delivers perverse incentives for older and disabled people and their families to put off getting support for as long as possible - because they know they may face huge care bills in the long-term and want to avoid running down their savings by buying lower-level care services. This puts pressure on family members to provide care without support, and also often leads to people who need care going without it, and risking a deterioration in their condition. This doesn't make sense for anyone, and a cap on lifetime care costs would allow people to plan better and encourage them to invest in preventative support where they can. We also support calls for more 'portability' in the care system – giving families more confidence that moving from one council area to another won't lead to the collapse of their package of care as they wait for a reassessment from their new council.

What carers need most is action– now. It has long been clear that the social care system needs root and branch reform, and families have already waited too long. The forthcoming white paper on social care must be the catalyst for the change that is needed across the government. We need a care system fit for the 21st century.

Heléna Herklots is chief executive of Carers UK
http://www.guardian.co.uk/social-care-network/2012/apr/19/support-carers-social-care-white-paper

Minimum wage is least care workers deserve - guardian

Minimum wage is least care workers deserve

If we really care about elderly people, the practice of paying care workers less than minimum wage must be stamped out

• Comments (152)

• • Gavin Kelly
  • guardian.co.uk, Wednesday 18 April 2012 21.30 BST
  • Article history

'When it comes to those caring for elderly­ ­people, the flouting of the minimum wage risks becoming the new normal.'

 

A good thing about the national minimum wage, you might think, is that even if it's set at a pretty modest level you can at least be sure that everyone will receive it. Sure, there will be the odd rogue employer who needs to be tackled for non-compliance. But it's not like there will be a major sector where there are large numbers of workers being paid less than the minimum. Because that would be illegal. So it wouldn't happen.
By and large you'd be right – but when it comes to those caring for elderly people, particularly providing care in the home, you'd be wrong. Here the flouting of the minimum wage risks becoming the new normal.
There are a variety of employment practices that result in the minimum wage being circumvented, the most common of which is when councils sign contracts with private providers who recruit staff to provide short slivers of care in the home. A quarter of an hour can be all that a care worker gets to wash, change, feed and talk to someone with dementia.
The ticking clock means both those receiving and giving care lose out. Dignity for the client is often the first casualty: a variety of groups representing the vulnerable, as well as some of the more scrupulous employers, fear that rushed care contracted by the minute often means inadequate care. Yet recent freedom-of-information investigations show that almost half of councils still set 15 minutes as their minimum time slot.
Care workers lose out very directly too: it's common for highly opaque remuneration systems to be used that, among other things, only pay per minute actually spent with clients, not the travel time between them. Dozens of these work-related journeys could be made each week – it's a core part of the job. Not being paid for this time means those who care don't get paid for a full day's work (and this is before we consider the fact that it's common not to get compensation for the cost of travel, the obligatory use of mobile phones, or the price of a criminal record check).
This is in clear breach of how the minimum wage is supposed to work in relation to travel time. It's long been known, of course, that care is a low-pay sector, but until recently there has been only a very sketchy sense of the numbers receiving less than the minimum wage. Now an authoritative study by Dr Shereen Hussein, of King's College London, estimates that there are between 150,000 and 220,000 care workers in this position. And this is using conservative assumptions – the real number could be higher.
If you haven't heard about this issue before, then you won't be alone. There is very little media interest and no political campaign, celebrity speaking out or public outrage. (Just compare this with the eruption over unpaid graduate internships.) Our largely forgotten care workforce – 80% female, low-skilled, lightly unionised at the bottom end, and with a high proportion of migrant workers – has little political muscle and few powerful friends.
Yet the relevant public agencies are well aware of the problem. The Department for Business (which oversees the minimum wage) has just produced guidance for employers making it crystal clear that care workers should be paid for travel time between clients. HM Revenue and Customs, whose job it is to enforce the minimum wage, expresses concern. And Paul Burstow, the care services minister, recently volunteered that it is "bad practice" to ration care by the minute. Plenty of talk, but the practice continues.
In part this reflects the temptation just to sigh and say that at root it's all due to the cuts and the underlying inadequate funding of care, so there is, regrettably, nothing that can be done. And of course funding is a crucial issue. But it also gives everyone an alibi. Care providers can point at councils, councils can blame their inadequate grant on Whitehall, the Department of Health can finger the Treasury, and so on.
None of which is of any comfort to the out-of-pocket care worker. When the national minimum wage was created, there wasn't small print saying "but you only get paid if your employer decides they can afford it". It's supposed to be the law of the land, not a nice-to-have.
At a time when the minimum wage continues to fall in real terms – it's now back at the level it was in 2004 – it is imperative that public awareness is maintained and that enforcement is prioritised. Those who don't comply must be named and punished. The risk is that in some sectors – not only social care – the wage floor is increasingly undermined by a growth in casualised employment patterns. Given this, the decision to freeze the already meagre budget for publicity and enforcement is deeply worrying.
If we truly care about dignity for elderly people, as all politicians endlessly say they do, we have to end patterns of care that fail to meet their most basic needs – and we also need to have consideration for those we entrust to look after them. The minimum wage is the very least they should expect. Resolving this can't wait until some distant future when a new funding settlement for care is finally agreed. Cases need to be taken; unions should agitate; and Whitehall departments and agencies must do their job and end this scandal.
• This article was amended on 19 April 2012. The headline and sub-heading originally used the word "carers", where "care workers" was meant. Carers are unpaid family members, partners or friends. This has now been corrected
http://www.guardian.co.uk/commentisfree/2012/apr/18/minimum-wage-carers-elderly-people

Why increasing numbers of young people are becoming care apprentices - Guardian

Why increasing numbers of young people are becoming care apprentices

With a record 40,000 people taking the apprenticeship route into adult social care last year, it's now a serious career path option

• Comments (3)

• Debbie Andalo
• Guardian Professional, Wednesday 18 April 2012 09.00 BST
• Article history

Apprentices bring a new dynamic to the workplace - one which is a slightly less scary than Lord Sugar's boardroom. 

 

When Hannah Langridge began her public sector career at 17, she became one of the first adult social care apprentices employed by Hertfordshire county council. Six years on, Langridge has worked her way up to become a council commissioner, buying packages of care for adults with physical disabilities and older people.

"The apprenticeship was one of the best things that I have ever done," Langridge says. "The whole experience was brilliant because I am a people person and it meant that I could learn on the job. It allowed me to acquire the knowledge and gain experience at the same time. The apprenticeship is such a great base to start from and it makes you employable right from the beginning."

A record number of young people are choosing the apprenticeship route to launch a career in adult social care. Last year 40,000 apprentices joined the programme, double the number the previous year, making it the second most popular destination for apprentices behind customer services. Skills for Care, the skills council for the sector, estimates that in the next five years apprentice numbers could double again.

Young people are taking the apprenticeship option because it offers a work-based route to learning with a more defined career path that may not have existed in the past. At the same time, they are guaranteed a weekly allowance which at least matches the minimum wage. Eva Juskova, 26, is just finishing her level 3 apprenticeship and works as a care assistant at Hendra House, a residential home for 28 older people in Ludlow, Shropshire. She says: "Apprenticeships give you knowledge and the training and you can build your career on that."

Nearly half of the support staff at Hendra House have completed apprenticeships because its owner, Vince Birmingham, sees the programme as an opportunity to "grow his own" while guaranteeing staff are trained to deliver high-quality care. Although his apprentices have been between 18 and 59, he says younger trainees bring a fresh perspective to the workplace. "They bring new ideas and don't have a stereotypical idea of what care is about. They are aware of technology and I know without them we wouldn't have thought about using the Wii with our residents." Hertfordshire county council's apprenticeship programme for adult social care began seven years ago, and is now a core part of its workforce strategy and nearly all trainees stay on after qualification.

These young apprentices bring a new dynamic to the workplace, according to Sarah Pickup, director of adult care services and vice-president of the Association of Directors of Adult Social Services. "They bring a new energy and a different age mix into the workforce," she says. "Our younger service users like it and the older service users like to have young people around."

Birmingham also believes that the apprenticeship scheme, which he sees as a partnership between the employer, training provider and apprentice, helps improve quality of care. "At our last but one inspection under the old system, we were rated excellent in all seven key indicators. We are recognised as the best care business in Shropshire and the best employer in the West Midlands."

Pickup agrees that the programme can help boost standards, but adds: "This is not about something which is all bad and these apprentices will make a miraculous difference. But they are being trained to treat people with dignity right from the start, they understand about self-directed support and that service users have rights; none of this is new to them and they are learning a lot of that from existing staff as well. What it does mean though is that we are bringing young people through and giving them a good grounding … to do the job effectively."

The head of apprenticeships at Skills for Care, Sue Smith, is also confident that apprenticeships drive up standards. "I think that the whole qualifications and curriculum framework and the discipline which contributes to that, pushes up standards," she says. The strong apprenticeship brand and government backing for the programme also helps.

"Apprenticeships now have a much stronger brand and older people using the service say they feel reassured [about their level of care] because by becoming an apprentice they believe that the young person has taken a serious career route," she adds.

The expansion of young people in adult care services comes as the sector expects to see its workforce grow by 65%, up to 2.6 million by 2025, because of an increasing older population. Pickup says it is one of the few economic growth areas for young people where entry does not require a degree.
Smith says young people are critical to the sector's future workforce needs: "They are crucial – and if we don't offer an attractive message they will go elsewhere."
http://www.guardian.co.uk/social-care-network/2012/apr/18/record-numbers-social-care-apprentices

Cuts could see disabled moved into care homes - Worcester News

Cuts could see disabled moved into care homes

11:50am Friday 20th April 2012 in News By Tom Edwards

 

Cuts could see disabled moved into care homes

DISABLED people across Worcestershire face being moved into residential homes or cluster-style flats under a controversial plan to save £200,000.
With spending on care packages for the disabled now ballooning to £50 million, bosses are going to offer people with physical or learning disabilities “cheaper” options as an alternative to at-home care.
About 2,000 people use the county council’s community care packages every year, which includes a mix of transport to day care centres, flexible visits at home and if needed, around-the-clock support with tasks such as washing, cleaning and shopping.
But council chiefs say the at-home care can cost up to £3,000 a week and they need to offer cheaper alternatives to avoid a “financial crisis” looming.
From September any new service users will be given less-costly care options which could include putting them in care centres, placing them in a cluster of flats next to other disabled people, or even offering them foster carers.

The most expensive service – at-home care – will generally be avoided unless families can contribute towards the costs. The changes have angered the disabled community.
Ruby Walker, from the Learning Disability Partnership, said: “Until now we have been encouraged to live in the community, but this policy suggests new users will be sent to residential homes to save money – it goes against everything the Government is doing to help people live ordinary lives.”
Brian Ferrow, aged 31, from Droitwich, who has learning difficulties, said: “I worry about where this will lead – it’s terrible news.”
The Conservative cabinet agreed to launch a three-month consultation yesterday and admitted it was a “sensitive issue”.

If approved, it will apply only to new applicants and existing ones whose needs escalate. Every year about 50 new disabled people apply for help.
Councillor Philip Gretton, the council’s cabinet member for adult social care, said: “We will still meet people’s needs, but it would not necessarily be in accordance with their first choice of care.
“This is principally about saving money – in many cases the at-home option can be very expensive, and we have limited resources.”
Councillor Simon Geraghty, deputy leader, said: “The key word here is consultation – it’s a complex and sensitive matter.”
The cabinet has pumped an extra £2.5 million into the service this year.

http://www.worcesternews.co.uk/news/9661421.Cuts_could_see_disabled_moved_into_care_homes/

Care providers challenged to stop bidding for low-fee tenders - Community Care magazine

Care providers challenged to stop bidding for low-fee tenders

Mithran Samuel

Friday 20 April 2012 10:10

Care providers should cease bidding for council contracts at prices they feel are too low to deliver the specified service, incoming Association of Directors of Adult Social Services president Sarah Pickup has said.
Pickup, who takes over as Adass president today, said providers had to take their share of responsibility where they felt poor care had resulted from inadequate funding from commissioners.
"If I go to a meeting with providers, many will say, ‘local authorities are terrible and they all commission badly’; but they don't," she told Community Care in an interview to mark her accession to the presidency.
"The commissioning specification would not have called for poor care. If you feel that you are not going to receive enough money to deliver to the specification, don’t bid for the contract." "If no one bid for contracts, councils would have to raise the price," she added, though she admitted this would not solve the problem of the overall under-funding of social care.
In the past year, care providers associations have mounted a series of successful judicial reviews that have forced councils to rethink their approach to setting fees and demonstrate that they have taken account of the costs of care faced by providers.
However, Pickup called for a new relationship between providers and commissioners, based on partnership. "We won't get far if we don't work with providers. Judicial reviews are not really the answer," she added. "They happen when both sides feel caught between a rock and a hard place.”
She encouraged providers to be open about their costs and finances and to work with councils to explore new business opportunities, such as providing intermediate care services that could offer NHS commissioners cost-effective alternatives to community hospitals.
But she said the extent to which providers' were open to diversification was variable: "Some providers are absolutely up for moving foward on that; others are not."
Pickup said she had been working constructively with national care provider associations on examining the true costs of care faced by services.
However, her comments about fees drew a sharp response from the United Kingdom Homecare Association. "Across the country, councils are often the only major purchaser of care services in the local area and they frequently exploit their dominant market position in the knowledge that without retaining existing contracts with the council, their local providers may not have a business to run," said UKHCA director of policy Colin Angel.

"Council tender processes rarely operate as exercises between equal partners. Councils determine the contracts (with terms stacked in the authority’s interests) and increasingly fix the maximum price at which prospective providers can bid. To bid above this price leads to instant disqualification. Accepting a lower-priced council contract can be preferable to being out of business, particularly where people who use services are unable to access direct payments quickly or at an adequate level to buy regulated care."
He said a UKHCA survey of members on commissioning had found that three-quarters felt councils valued low price above high quality when tendering for services. While he agreed judicial reviews were not the way forward, Angel added: "Providers could be forgiven for thinking that legal action may be the only device left to redress the imbalance at local level."
http://www.communitycare.co.uk/Articles/20/04/2012/118150/care-providers-challenged-to-stop-bidding-for-low-fee-tenders.htm