A single issue – in fact, a word added to the Oxford English Dictionary only a year ago – dominated 2017 and will also command the political agenda over the next 12 months; Brexit. With ministers and civil servants focused on the UK’s withdrawal from the EU, social care is starting this year as we left the previous one – in a policy void.
So far, our response as a sector has been to treat the lack of focus as an ongoing challenge to battle. Collectively and individually, care providers have been lobbying government for extra funding and a sustainable future. But our pleas have been met with silence. In the Chancellor’s Autumn Budget statement, for example, social care was noticeable by its absence. With no new money in the Local Government Finance Settlement 2018/19 for children and adult services, commissioners and providers need to brace for continued pressures as demand and unmet need continue to rise.
So might 2018 be the year that voluntary organisations think about and deliver social care differently? Can we in fact use the policy vacuum and the distractions of Brexit to the advantage of people who require care, and positively influence support across the sector?
The scale of the challenge is clear. VODG and others have long voiced concerns about rising demand for services and falling supply of funding. There is nothing left to trim from services. Since 2010, cumulative adult social care savings have amounted to £6.3bn, according to the Association of Directors of Adult Social Services. And because most people supported by voluntary sector providers are publicly funded, our sector is disproportionately affected by social care budget cuts.
Additional pressures include the “sleep in crisis” which could be devastating for care organisations. The crisis has been caused by Government’s own admission that its previous guidance on National Living Wage (NLW) payments was “potentially misleading” yet it is failing to resolve the problem. As the Care Quality Commission says, the sector is already at ‘full stretch’ in terms of funding. Consecutive governments have failed to properly fund social care, something that is piling additional pressure onto the NHS.
And by 2025 there will be 11.7 million disabled people in England. This sizeable 20% of our population is also ageing, creating even more need for disability-specific support for older people.
This is the already difficult social care backdrop to Brexit. Although the political and policy agenda is distracted by our withdrawal from the EU, the irony is that the government is ignoring the impact of Brexit on the already beleaguered social care landscape.
VODG is part of the Cavendish Coalition which lobbies on Brexit-related workforce issues. We know that Brexit may undermine support for disabled people through, for example, the loss of EU care workers as some 90,000 people from EU countries are employed in adult social care. There will also be a drop in funding from and partnership opportunities with the EU and a potential erosion of the rights of disabled people (many disability rights originate in European law).
It is worth noting that the recent announcement of a Green Paper on older people and an industrial strategy for Britain had a strong focus on the impact of ageing, but made no mention of disability. Such policy efforts are welcome, but they fail to address the growing numbers of disabled people who require support. The government has “a parallel programme of work” to focus on working-age adults with care needs, but the solutions for social care lie in looking at different parts of the funding jigsaw together – as separate entities.
Meanwhile, as much as some challenges are familiar, like dwindling funding and growing demand, there is a new political context for our sector. Aside from the uncertainties caused by Brexit, the government is itself changing fast – who could have predicted the power now wielded by the Democratic Unionist Party following the 2017 general election?
So we need new approaches to spark government action and to create change within our sector; we cannot wait for government to act.
Take the work of the national inquiry Civil Society Futures (CSF) to start a countrywide conversation about the future of the voluntary sector. The aim is to explore how civil society can develop in a fast changing world and VODG recently hosted a CSF conversation on the future of disability support.
There are many new conversations we need to have to strengthen social care, especially if government’s attention is on internal party crises, or Brexit. How should organisations be managing themselves and working with others? This is something being explored by the Care Provider Alliance, which VODG is involved in. The alliance argues for more engagement between the independent and voluntary adult social care sector and Sustainability and Transformation Partnerships, which aim to transform England’s health and care system.
How can support providers redesign services to be fit for new futures? What discussions are needed with commissioners to avoid poor quality services being commissioned in the same old way? One proactive approach is the STOMP campaign (Stopping the Over-Medication of People with a learning disability, autism or both). VODG and NHS England recently launched the refreshed STOMP pledge for social care to encourage health and social care providers to work together to tackle the over-medication used, for some people, to control “problem” behaviour. It is badly needed, as I have argued before.
Similar provider-led action includes the updated Health Charter for social care providers who support people with a learning disability. Developed with people themselves and their families, this aims to improve the overall health and wellbeing of people supported. There are also great examples of individual organisations strengthening families’ involvement in services and VODG has also developed a guide to help people choose their support provider.
As concerns mount about the growth in large institutional provision, the voluntary part of the sector needs to collaborate, share new ideas and play a leadership role in forcing change. Infrastructure organisations like VODG must support new ways of working, which is why we recently held a leadership seminar and continue to champion providers creating innovations, like digital solutions.
People and their families must have a stronger and louder voice in social care – providers should enable this. VODG is committed to support the concept of a social care sector led by disabled people (our work with partners over the party conference season had this aim in mind).
Challenging mediocrity and providing crucial support during a crisis are ambitions that lie at the root of many disability charities, whether set up in recent times or by the philanthropists of the past. There is much more the sector can and should do to protect the future of social care and the people and families who rely on it.
Voluntary sector disability organisations came into being because the status quo was not good enough, surely now is the time to act on those founding principles.