INTERVIEW: Hft public affairs and policy manager Billy Davis

Billy Davis

When Hft released its third annual Sector Pulse Check report yesterday, HCI was one of the first news organisations to speak with the national learning disabilities charity about what the research means for the future of social care the sector.

Here, Hft public affairs and policy manager Billy Davis shares the charity’s perspective on the research findings, including the dramatic rise in adult social care providers being forced to cut support to vulnerable adults to cope with financial pressures.

Click here to download the report in full.

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Your research shows that 59% of providers believe the social care sector was in worst condition when Theresa May left Downing Street compared to three years before. Which factors played a part in this?

Our report asked providers what they believed, not why they believed it. From our perspective, Hft was disappointed that Theresa May’s proposed green paper on the future of adult social care never materialised during her time as Prime Minister. The constant delay to the green paper meant that conversations on the future of social care continued to be avoided, and so we saw the sector stagnate under her watch. With Boris’ Johnson’s “ready to go” White Paper on social care similarly failing to materialise, our hope now is that the planned “cross-party talks begin sooner, rather than later.

The government is aware of the problems in social care, and with so many statistics flying around about the consequences of cuts to funding, why is social care at the bottom of the priority list?

I agree, it is indeed surprising – given the huge amount of data around social care funding – that the issue of reform seems to languish at the bottom of the government’s agenda.

Hft’s Sector Pulse Check was born due to a lack of robust data focusing on support for working age adults with learning disabilities. From our experience, the vast majority of reports focused primarily on support for older people, particularly those in care homes. By focusing primarily on the learning disability sector, our aspiration was to provide local authorities, politicians and other policymakers with a compelling annual report to provide an annual snapshot of the financial health of the sector, and gauge how providers have reacted to the events of the past twelve months.

We are pleased to see that, year after year, the number of providers that respond to our survey increases. At the same time, we have also seen respondents expanding beyond the learning disability sector, to include providers from all other types of adult social care – such as support for older people, and adults with physical disabilities. With providers recognising the value of responding to our Sector Pulse Check survey, we are able to provide a more complete picture of how the sector is faring.  

Any reforms to the social care sector must be data-driven. We believe the findings of Hft’s Sector Pulse Check surveys have a role to play in that.

Your survey shows that the increase in the National living wage is the biggest financial pressure for providers. Why do you think this isn’t always factored into the rates at which social care packages are commissioned?

Hft welcomed the introduction of the National Living Wage, and we have always supported any increase to the National Living Wage rate, which would see our hardworking staff paid more for the invaluable work that they do.

However, the introduction of the National Living Wage has come at a time when local authorities across the country have experienced cuts to the amount of money that they receive from central government to fund essential public services such as social care. This in turn has put downward pressure on commissioners, who are trying to balance smaller budgets at a time of growing demand.  

This has meant that social care providers have witnessed a reduction in the rate at which social care packages are commissioned. For Hft, staff pay already accounts for up to 80% of our total expenditure, with the remaining 20% needing to be used to pay for all the other aspects that go into delivering high-quality, person-centred support. As the National Living Wage continues to rise, this has led to the cuts and internal efficiency savings we have seen providers engage in to become financially sustainable.

The underfunding of social care is a national crisis, and so requires a national solution.

The demand for services is set to increase as the government rightly moves individuals out of inappropriate Assessment and Treatment Units (ATUs). How will this affect care providers going forward?

Demand for support for adults with learning disabilities is the fastest-growing sector in adult social care in England in terms of demand. While this is in part due to adults with learning disabilities leading longer, healthier lives, adults being moved on out of inappropriate ATU settings and into supported living will no doubt add to the demand pressures providers are facing.

It is also widely acknowledged that there is a recruitment crisis in the social care sector. This is particularly true for services that support people with complex needs, or display behaviours that challenge. Our survey has found that 76% of providers say recruitment to such services is “significantly more difficult” than in services for people with mild to moderate support needs, and 82% also warn that they struggle to retain staff once they are hired.

With social care being commissioned at a rate that assumes employers pay at just the National Living Wage rate, providers will continue to struggle to make salaries more attractive, and more reflective of the excellent work that staff do to support these vulnerable adults.

The Department of Health and Social Care has previously said that it was down to the local commissioners to provide appropriate placements. But won’t they require extra funding to meet demand?

Our research polled providers from across England and a reoccurring theme is that local authorities are having their central government funding cut at the same time that demand for social care services is growing across the board. What is clear to Hft is that this is a national crisis and so it requires a national solution. This will only come from Westminster, not from local authorities.

One of the most distressing findings from the survey is that there has been a 12% rise in organisations having to offer care to fewer individuals. Why was there such a dramatic rise in 2019 in particular?

Our 2018/19 survey showed a dramatic spike in the number of providers handing back contracts, reducing the scope of services they offered and shedding staff. This year, it is perhaps then unsurprising to note that the biggest increase in cost-cutting measures have been providers noting that they are offering care and support to fewer individuals – it is a knock-on effect from the cuts made last year.

No organisation sets out to offer care to fewer individuals. It is culturally at odds of what we do. What this year’s report is showing is that cuts are now starting to affect people, not processes, as staff and the people we support begin to bear the brunt of further funding cuts.

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Sarah Clarke

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