Removing barriers for adult social care

Published on Tuesday, 11 December 2012 13:00
Written by Sarah Pickup

Web Editor, Scott Buckler sat down with ADASS President, Sarah Pickup, to discuss personal budgets, CCGs, cuts and the role of the third sector

Sarah, how do you think the further cuts to local authority budgets made in the recent autumn statement will impact adult social care?

Heavily. Although the government announced some extra resources, transferred from the NHS into adult social care, to accommodate the costs of delivering some of the white paper aspirations, the issue with adult social care is you cannot sit it in isolation within the remainder of council budgets. Adult social care is around 40% of a local authority's budget, so cutting by 2% of a council's budget inevitably you do not leave adult social care untouched. It seems a bizarre thing to do in the current context and given the issues of funding adult social care. We are all aware there are huge economic pressures but it is making social care worse. We are heading further into cuts rather than re-structuring new types of services, new forms of delivery and re-designing current services. There must be more done to break down the barriers between health and social care. Social care and health budgets are always being spent on high end needs but we need to get investment in earlier to prevent high end needs occurring. There are many who end up in high cost provision whom necessarily should not be there.

How essential will the relationship between local authorities and CCGs come April 1st?

Absolutely critical, the CCGs are important for all Health and Wellbeing Boards. We need HWBs to work effectively in terms of adult social care provision. If we used our joint resources better we can deliver better outcomes. It is extremely difficult financial climate at the moment. Often it's the case that the place of where the cost falls is not necessarily where the saving lands. The incentive for all CCGs and HWBs is the opportunity to work across boundaries. We must not see the CCGs as bailing out social care, instead we need to stand back and look at sharing our resources.  I think if we start viewing CCGs as cash cows then the relationship will start on the wrong foot and our aspirations will not be met.

How do you believe the role of the VCSE sector will change come April 1st?

The VCSE sector is hugely important, where I am based, in Hertfordshire County Council, the VCSE will not sit on the boards of HWBs, however they will be involved in health watch groups (previously Links) and be able to influence accordingly. We really need to build on the good community infrastructure we are seeing up and down the country. We are already witnessing people who can raise awareness of community services, people who support independent living and a whole community approach. We need to move towards dementia friendly societies such as those outlined in the PM's Dementia Challenge initiative. The VCSE sector are helping communities understand and support those receiving social care services, but, wouldn't be nice if we could ensure every local supermarket or bank recognised these people and developed their services to accommodate them.

How do you think personal budget control and design will enhance adult social care?

We need to have budgets which allow for overlapping between health and social care, such as those with long-term conditions. If we create a single budget bringing health and social care together we will get better outcomes. If we continue to look at budgets as single entities we will see difficulties. A good example around personal budgets is the cost of respite care, how many people know what the cost of respite care actually is? If they did they might instead choose to visit a friend or stay with a sibling to save their money.

Finally, your thoughts on the proposals by Jeremy Hunt into a new care rating system?

ADASS welcomes the review into care ratings. There are different interpretations of good quality care. If you simply have a tick box exercise you can miss what is most important. There is subjectivity involved, each person's opinions of good care differs. If you questioned most people about what good quality care is you would most likely get the reply, compassion, caring and support. The aspiration for service providers should be to draw on the data currently available from local authorities which highlights where standards in care are dropping. There is a strong desire to have a comparison site to check standards of care and provide options which I feel may allow people a more detailed view of standards.  There are challenges to doing it, but ADASS will be working with the Nuffield Trust to offer our support and input from an adult social care viewpoint.

Jo Cleary, Honarary Treasurer at ADASS will be chairing Govtoday's Social Care Conference on March 13th

The views expressed in the contents below are those of our users and do not necessarily reflect the views of GovToday.


0 #1 Joe GoddenJoe GoddenProfessional Officer 2013-01-09 16:29
BASW supports much of what Sarah Pickup says. It is a very honest opinion about the impact of the cuts in budgets and the huge challenges facing social care and social work. I particularly like the honesty around how difficult it will be to move from the downward cycle of only dealing with those with the greatest need, thus escalating costs further. There are opportunities and challenges with the pending Clinical Commissioning Groups and Health and Well Being Boards and Sarah is write to say that they should not be seen as cash cows. There must however be an improvement in the sharing of budgets, or transfer of budgets. The failings of Winterbourne View epitomize that. The Serious Case Review and the DH Concordat highlight that finding and developing services that are local can only be achieved when there is a willingness to share budgets.
BASW also support the recognition that quality standards must include locally generated information - information from users of services, carers, social workers and contracts and commissioning units. Clearly there will not be a return to the days of inspection being a part of the local authority, but as a minimum there needs to be a recognition that that system where it worked well enabled concerns to be quickly reach people with local knowledge, who could act quickly. Winterbourne View, Staffordshire Hospitals and many others had good CQC inspection reports. That is is scandal and we hope that the expertise of social workers, with real knowledge of placements will be taken into account in the Nuffield Trust Review of what is good quality care and how it is measured. Joe Godden Professional Officer BASW

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