Equality: Social care has become a lottery
Last week the Chancellor Philp Hammond grudgingly faced the crisis affecting adult social care, he proposed an extra Â£2 billion worth of funding, with half to be available between 2017-18, and the remainder spread over the next three years.
In my view, I don’t think this is an opportunity to celebrate, until there is an overhaul that focuses on improving the quality of staff and care for service users. The reason I make this point is because whilst many people are making lucrative profits from adult social care, many members of staff in adult social care receive poor pay, insecure employment, inadequate training, a lack of supervision and excessive performance- managed tasks driven by managing demand efficiently and profits. This is backed up by the fact there is a 25% annual turnover in terms of staffing nationally. Therefore, until the status of social care as a profession is improved, attracting compassionate staff and hoping for quality of care for service users will always remain a key issue. The fact is the rhetoric around service users exercising “choice” over their care and support has not served people well. Too often decisions are being made at a time of distress and on the basis of inadequate information, Local Authorities are not required to publish details about individual services, and the care quality commission is focused on publishing information about providers that meet minimum standards. My experience of adult social care in Sheffield stems from the care my grandmother received at the hands of two different care providers at our family home. Here was a woman that had lived a full life, realised that her human rights were connected to the human rights of others. When she passed away on the 4 th of March, she left behind a legacy that includes a 60-bed hospital, a school for children with disabilities and an ambulance service. For 60 years this woman economically and socially contributed to Britain, her home. In the latter part of her life, despite the many contributions that she had made, she like many others of her generation had to fight for dignity in the care she received.
My grandmother was provided care by two providers, one that was driven by performance managed tasks, whilst the other was driven by performance and my grandmother’s dignity and quality of care. In both cases we had limited information in terms of choice – though we instantly knew as soon as the carers walked in, which was interested in the care of my grandmother and which wasn’t – but like most families we too kept faith in the system, and the commissioning decisions of the Council. My grandmother never stepped into a care home, and we were blessed that 99% of the time we could maintain her dignity at home, though through her, we realised how poorly the adult social care system that my grandmother receives is designed and monitored. Thankfully, because of holding the Council and the poor provider of care to account we were eventually able to change things round for my grandma, though the psychological trauma that my grandmother, and probably other people of her generation suffer in this country should never be under-estimated. The point is that my grandmother at her latter stages of her life lived at home with a devoted family, in a place of dignity. Our experience told us that adult social care has become a bit of a lottery, and unless families and carers are strong and have the will to coherently complain pressing all the buttons systematically; needs to do with gender, culture or dignity is a luxury that frankly the system has no time for. My grandmother was fortunate that she had a large extended family at every step of her life; my fear is what happens to those people who don’t – what happens to their dignity and voice, who speaks up for them and holds the authorities to account? Do people even know 65% of local authorities have reported provider failures in the last 6 months? In my view, it is about time we made changes the way the adult social care system operates in this country, firstly we must learn lessons from current service users, put adult social care on a par with the NHS, introduce meaningful rates of pay and cap profits. Similar to the NHS put in place a national 5 year strategy, and more importantly in every school up and down the country we should consider introducing a system where our young people / talent have to volunteer at a care home as part of citizenship studies – the course could be called “dignity is a right, not a luxury”.