Watching the government’s announcement on Tuesday of a new health and social care levy in England, I couldn’t help but feel a sense of deja vu: it was the type of damp squib moment that those of us who work in the care sector have become used to over the past 30 years.
The rise in national insurance will raise £36bn in the coming three years – but the bulk of that is going to tackle shortfalls in the NHS. Only around £5.4bn is likely to find its way to social care – a term that refers to the providers of care for elderly and disabled people. Factor in that £2.5bn of that will be needed to fund the new cap on care costs, which should stop people from paying over the odds, and that just leaves £2.9bn.
Well, £2.9bn over three years to tackle a crisis in social care that has been decades in the making is not going to scratch the surface. It’s certainly not enough to tackle the chronic underfunding we have experienced since 2010. And it’s also not enough to properly reward the highly skilled staff who have given their all during the pandemic – and who deserve better pay and conditions.
It is good, at least, that the issue has come to the forefront and we will see some action – so credit to Boris Johnson for that. But I once again got up on Wednesday wondering: how I am going to find the people to cover shifts across my care homes? In common with other nursing and care home owners, I worry about how long I can continue to find enough staff to operate my homes safely. Homecare providers will be looking at whether they can continue to provide a service – or hand back their contracts to the local authority and shut up shop.
There was nothing in the proposals to help us to recruit people to do the job on the frontline. We have staff vacancies, and there are 1,000 vacancies across North Yorkshire and at least 120,000 vacancies in England – plus 40,000 people are predicted to leave the sector because of the rules mandating vaccination.
The pandemic took a huge toll on care providers like us. Aside from the terrible losses we saw and the blood, sweat and tears shed by our staff to care for older and vulnerable people, the past 18 months has seen us take a severe financial hit.
The huge extra costs associated with providing the right personal protective equipment, and massive increases in staffing costs, including bonuses for our deserving workers, have all taken us to the brink. Yes, the government did provide some support, but it fell short of what was needed. Falling occupancy rates did not help us to balance the books. We need to make a surplus, not only to survive but also to comply with Care Quality Commission operating rules. In my business, we faced an extra £250,000 in costs from loss in occupancy and higher staff costs alone.
And now we just don’t have the workforce to meet the recovering demand. We’re trying hard to recruit, offering “golden hello” bonuses and “refer a friend” schemes, but ultimately the vast majority of our work is commissioned directly by cash-strapped councils – and they just don’t have the funds for us to compete with, for instance, local jobs in hospitality. Many care staff have left the sector to take on other jobs; Brexit reforms mean we can no longer recruit as many people from overseas.
It is excellent that we have proposals to cap costs faced by those needing long-term care. It is wrong that so many people lose everything, including their home, to pay for care. It is particularly unfair for those diagnosed with dementia, a terrible and debilitating illness. At the same time, the “cap” is not all that it seems. What many people don’t realise is that it won’t include accommodation and food costs, which will still need to be met by those seeking care.
It looks to me suspiciously like there will be very little new money going to local authorities to properly fund the provision of care and help the 1.5 million people who cannot get the support they need.
So after campaigning for 30 years for a better deal for social care, we have been let down. All we have is another sticking plaster to get some money into the NHS because it has been battered by Covid – and left in a situation where thousands of operations and treatments have been pushed back.
The social care sector has been fighting Covid side by side with NHS institutions. Yet it continues to be treated as the less important, poor relation. Proper reform has been booted down the road until the promised white paper “later in the year”. I can’t help but feel that those of us looking after some of the country’s oldest and most vulnerable people are in for another long wait.