The link between social care and housing is crucial
"We have a once in a lifetime opportunity to bring the tectonic plates of health, care, and housing that underpin our society together and create a strong foundation for our future."
Chan Kataria, Chief Executive
The links between housing and social care have never been more important. And social care has never been in more of a crisis.
The number of people aged 65 or over in the UK is expected to increase from 11.8m to 17.5m over the next 20 years. When you add the number of vulnerable adults under retirement age with care needs, the LGA estimates that by the end of the decade there will be a funding gap for adult social care of over £1bn. Beyond 2020 the sector will be on the brink of collapse unless we act now.
At emh group our mission is to provide housing and care to improve opportunities for people. Our specialist care subsidiary, emh care and support, has over 500 employees and provides around 7000 hours of care every week. The challenges in this part of the business are in stark contrast to the certainties of the housing world, which at least enjoys the benefits of inflation indexed rent increases and funding for development under strategic partnerships.
So what are the challenges facing care and support?
Funding is the first issue. A recent survey by the Association of Directors of Adult Social Services (ADASS) found that last year half of the local authorities in England overspent on their adult social care budgets. Since 2010, social care spending has been cut by £7bn and in the forthcoming financial year local authorities plan to push through further cuts of £700m, or five per cent of the total £14.5bn budget. So the recent news that Northamptonshire County Council was close to bankruptcy would have come as no great surprise to many.
In addition, the lack of a strategic and holistic approach to social care policy is all too apparent. Take for instance the recent Court of Appeal ruling in favour of Mencap regarding back pay for care workers available for night time working. Had the previous tribunal decision prevailed, it would have cost the care sector some £400m in terms of six years’ back pay for sleep-in shifts. This would have forced some care providers out of business at a time when the market is already volatile.
The threat has not totally disappeared, however, as Unison has applied to the Supreme Court for permission to appeal. Ultimately, the real answer is to have sufficient funding to pay care workers a rate that shows how much we value them.
Another example of this muddled approach is the endless review of funding for supported housing which, over the last few years, has gone through various possibilities, ranging from capped Housing Benefit to ring-fenced funding administered by local authorities. The uncertainty before the U-turn on this policy lasted three years, during which time emh group delayed the building of a much needed extra care scheme.
Then there is the anachronistic local authority care commissioning system. It seems perverse that housing organisations are taking risks associated with the capital funding of an extra care scheme and then finding themselves having to compete for care contracts in the same scheme, sometimes for as short a period as 18 months. There is no reason why such commissioning can’t be done on the basis of long term commitment and partnership with local authorities, subject of course to appropriate demonstration of value for money.
These problems, along with others such as health and care integration, market instability, and a skills shortage provide the backdrop to the long awaited adult social care green paper.
Now due for the autumn, the green paper will initially focus on older persons. However, the underlying principles of a good health and care system have already been announced. These include a long term sustainable funding model, holistic and person-centred integrated health and care services, a cap on lifetime care charges, and measures for market shaping and capacity building. If the green paper can deliver these principles, then I am very hopeful about the future for care and support.
At emh group we believe that the provision of homes is essential for people to meet their aspirations in life. But this is not enough for adults with care and support needs, and our ambition is to deliver high quality, person-centred services for them so that they can maximise their potential to lead full and active lives.
We have a once in a lifetime opportunity to bring the tectonic plates of health, care, and housing that underpin our society together and create a strong foundation for our future. If we do not get it right, we will feel the seismic shocks for generations to come.