Transforming Social Care
- Published on Friday, 12 November 2010 00:00
- Written by Paul Burstow
In the north of England councils such as Manchester have come out fighting, insisting there will be neither major cuts to frontline services nor any knee jerk reactions”. So how fitting it was to see Manchester hosting the annual National Children and Adult Services Conference- Shaping the present, Building the Future.
A Conference which aims to identify the future of social care transformation in the light of recent spending cuts. Social Care, an area which has been ring-fenced by the coalition government, will receive an extra £1bn a year taken from NHS funds as part of an overall £2bn of extra funding every year by 2014/15.But this is set against a backdrop of 26% cuts in central government funding to local councils over the next four years. And, while health spending will be protected in the immediate future, the NHS is still expected to find "efficiency savings" of £15bn to £20bn.
Key speaker on day one of the Conference was Care Services Minister, Paul Burstow. GovToday Editor, Scott Buckler sat down with the Minister to find out his and the Coalitions plans for social care transformation...
Minister, in your speech today you spoke of the need to remove red tape and reduce regulation currently burdening social care services within local authorities. Both authorities and service providers would concur with this urgent need, however how do you feel it has prevented the transformation of social care services?
I have two areas of concern around regulation and red tape, the first is on the burdens local government currently face and the second on the role of the CQC in their annual performance assessments of local authorities. Let me address the issue of performance assessments first. The trouble with the CQC assessments is that the process and the result were merely a snapshot of social care practices. By the time the CQC had published their reports they were all ready out of date by a year. I believe it was not a sufficiently focused mechanism to drive continuous improvement, so we are now working with local government, who will be co-producing a way of delivering continual improvement and peer support from local authorities which will be a powerful way of raising standards.
What about red tape Minister, Departments such as the CLG have been quick to remove reams of red tape and cut over regulation of frontline services. This seems to have accounted for many problems Local Government has faced in the past, would you agree?
Red tape and regulation gets in the way of delivering high quality care. Today in my speech I gave an example of a lady living in a block of flats who was cooking meals for her elderly neighbours and was approached by environmental health who were concerned she needed certificates for hygiene standards and should be classed as a business. This is a typical example of red tape, however in this case good intervention by the local social services team prevailed. They could see past the immediate regulation problems raised by the environmental health and recognise the value of community building which she was contributing to and they were able to work out ways in which the system could facilitate her. She now cooks for all residents in the flats and this both empowers her and helps with supporting other members living close by.
Speaking of supporting members of the community, you spoke very passionately about the important role of the ‘Big Society’. Could you explain more about how you envisage communities and civil society delivering social care services around the country?
The whole idea behind the big society is that we have a real transfer of power, as a liberal I believe in distributing power in society. Too much power has been held in the centre, in Whitehall and in institutions. The big society is about citizens standing up and getting what they need for themselves and their communities. The civil society are key actors in this and as a government we are determined to ensure they can play that role fully. My message to local government today was that this is a perfect time to embrace and engage with the voluntary sector and co-produce and design services. The innovation we can see in the voluntary sector really is the way we can get every last ounce into social care. It creates value for money.
Value for money has been the key theme of the Coalitions agenda since entering power back in the spring; however in order to save money you must spend money in the right areas.
Back in October you and the Department of Health announced a Re-ablement package of around £70 million pounds. Can you tell me how the package aims to support people and cut re-admission rates to Hospital?
The research evidence around re-ablement services is very compelling. About half of the people who go through a re-ablement service do not need ongoing social care packages to support them, they return to full independence. That is the aspiration of every person leaving hospital, they want to be independent, and this is about their self-confidence being restored as it is about their physical ability to live a fulfilled life. The £70 million will really kick-start the building of the infrastructure for places which have not yet got these services in place. I see it as a win, win , win , firstly a win for the individual, secondly a win for social care and thirdly a win for the NHS. It will create the collaboration we need to see in health and social care.
Throughout the Conference there has been much discussion regarding personal budgets. You spoke of your disappointment at the number of people whose care packages are paid for with a personal budget, saying (quote) “personal budgets should be a right, not something that people just have to hope for.” You also confirmed that the coalition is keen to look at the widespread expansion of personal budgets beyond adult social services, but allocating budgets is good and well, however how do you expect to monitor the results of such allocations and measure the outcomes of service users?
The key concern about personal budgets is that they do not become a tick box exercise, if we just end up with local government saying “ well we have 100% of people on personal budgets, yet we do not know much about the quality of those budgets and the quality of the services commissioning” then we will not achieve the ambition of this government which is transforming the way services are provided and empowering service users. So we will have to consult via our outcomes framework which measure the quality and the results the services deliver rather than measuring the processes and the inputs. We must make sure we develop service user measures so we can understand what quality looks like from the service user’s perspective.
Finally, there were a number of questions from delegates regarding the wellbeing and welfare of family carers. There concern obviously stemming from the recent cuts to the disability allowance, which many carers have come to rely on. How do the Coalition and the Department of Health plan to support carers who play an integral part in social care across the UK?
There were two key questions yesterday; one question was to remind me and the government that we should not forget the role of carers. I can assure the GovToday audience that I would never forget the role of carers, the contribution they make is huge. A lot of what the Coalition are trying to do to personalise this service will be a benefit to carers too. In particular the idea that carers should have the access to personal budgets is something we will be speaking more about soon. Where they are being used at the moment they are being used effectively at giving back people a bit of their lives they are no longer define their lives solely through their caring responsibilities.
A key point to make is that as a coalition we have had to look at priorities in the spending review, we have not just salami sliced every budget, we have made decisions where to make significant savings in order to re-invest in higher priorities, we have done this in terms of social care. We have put far more money into social care than would have been applied through a straight forward cut across all public expenditure, by doing this we are protecting social care and the most vulnerable in our society. Benefits introduced in the 70’s, 80’s and 90’s were all about a more personalised approach to support and care, however social care has moved on leaps and bounds since those benefits were introduced. Now with more direct payments available we have a social care system which is delivering the same if not more personalisation than those benefits delivered in the past, so there is change taking place. Change can be unsettling we understand this so we must make sure we do this in the most sensitive way we can.