Social care is back in the headlines today, as the CQC launches it’s annual review of health and social care services ‘The State of Care’. The report gets straight to the point, focusing in on the precarious nature of future quality, and the notion that staff resilience is not inexhaustible. The full report can be accessed here
and NCF have issued a press commentary which can be found here.
What is so interesting is that it was less than a week ago that
the headlines about social care that grabbed the media’s attention was the
reported comments of the Parliamentary Under-Secretary with responsibility for
Social Care – Jackie Doyle-Price MP. The summary reading of her assertions to a
fringe meeting at the Conservative Party Conference was that families and
neighbours needed to take on more responsibilities for caring. On reading this,
I felt a peculiar sense of déjà vu – and therefore am extraordinarily indebted
to the work of Ageing without children – who helped me to remember just how
many times ministers or those with a responsibility for the care portfolio have
replayed these propositions in recent years. The list is quite stark and I am
going to provide you with a couple of examples from their interesting blog.
“A wholesale repairing of the social contract so that children see their parents giving wonderful care to grandparents – and recognise that in time that will be their responsibility too” - Jeremy Hunt Sec State for Health 2015
“We need to start thinking as a society about how we deal with care of our own parents. One of the things that has struck me as I’ve been doing this role is that nobody ever questions the fact that we look after our children, that’s just obvious. Nobody ever says it is a caring responsibility, it’s just what you do. I think some of that logic and some of way we think about that, in terms of the sort of volume of numbers that we are seeing coming down the track, will have to impinge on the way we start thinking about how we look after our parents. In a way, it is a responsibility in terms of our life cycle that is similar.” - David Mowat Minister for Care January 2017
In the absence of any other direction or focus on the resolution of social care funding – this creates a concerning perspective on the potential thinking behind the green paper. The ongoing wait for the Carers Strategy – postponed from earlier in the year – serves to create a further vacuum in the debate on ‘who cares’ within an increasingly complicated ageing population. In the same week that the fringe meeting was held, we also heard from the British Medical Journal that the impact of austerity on delayed discharge could be a contributory factor in increases in mortality. Healthwatch produced a report providing evidence about the delays and their impact on people’s ability to return home, and the adult social care survey demonstrated a year on year increase needs of people who are in receipt of social services support.
The CQC’s report further emphasises the fragmented nature of
care that people receive, and the ever growing number of older people with
unmet care needs. In all of these reports the common factor is that an
appropriate and effective response is one where fully integrated health and
social care work in harmony to meet individual’s needs – people need a
personalised professional response to their individual complex circumstances.
This is of course, not to undermine the absolutely crucial role
that families and neighbours play in the day to day delivery of care. To
suggest, as unfortunately all these commentaries by ministers are interpreted
as doing, that people are not ‘pulling their weight’ in some ways is to ignore
the evidence of organisations such as the Carers Trust, and Carers UK who
document on a regular basis the contribution of carers almost from cradle to
grave in supporting their loved ones, friends and neighbours. In addition,
there are vast swathes of volunteers and community organisations out there
combating loneliness and isolation – as well as offering critical information
and advice to support people to retain their independence.
So as the CQC report fades from the headlines, it can be
difficult to sustain confidence that anyone is listening to multiple calls for
action. However, as the evidence continues to mount about the need for both
immediate investment and sustainable change – the question of ‘Who Cares?’
becomes increasingly replaced by ‘Who can afford not to!’