Social Care Funding

Debate between Thelma Walker and Barbara Keeley

Wednesday 17th October 2018 Commons Chamber

[Barbara Keeley]

I am constantly astonished when Conservative Members talk about a cross-party approach. It is up to their party to come up with some proposals. When it has some proposals, there will be something to talk about. All that we have seen the Conservatives do is to abandon all the proposals that they have previously had. We legislated, in the Care Act 2014, for a cap on care costs and a lifting of the ceiling—the asset threshold—but the Conservatives have abandoned that now. They had a set of policies at the time of the election last year, but they have abandoned that. The hon. Lady needs to speak to her own Secretary of State, and I hope that she can have a constructive conversation with the Chancellor as well.

The Government’s cuts have not just reduced access to care in the ways that I have outlined; they have reduced care quality. Cuts mean that there is less good-quality care, which causes great indignity to both older and younger adults. The Care Quality Commission tells us that one in five care services—about 4,000 facilities—requires improvement or is inadequate. In too many care facilities quality is hanging by a thread largely because of the good will and dedication of care staff, but there are times when even their efforts cannot prevent standards falling. In a recent case in Tameside a care home rated inadequate was eventually forced to close for financial reasons. Care home staff were not only not being paid themselves, but they had paid out £5,000 for the food for care home residents, and an agency was owed £37,000 to pay care staff. An earlier CQC report had noted that that care provider had been made bankrupt. During the time before this home was closed, care quality was scandalously low. In 2017 the CQC found that one resident had been left in bed for five months without a bath or shower. It beggars belief that the Government think that care home managers in such situations should be given responsibility in the process for assessing a cared-for person’s mental capacity under the proposed mental capacity legislation currently in the other place, but that is what the Bill currently says—even care home managers in that failing home would be given a part in the process of assessing mental capacity—and it seems that the Government will not shift from that. I join others in the other place and urge the Secretary of State to pause the passage of the Mental Capacity (Amendment) Bill and listen to the concerns being raised about his proposals, because that is not a role that should be dumped on care home managers in the way the Bill is trying to do.

[Thelma Walker (Colne Valley) (Lab)]

The Kirklees Solidarity Economy Network in my constituency is working to establish a community-based care co-operative. The model it is developing seeks to demonstrate that a better way is possible by putting people before profit, valuing, rewarding and respecting careworkers, and ensuring that the people receiving care and the workers providing that care have a real say in how the service is run. Does my hon. Friend agree that we could all look to that model in the future?

[Barbara Keeley]

I very much do and thank my hon. Friend for making that point. There is a great place for co-operatives and mutuals and other such organisations. Organisations like Shared Lives are producing outstanding care in some parts of the country, and we must look at all those models.

I want to talk about hard-pressed family carers, because the situation of less care and lower quality care means that family carers are under pressure as never before to step in and provide care. The strain of caring has seen almost three quarters of carers suffer mental ill health and nearly two thirds suffer physical health problems, according to Carers UK. But too few carers can access respite from caring; they are at breaking point.

Problems with poor care quality and a lack of support were highlighted earlier this year in a report by Age UK entitled, “Why call it care when nobody cares?” At the launch of that report, both I and the Care Minister heard from carers like Joyce. At 73, Joyce cares full-time for her husband David who has had a stroke and a massive brain haemorrhage. Joyce has to do everything for David to make sure he is

“clean and comfortable at all times”.

That involves regularly lifting him in and out of his bed or chair to wash him, or take him to the toilet, throughout the day and night. She said:

“It is extremely hard to get good respite care where we live in Cheshire. Our local care home is no longer an option due to being cut as a provider by the local council. I had to fight tooth and nail for the care David currently gets in a day centre—but it just isn’t enough.

I don’t know how I’ll continue to cope without more support and regular respite breaks. Our care was cut in March, the third time that we have had respite care pulled. I am so angry and frustrated, I am so worried at what is facing us at the moment I hardly dare think about it.”

What carers like Joyce need is comprehensive support and carers breaks to allow them to look after themselves as well as the person they care for. What they have received from the Government is the damp squib of a “carers action plan” in place of a proper national strategy.

Labour has already pledged to deliver a national carers strategy as we did with our second national strategy in 2009. That national carers strategy pledged £150 million of funding for respite care breaks for carers. That funding has now disappeared into a black hole in the better care fund, leaving carers like Joyce to fight “tooth and nail” to get any respite at all.

Social Care

Debate between Thelma Walker and Barbara Keeley

Wednesday 25th April 2018 Commons Chamber

[Barbara Keeley]

It is reported, in fact, that the total back-pay bill across the social care providers that provide sleep-in cover will be about £400 million, so it is not surprising that a care provider such as Lifeways would say that. The Government have to come up with answers for this, because there has been a dragging of heels, the guidance has been very confusing, and it is a serious matter. I understand, too, that the Government have completed two reports, but they have not been made public. Hon. Members and I would certainly welcome having those reports placed in the Library so that we can get that information.

We have seen warnings from the Competition and Markets Authority that care homes would find themselves having to close or move away from local authority-funded care because the funding is now only just covering day-to-day running costs. It is quite clear from all this that there is a growing funding gap in social care that must be filled. The Local Government Association has said that our social care system needs an immediate injection of £1.3 billion to fill that gap, and this is projected to rise to £2.5 billion by 2020, according to the King’s Fund.

In our last Opposition day debate on social care, in October, the strain social care was under—from the weight of growing demand, reducing supply and the lack of funds from Government—was plain to see, but since then the system has cracked still further under the pressure of Government funding cuts.

[Thelma Walker (Colne Valley) (Lab)]

When elderly people fall, they often have a stay in hospital, putting additional pressures on the NHS, and when they are ready to be discharged, hospitals sometimes cannot discharge them, because local social care provision is not available. Two thirds of admissions to hospitals for falls could have been averted by early intervention in the home. Does my hon. Friend agree that we need more money for our adult social services?

[Barbara Keeley]

I do absolutely—and that is the point I was making. It was only when the number of delayed transfers of care hit a record high that the Government started to pay much attention to this issue. The other worry is that, as the British Red Cross has reported, in attempting to reduce the number of delayed transfers of care, hospitals often eject people before they are ready. One can see a vicious cycle of admission and readmission.

As I was saying, the system is beginning to crack. Hard-pressed councils and their associations are pleading for more funding to deal with the ever-increasing demand for social care. In December, the former president of ADASS, Margaret Willcox, said:

“The crisis facing us is so acute that we fear social care could pass the point of no return in 2018 while we wait for decisions to be made.”

The National Audit Office has warned that councils could face insolvency after using their reserves just to meet those increasing costs of social care. As well as Northamptonshire County Council being technically insolvent, we recently learned that Worcestershire County Council has a massive budgetary disparity. A report from the Chartered Institute of Public Finance and Accountancy has warned the council that it faces a £26 million hole in its finances this year and that that would rise to £60 million in 2020, owing mainly to an increase in demand. The council chief executive, Paul Robinson, has said that

“there comes a point where cost-cutting can’t go any further – there has to be a solution, and I think it has to be a national solution.”

Lord Porter, the Conservative chair of the LGA, has said to councils that:

“you can’t keep dipping into your savings; sooner or later the money will run out.”

Let us think about what these cuts to social care mean for the quality of care that people receive. In the recent words of the Secretary of State himself, there is unacceptable variation in the quality of services. One in five care facilities receives the lowest quality rating from the Care Quality Commission, and Labour’s own research has revealed that over 3,000 care facilities that already have the lowest quality rating continue to receive the lowest rating even after being re-inspected. Cuts mean providers have less money to pay staff or to invest in training or building renovations, which can obviously lead to their getting trapped in a cycle of poor-quality care provision, and that poor-quality care has a serious impact on the lives of people who need care.