THINK TANK DEBATE: How would registered managers reform the social care sector?


After several delays, the Prime Minister has confirmed that the government will publish a plan for social care reform later this year.

With this in mind, HCI asked members of our Registered Managers’ Think Tank to share the top three proposals they would most like to see in this plan, and how these ideas would help improve the system.

Claire Jackson, Good Oaks Home Care (Poole)

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Care insurance
A ‘Care Insurance’ system could put people’s minds at ease, so that if they are hit with hundreds of thousands of pounds worth of care bills they will be able to afford it. Too many people are forced to sell their family homes that they have lived in for many years in order to pay for the unexpected care they now require. This can put a lot of stress on the individual and other family members at a time where they should be made to feel as comfortable and relaxed as possible to help them adjust to their new routine.

Ban of 15 min visits
Loneliness is one of the biggest issues for the older generation – some people can regularly go days without seeing someone. Fifteen-minute visits simply aren’t long enough to provide a person with suitable care and build up a bond with them. Visits that last for a minimum of 30 minutes enable carers to provide the care the individual needs and also have the time to speak to them properly and listen to them. 

Clear funding plan for the future
Over the last 10 years, billions of pounds have been cut from the social care budget, and with an aging population there is an increasing demand for adult social care. With a clear plan in place for future funding, people can continue to recruit, train and invest in technology, knowing the funding will be there to support them.

Hannah Morgan, The Good Care Group (England)

Given the difficulties that the sector has experienced in the last 18 months, the need for reform is more evident than ever. Many organisations have been left with no option but to close due to the lack of support, both financial and strategic, and the additional costs that Covid-19 has generated.

Increased funding
I would like to see increased funding across the sector, with an uplift in the minimum hourly rate for commissioned providers, as well as a move away from short home care visits, which we know are ineffective and damaging.

Investment in technology
Importantly, increased investment and use of technology is pivotal in reforming the sector. At TGCG, we use technology extensively to improve outcomes for our clients and work more effectively with other providers. Increased use of technology and more joined-up working between providers and between the NHS and social care is essential when it comes to improving the quality of care and customer experience.

Raising awareness
Finally, improving the reputation of the social care sector is critical. Increasing awareness of the opportunities and creating and promoting an image of this incredible sector that makes it an appealing career path would be a welcomed change.

Helen Garland, Right at Home (Bournemouth and Poole)

Tax rebate
Rather than expand eligibility, it would be politically difficult for a social care reform plan to bring existing funding up to the right level. Trying to survive on local authority domiciliary care contracts means providers stand little chance of gaining top regulatory ratings so service users do not experience good care: clipped calls, late calls and missed calls seem to be an accepted part of local authority funded care.  

If providers find it hard to sustain local authority clients, they should stop taking local authority work. A reform plan could perhaps see providers who take care packages below a nationally agreed minimum rate getting a rebate, perhaps through the tax system. 

Realistic recruitment campaigns
In terms of recruitment, we should stop romanticising the role of care workers and make sure recruitment campaigns are realistic. Carers are incredible people who achieve incredible things, but treating them as heroes rather than people hides the fact we ask them to make breakfast for a client on a weekend morning when they might be at home doing the same for their kids. We forget that the busiest times for social carers are the times the average citizen normally has plenty of family commitments.

Oona Corke, PillarCare

Hospital discharge protocol
The government needs to act quickly to develop a hospital discharge protocol that integrates social and health care systems so that people’s health and care needs are met from hospital to home. This would prevent the often avoidable pattern of hospital readmission for preventable conditions.

Dementia care programme
The forecast of people diagnosed with dementia rising over 200% by 2050 calls for a skilled, trained, valued and confident social care workforce to help people living with dementia live meaningful and empowered lives. A nationally recognised dementia care programme could help to achieve this outcome.

Workforce recognition 
I would also like to see a commitment to raising awareness of the indispensability of social care staff working in our community, who deliver the same critical services as health professionals, with little of the professional recognition or career structure.

Robert Stephenson-Padron, Penrose Care

At Penrose Care, we would like to see social care reform include the following:

  1. A statutory requirement to pay the National Minimum Wage when a worker is sleeping at a service user’s home;
  2. a crackdown on the sham classification of care workers as independent contractors to avoid labour rights, holiday and Employer’s National Insurance Contributions;
  3. and the standardisation of forms to reduce unnecessary paperwork and make it a seamless process when service users move across the health and social care sector.

Improving working conditions is essential to being able to attract and retain the best talent possible to serve the most vulnerable in our society. Cracking down on illegal forms of reducing costs will bring improved health and vibrancy to the self-pay segment of the social care market, which should be cultivated to a point where it is so healthy that it can subsidise the publicly-funded portion of the social care market.

There is a lot of unnecessary paperwork in health and social care and therefore standardising forms and procedures across the sector would both make it easier to transfer people across the health and social care system and reduce the need for unnecessary forms and unnecessary policies and procedures.

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Sarah Clarke

The author Sarah Clarke