Time for reform not blame, say providers
Prime Minister Boris Johnson has sparked outrage among the care sector and the wider public and has been accused of trying to shift the blame for coronavirus deaths onto care homes.
The prime minister said on Monday that “too many care homes didn’t really follow the procedures”.
Care providers feel they have been slapped in the face by the Government whilst battling to bring the death rate in care and nursing homes down to today’s new low.
Figures from the Office for National Statistics (ONS) show that 181 people in England and Wales died in care and nursing homes from Covid-19 in the week up to 26th June, down from 249 the week before and the lowest so far.
Whilst welcoming the reduction, the Independent Care Group (ICG) said care workers would still be furious over yesterday’s “slap in the face’ from the Prime Minister.
The Prime Minister said that some care and nursing homes had failed to follow coronavirus procedures.
ICG Chair Mike Padgham said the comments had caused upset.
“We warmly welcome today’s continued fall in the death rate in care and nursing homes and feel it is a testament to the amazing, selfless and brave efforts by care workers during this horrific pandemic,” he said.
“Which makes it all the more upsetting for the sector when the Prime Minister makes the comments he did, a real slap in the face for those workers after they have given and sacrificed so much.
“We hope he will reflect on those comments and see the incredible work the care sector has done in the recent months to care for older and vulnerable people, with late and conflicting advice and poor support in terms of PPE and testing during this awful pandemic. And we hope it will spur him into long-promised action to reform the sector and end the crisis in social care which left us so vulnerable to a virus like Covid-19.”
He said the continuing deaths proved that coronavirus hadn’t yet gone away and care providers were still very wary.
“Every death is one too many, and is a loved one – a father, mother, brother, sister, aunt, uncle or friend. We are still very scared of a second wave, still in need of further support and not becoming complacent,” he added.
“Care providers are very nervous that the relaxation of lockdown restrictions will itself spark a second spike in coronavirus, which has already had a devastating impact upon care and nursing homes.”
Ian Kessler, a professor on Public Policy & Management at King’s Business School has issued said: “The Prime Minister’s comments on care homes distract attention from the highly fragmented, largely outsourced system of social care provision, delivered by low paid and insecure workers, as highlighted in our recent report on Fair Care Work . The report notes how these systemic features of the social care model generated major challenges and difficulties in dealing with Covid-19 in care homes, and the value of improving the treatment of staff in the sector as a step towards addressing them.
“We need a new fair deal at work for social care workers which addresses the precarious nature of work and the often poor employment conditions found in the sector and as cruelly exposed by the Covid crisis. As the initial terror of this pandemic begins to subside, it feels like the right moment to start talking about how to rebuild and re-regulate our health and social care system. It is not enough to just clap for our carers, it’s time to make meaningful changes to the working practices that have seen them undervalued and dismissed for far too long”.
Speaking exclusively to THE CARER Jonathan Cunningham MBE Registered Care Manager at Birkdale Park Nursing Home said “the Prime Minister’s comments though fully anticipated are absolutely abhorrent, and are deliberately calculated to deflect responsibility the excess deaths in social care. Under this government the sector has suffered a lack of direction, lack of resources, low PPE supplies, no support, and unfortunately there are no votes to be gained in a fragmented social care sector. The Prime Minister has undoubtably thrown the entire sector under a bus ”
The ICG says instead of trying to blame providers, the Government should, as Mr Johnson also says, start looking at future reform.
Almost £8bn has been cut from social care budgets since 2010, leaving the sector in crisis before coronavirus struck. Even before Covid-19, some 1.5m people were living without the care they need.
Rocketing costs from buying personal protective equipment (PPE) and extra staffing costs have hit care and nursing homes hard at a time when admissions are falling. Age UK has warned that as many as 20,000 care homes could go out of business without urgent extra support.
Local authorities have been given £3.2bn by the government to support all of their extra work during the pandemic, and there is a £600m infection-control fund for care and nursing homes. But estimates suggest that care providers will face additional costs of £6.6bn between April and September.
“The pandemic has left many providers in financial crisis and we have already seen some fail and close,” Mr Padgham added. “We need to see action and we need to see it now, before the loss of care providers means we can no longer meet demand.”
He says the Government should be held accountable and called for a similar pledge to that given by then prisons minister Rory Stewart in 2018. He promised to resign in a year if he failed to reduce the levels of violence and drug use in prisons.
“Mr Johnson, when he first stood on the steps of 10 Downing Street as Prime Minister, promised to sort out social care once and for all. We are still waiting,” Mr Padgham added.
“We have been promised a Green Paper for years but it has been repeatedly put back and we are still waiting. Social care cannot wait any longer. We had a promise from Tony Blair to sort out care in 1997, followed by Gordon Brown in 2008, David Cameron in 2012, Theresa May in 2017 and Boris Johnson in 2019. ”
There have been 13 social care ministers in the past 20 years and at least 13 documents in 17 years, including four independent reviews/commissions, four consultations and five white and green papers, all without any reform coming.
The ICG says the Government could make a start by making social care providers zero-rated for VAT, providing an instant financial saving. Care providers pay VAT for goods and services but cannot charge VAT themselves, to offset some of those costs. Making social care providers zero-rated for VAT would provide a much-needed boost to providers.
The ICG has written to Chancellor Rishi Sunak calling for him to do that immediately.
The ICG has also set out its priorities for reform:
- A root and branch overhaul of the way social care is planned and funded
- NHS health care and social care to be merged and managed either locally or nationally
- Extra funding for social care, funded by taxation or National Insurance
- A guarantee that people receiving publicly-funded care can receive it in their own home or close to where they live
- A commissioner for older people and those with Learning Disabilities in England
- A properly-costed national rate for care fees linked to a national career pathway and salary framework for care staff
- Dementia to be treated like other high profile, high priority illnesses, like cancer and heart disease
- A fixed percentage of GDP to be spent on social care
- A cap on social care costs, including ‘hotel’ charges
- Local Enterprise Partnerships to prioritise social care
- A national scheme to ensure people save for their own care, as they do for a pension
- A new model of social care delivery based on catchment areas – like GPs
- Social care businesses to be zero-rated for VAT so that they can claim it back, as other business sectors do
- CQC to have much greater powers to oversee all commissioning practises such as per minute billing and 15-minute visits
- Less duplication of inspection between CQC and local authorities/clinical commissioning groups
- Greater recognition of the role of the independent sector and utilisation of its expertise in the commissioning and delivery of social care
- Guaranteed equal partnership working through seats on Health and Well Being Boards, CCGs and NHS
- Giving providers and CQC greater flexibility in delivering services
- Providing telemedicine incentives
- Allowing nurses and social care staff from overseas to work in the U.K. including lowering the salary cap
- More nurse training and bursaries to encourage recruitment and end the shortage of nurses
- Long term measures to integrate older and younger people in care settings and change the perception of the generations
- Investment in research and development into new models of social care delivery
- Funding to help upgrade older care homes to maintain a range of choice for the public and investment in domiciliary care
- Funding for leadership training.