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Blog Post 30 April 2017

Getting the bigger picture and forging change

With a hunger for reform on the issue of fees paid to service providers by local authorities, the matter is top of the agenda at the next meeting of the Care Association Alliance.

Co-chaired by myself and Erica Lockhart of the Surrey Care Association, it will provide a platform to essential data sharing as it continues to lobby national organisationa and politicians on social care matters.

For me it's hugely important for us at this time to know what other local authorities are doing in their response to the latest Budget monies that have been made available . . . and not least, the General Election news.

Playing an active part in the Alliance helps us to see a bigger picture and assess what’s happening in the current ever-changing circumstances within the sector.

Any nuggets of news from the London meeting, we’ll get out to members via the website and newsletter.

 

Blog Post 30 April 2017

Social care lessons from our colleagues in Wales

If I’m truthful, I reckon the Welsh know a thing or two. All that rich heritage – castles with their towering fortifications, graceful abbeys, ancient monuments . . . I could go on and on.

They are the practical examples of history and in my opinion no history lesson can be complete without a field trip to study those Norman, Edwardian and indigenous Welsh-build structures.

Which leaves me wandering: Could we get a lesson from the social care reform model in the land of the red dragon?

I read with interest on the Care Management Matters website the Welsh Government has made social care a priority and has been backing this up with funding and targeted initiatives. Am I dreaming?

As central government is gearing up for a Green Paper on the future of social care, the article asks is there anything that can be learnt from Wales?

Let me quote: “Since devolution in Wales, the Welsh Government has had policy responsibility for health and social care, amongst other areas.

“Under this responsibility, it aims ‘to promote, protect and improve the health and wellbeing of everyone in Wales, by delivering high-quality health and social care services, including funding NHS Wales and setting a strategic framework for adult and children’s social care services.”

Social Services and Well-Being Act

In April 2016, its first big social care policy change came into force with the Social Services and Well-Being Act 2014. It aimed to transform the way social services are delivered in Wales, to meet the needs of the individual and ensure services are sustainable for the future.

Critically, the Social Services and Well-Being Act set out to ensure services are available to provide the right support at the right time and people have a stronger voice and real control over the support they need to remove barriers to their wellbeing.

As the CMM article says: “It focuses on earlier intervention, increasing preventative services within the community and helping people maintain their independence. It provides a framework to enable people to get the help they need before their situation becomes critical. The Act also promotes health and social care integration to achieve improved wellbeing outcomes and provides for a strengthened approach to safeguarding.”

There’s an embarrassingly basic question going around my head . . . How the Welsh achieve this and we can’t.

The act also:

  •   Introduced new eligibility criteria focused on individual need, replacing the current threshold system 
  • Gave carers an equal right to assessment for support to those they care for
  •  Ensured easy access to information and advice is available to all
  • Kept children and vulnerable adults safer by making powers to safeguard people stronger
  • Required local authorities and health boards to come together in new statutory partnerships to drive integration, innovation and service change.

At the time, Health and Social Services Minister, Mark Drakeford called it, ‘A radical, made-in-Wales system for the care and support of our most vulnerable citizens, which is fairer and more sustainable.’

Currently, seven Regional Partnership Boards are spearheading the changes – undertaking their own area population assessments to enable them to plan tailored solutions based on firm evidence of what the people in that region want and need.

What a great idea! As well as multi-agency representation, the citizen voice is increasingly present in the decision-making process ensuring solutions are being co-produced with input from all of those involved.

To support the Act, £60m was invested over 2016/17 to ensure children, adults and older people in Wales receive joined-up health and social care services.

Some £50m came from the Intermediate Care Fund, now known as the Integrated Care Fund, with an additional £10m of capital funding. Sadly, this is stuff we can only dream of.

£30m of the Fund was invested in services to support older people to maintain their independence and remain at home; £20m was allocated to establish new integrated services for children and adults with autism; and the final £10m to assist all groups, especially those with long-term conditions, through reablement or step-down beds in the community.

The primary aim of these investments? To avoid unnecessary hospital or care home admissions and prevent delayed discharge.

Based on independent research on the cost of these policies, says CMM, “the Welsh Government has made £4.8m available in total to support implementation of the higher capital limit and the full disregard of the War Disablement Pension.”

In addition to this £4.8m, an extra £55m has been made available for social services in 2017-18. This includes an additional £10m for social care to help meet the costs associated with the introduction of the National Living Wage, and £25m extra for local authorities in recognition of the growing pressures that social services face.

The CMM piece concludes with a raft of questions. Has Wales got it right with its social care reform? Is the situation in England too complex to solve in this way? Is there too little money available? Is it more straightforward in Wales? Or does the political direction of the Government have more of an impact? What can or should England take away from the Welsh social care policy?

Interesting, isn’t it, that CMM deliver no answers or opinions. For me, however I think there’s a lot we can learn – not least one of priorities on Government funding. Over to you Mrs May, but I suspect you’re distracted by the looming General Election.

Blog Post 25 April 2017

The Assoication is part of the Care Assoication Alliance which is made up of all the other Assoication from other Counties in the Country. We help each other run succesful Associations so that we can support Care Providers who want to give good care, as well as ensuring the National voice includes the local implications.

I went to London yesterday to catch up with the  other Associations to discuss what is happening, particularly with fees for Care Homes, Home Care and LD. We also talked about what other areas are doing with the precept and the £2 Billion.
A Couple of the areas have said they are going to use the £2 Billion to increase the fees to Care Providers to safeguard the future of the Care Industry. However the majority feel they have already addressed that with the small increase they have given. These areas are looking for other options to spend the money. Nationally we are going to collate all these ideas and feed them to the National Bodies to ensure the Government see the piece meal way in which their money id being spent

we are putting information on the blog if you want to keep up to date there.

One of the other people that we talked to was Neil Eastwood from Sticky People who is just about to publish a readable book called 'saving soical care'. The book will be about chosing and keeping the staff. Neil has been to a number od our conferecne and talks a lot of sense. The book is being launched in June and will be £1.99 if you have a Kindle and their will be 20 ways you can use to help. I am hoping to get a sneaky peak before then.

Blog post March 22, 2017

Panorama: Historic underfunding, recritment ills and more chaos

Everyone in the social care sector is aware that care firms are cancelling contracts with local councils because they cannot deliver the services required for the fees paid.

Now viewers of last night’s Panorama also have an insight to the care crisis gripping our nation. A new audience, I hope, which might help forge change for the better.

The BBC investigation highlighted that care businesses could not recruit or retain staff – wages elsewhere were much more enticing, problems “historic underfunding” and an ageing population were not being effectively addressed and a Freedom of Information request which was responded to by 197 of 212 UK councils showed 95 had experienced care provider contract cancellations.

According to the research, carried out for Panorama by Opus Restructuring and Company Watch, 69 home care companies have closed in the last three months and one in four of the UK's 2,500 home care companies is at risk of insolvency.

The figures are shocking – and yet they’re just a snapshot of what’s happening.

In the Midlands, which did not feature in the programme, things are just about as bad as anywhere else in the country not precluded by a wealth-laden demography.

On average, dom-care providers are getting £13 per hour and there’s no sign of an increase this year.

Dudley, which pays slightly more, but still under £14, is pressuring providers to accept 15-minute calls. And there lies madness, with travel time having to be paid.

Desperation is the only word I can think of for Birmingham, with some contracts secured at a ridiculous £10 per hour, The figures just don’t stack up.

Some are with new companies which simply don’t understand the full implications of the business, but ultimately it will leave those in need of caring

without the wellbeing guarantee of continuity.

On the DP (direct payments) front, again there’s no increase for those who manage their own budgets.

I am immensely proud to be part of a regional care sector that still maintains standards, but the time is now here where some of the best are being forced into debating whether their businesses can any longer survive the squeeze.

Councillor Izzi Seccombe from the Local Government Association, which represents councils across England and Wales, said on the Panorama programme: "We have warned that the combination of the historic under-funding of adult social care, and the significant pressures of an ageing population and the national living wage, are pushing the care provider market to the brink of collapse.

"These figures show the enormous strain providers are under, and emphasises the urgent need for a long-term, sustainable solution to the social care funding crisis."

Last October, the regulator for England, the Care Quality Commission, warned the council care system had reached "tipping point" and was in the worst state he could remember during his 38-year career in the system.

In an unprecedented step for the regulator, CQC chief executive Sir David Behan called on ministers to pump more money into the council care system.

One home care company featured in the report, Cymorth Llaw, which had contracts with three councils in north Wales, told Panorama it had recently stopped working with one - Conwy, which had initially paid £14.20 an hour for care.

It offered to raise that to £15, but the company decided that still wasn't enough and handed back the contract.

Ken Hogg, at Cymorth Llaw, said: "We didn't think we could do it for the money - it was as simple as that.

"We pay as much [in wages] as we possibly can and we've always paid above what was the national minimum wage and the national living wage.

"[Carers] get a mileage allowance, they get paid travelling time between their clients."

Mr Hogg said the company was legally obliged to pay 1% pension and 13.8% national insurance contributions, along with training and other staff-associated costs, which "doesn't leave a great deal".

Conwy Council said it was committed to supporting vulnerable people in communities, despite the financial challenges.

Home care company Mears used to have a contract with Liverpool City Council but cancelled it in July, saying £13.10 an hour was not enough to cover costs.

Mears said it needed at least £15 an hour, and like other companies across the UK, argued its costs are often greater than what councils pay.

And far from being hostile towards care providers, the tone of the programme was stereotypically old school BBC: The facts and no ‘spin’.

Alan Long, executive director at Mears, said: "That was a terrible thing to do for both service users and for care staff.

"We absolutely did not take that lightly, but frankly what choice did we have?

"We just cannot do the two most basic things that you need to do in home care - pay staff the absolute minimum of a living wage and be able to recruit enough people to deliver the service that Liverpool Council actually expected from us."

It’s an all too-familiar response I’ve heard from care companies all over the UK.

Policy and campaigns director of United Kingdom Homecare Association, Colin Angel, said some care providers are "really desperate" and "really do not know whether they're going to be able to continue in business, beyond the next year."

He added: "That means they're really having to make some hard commercial decisions, whether they might need to cease trading or indeed just hand back work to local councils."

Mike Furlong, manager of the Granby Rehabilitation Unit in Liverpool, told Panorama that while on average people spend 28 days at the care facility, "some patients have been with us 12 and 14 weeks because all the therapy is complete, but unfortunately there's no care package available at the end of it".

Liverpool City Council said that, over the last seven years, its budget had been cut by £330m and it now needed to find a further £90m over the next three years.

As for the £2bn Budget handout – it’s just not enough to keep up with demand.

I’d love to believe such a powerful presentation would furnish the sector with real results, but I’m convinced the intransigence of Government will remain; well at least until the promised Green Paper.

 

Blog post March 22, 2017

Don't miss an opportunity to celebrate care

Celebrating excellence in social care, our west Midlands Care Association will again be involved in the Great British Care Awards that come to the city’s ICC at the end of the month.

A glittering national finals awards ceremony on March 31 will be the culmination of taxing selection processes that will honour a whole raft of care qualities shown by individuals, business and teams.

There are 21 award sections which represent all areas of the social care sector, whether it be older people or specialist services, residential or home care. From frontline staff such as care workers and care managers to people who have made an impact in other ways such as training and innovation – they will all get their moment of glory in a very public display of marking quality caring.

The awards will bring together the statutory, independent and voluntary sectors, as well as unpaid carers.

And on the selection panel our Debbie has been busy interviewing some of the nominees. As you’d expect, despite all of the industry gloom, the standards are exceptionally high.

Awards include­ – see http://www.care-awards.co.uk/categories/

 

The Care Employer Award

 

The Care Home Worker Award

 

The Home Care Worker Award

 

The Care Newcomer Award

 

The Care Home Registered Manager Award

 

The Care Home Cook/Chef Award

 

The Dignity in Care Award

 

The Dementia Carer Award

 

The Care Team Award

 

The Care Home Activity Organiser Award

 

The Ancillary Worker

 

The Home Care Registered Manager

 

 

The Care Trainer Award

 

The Care Innovator Award

 

The Frontline Leaders Award

 

The Home Care Coordinator Award

 

The Putting People First/Personalisation Award

 

The Housing With Care Award

 

The Good Nurse Award

 

The Palliative Care/End of Life Award

 

The Care Assessor/Care Planner

 

The Unpaid Carers Award

 

The Outstanding Contribution to Social Care

 Our care association message is clear: Get involved and help us ‘big up’ the great care our sector delivers as it helps change lives for the better. The past, the present and what’s to come will be represented in the gathering of people who’ll attend. Go on – book a table – http://www.care-awards.co.uk/product/table-booking/

Blog post March 16, 2017

A valuable insight into safeguarding

There’s play I should catch in London which has its last showing on Friday (18th) at the New Diorama theatre.

According to The Guardian it’s “a wonderful, funny and absurd play” with a message that explores risk and the implications of its mismanagement.

The plot centres around a bunch of character trying to put on a play. But their endeavours are thwarted by people intent on keeping them “nice and safe”.

A health and safety officer says prop umbrellas are potentially lethal, a local councillor worries about slips, trips and falls and a care assistant just wants them to sit down and drink tea.

By the end the production and its characters are indeed safe, but the play . . . well, I guess it could be viewed as collateral damage.

I’ve blogged before that risk is an element of all our lives and without it life can lose its spontaneity and thrill.

As The Guardian says, it may well be an absurd production, but “the frustration on stage echoes frustration in life.”

The cast comprises older people (most actors are aged 65 and over) and those with learning disabilities. Each has been told at sometime not to attempt something because of the risk involved.

There is a tricky balance between protection from harm and support and in the mix comes a whole raft of legal what-ifs.

The play’s strapline – “Take risk away, and what’s left?” – is something the social care community continues to debate.

Admirably put, let me quote from the article: “The obvious challenge in terms of safeguarding is that despite the legislative and policy frameworks we have – the Care Act, safeguarding boards and reams of organisational guidance – so much of it comes down to individual professional judgment. The decisions that are weighed up and taken day after day, in partnership with the people being cared for, will inevitably need regular revision as circumstances change.”

 

  April 13, 2016

Osborne’s social care cash ‘used to balance books’

Funds being raised by Dudley Council to shore up the costs of social care are to be used to help balance the books on the previous year’s overspend, it has been claimed.

Under Chancellor George Osborne’s plan to fund care sector needs, he sanctioned a two per cent hike in council taxes during the Spending Review last November.

But it emerged at an emergency members’ meeting of the West Midlands Care Association, which represents private and charitable care providers, the new monies will have no impact on the current industry crisis that has seen 1,000 social care beds lost across the country since January.

Neither will there be any new monies generated for social care from Mr Osborne’s 2016 Budget proposals.

Hopes that he would heed calls by the Directors of Adult Social Services (ADASS) to bring forward £700m of social care funding never materialised.

Association chief executive Debbie Le Quesne (correct) has warned “the outlook can only get worse” as care providers struggle to make ends meet.

Ms Le Quesne said: “We understand 50 per cent of the public in Dudley agree with the Chancellor’s precept of two per cent in the belief that it will help adults requiring social care packages to continue to receive them in a sustainable way.

“But the truth is that the two per cent is just not enough and is being directed towards last year’s accounts shortfall. There are no provision margins from such funding for the current financial year.”

At a packed meeting at the Quality Hotel, Dudley, delegates from across the Midlands, heard the next three to four years would be “critical to the survival of social care as we know it.”

For the last nine years, members claim fees have fallen below the viable cost of running a care home.

Latest figures from Industry analysts LaingBuisson (cor) reveal English councils pay on average £91 a week less than what is needed to provide fully compliant care.

Ms Le Quesne added some homes were being kept operational only by private funders who shore up the shortfalls on the cost of care being paid for by local authorities.

“At best we have three to four years before the landscape of care changes beyond recognition and there will be no way back to the required bed levels our ageing population needs to provide some kind of fluid service to hospital discharge managers wanting to avoid bed blocking.” she said.

In a desperate attempt to secure a funding lifeline to the industry, MPs, councillors, local authority officers and Clinical Commissioning Groups (CCGs) have been asked to meet with the organisation to discuss ring-fenced funding for social care.

The vast majority of Black Country care businesses rely on placements paid for by councils as a primary income generator. More than 26,300 people across the region are receiving residential care. A similar number have care at home.

In September last year the association revealed Dudley Social services had given rises totalling 8.9 per cent over a five year period while, the Consumer Prices Index was at 11.6 per cent, the Retail Price Index at 15 per cent and wage rises hitting 12.3 per cent.

Added Ms Le Quesne: “The rises don’t track cost, and what increases have been offered are still well adrift of reality.”

 

April 1, 2016

Living wage threatens future of care to most vulnerable

West Midland businesses providing social care for thousands of people across the region are now facing a “monumental struggle” to survive as George Osborne Living Wage legislation comes into force today.

At a recent emergency meeting of West Midlands Care Association – the representative body of the private and charity care sector – delegates heard it would be the final straw for many operators who rely on local authority referrals as their main source of income.

Chief Executive Debbie Le Quesne (correct) said: ‘I cannot think of one member who does not wish to pay their staff better wages, but there simply isn’t enough cash in the business models so many have been forced to adopt under the current austerity measures.”

In an impact analysis survey carried out by the association, 50 per cent of providers reported there was no long-term sustainability for their businesses paying the living wage.

Findings also included:

·         Currently care providers in the West Midlands have not agreed the figures proposed by any of the local authorities for the purchase of care services

·         Care for the learning disabled could be the hardest hit with no fee increases being paid since 2008 and none currently on the table

·         Those with direct payment contracts – where budgets are self-managed – will not get any extra local authority funding to pay potential living wage increases

·         Local authority fees paid for domiciliary care, residential and nursing home services have not tracked the real cost of care for nearly a decade

 “While none reported imminent closures, more than half said they would actively be looking to increase fees, sell up, or cease trading in the future. It is a desperate day for the care industry and threatens not only the region’s businesses, but also the stability of care for the elderly, frail and learning disabled,” added Ms Le Quesne.

More than 26,300 people across the region are currently receiving residential care. A similar number received care in their homes.

The National Living Wage applies to people over 25 and is set at £7.20 per hour, a 50 pence per hour rise. It will increase to £9 by 2020.

“We recognise fully that carers are worth the extra money. However, Mr Osborne has chosen to be blind to the implications to the care sector where council fees for beds have failed to track real costs for some nine years.

“To put things into context, the annual increase in wages for one provider with 100 full-time workers would be £96,000.”

“With profit margins already squeezed, this is stretching the economies of many of our homes and domiciliary care businesses to breaking and they face a monumental struggle to survive,” added Ms Le Quesne.

In the West Midlands there are 410 residential homes, 446 learning disabled homes, 97 nursing homes, 49 mental health homes, 12 physical disability homes and 80 homes specialising in dementia care.

“That represents 27,000 beds and the take-up is almost full capacity. From today onwards there is no knowing how long those beds will be available. Additionally, there are 500 community care business across the West Midlands serving another 27,000 people with operators collapsing every week. In this environment there is little continuity of care,” Ms Le Quesne said.

“The industry is at a point of meltdown. If a major employer were to make this kind of warning there would be huge political interest over the potential loss to the economy. What we have here is a bunch of businesses across the region that create about 125,000 carer jobs for adult social care.

“That dwarfs the employment stats of, say, Jaguar LandRover and it’s deeply worrying that few of these jobs are secure under present funding models.

“Hard choices need to be made where government could find the monies needed by the sector. As more homes inevitably close, domiciliary care becomes increasingly unstable and the care of our vulnerable is uncomfortably exposed, I suspect only a public outcry would dictate a revised political agenda,” added Ms Le Quesne.

Additional information

In 2013 Birmingham City Council and other Midland local authorities commissioned accountants and analysts KPMG LLP to establish the true cost of care through the Open Book initiative, where care providers were asked to submit their accounts.

Some 380 homes were targeted and the results showed that to meet escalating costs, care commissioners would need to pay £460 per week. Currently, the average fee across the West `Midlands is £400.

Three years on, and not including the financial implications of the living wage, Ms Le Quesne said It would take an increase of six per cent to bring homes in line with the minimum figures used by the Association of Directors of Adult Social Care (ADASS) as its threshold for safe care.

 

1st September 2015

Care crisis: Time to work together

Currently across the West Midlands some 26,300 people are looked after in residential care settings and a similar number receive care packages in their homes.

The majority of that care is from private providers, who, according to regional figures released by Skills for Care – the development body for adult social care in England – employ a staggering 125,00 carers.

It’s an immense workforce and sadly, like no time ever before, is under threat.

Unlike more economically privileged regions, care businesses in this part of the country rely heavily on local authorities purchasing beds as a primary income generator.

Revised regulatory governance, government austerity measures, the Chancellor’s living wage legislation and councils paying fees for the last nine years that have not tracked the real cost of care, now result in homes on the verge of closure.

Occupancy across the region is running at 97 per cent. When our homes fail, where will we put those who are displaced?

We have been creative and made savings to the point where there are none left to make without compromising Commission regulation and desperately need ring-fenced financial intervention.

We are at five to midnight and are appealing for MPs, councillors, local authority officers and Clinical Commissioning Groups to join with us to find a way ahead. Our individual responses will, I believe, be all the more fruitful if we can work together.

 

September 1, 2015

Fees lifeline plea as care homes crisis deepens

Care providers throughout the West Midlands are calling on councils to stop hiding behind government austerity measures and pay a “viable rate” for care beds purchased from the private, charity and voluntary sectors.

In a bleak warning they said closures were imminent and there was little regional capacity to take up those frail and needy residents who may be displaced.

At an emergency meeting of West Midlands Care Association (WMCA), which represents private and non-for-profit providers, members heard George Osborne’s living wage directives could “be the final nail in the coffin for care as we know it.”

In a desperate attempt to secure a funding lifeline to the industry, MPs, councillors, local authority officers and Clinical Commissioning Groups (CCGs) were now being asked to meet with the organisation to discuss ring-fenced funding for social care.

The vast majority of Black Country care businesses rely on placements paid for by councils as a primary income generator. More than 26,300 people across the region receiving residential care. A similar number have care at home.

In recent weeks, five care home corporates with 1,200 properties between them have written to the Chancellor warning of impending disaster following his Budget reforms on the living wage.

The big five – Four Seasons Health Care, Bupa UK, HC-One, Care UK and Barchester – look after 75,000 frail, old people. They claim a major provider is likely to close within a year to 24 months unless the Government releases its purse strings.

Debbie Le Quesne, chief executive of WMCA, said: “The national picture is gloomy, but in our region it’s much, much worse and Osborne’s announcement could be the final nail in the coffin for care as we know it.

“Our members were in crisis before his landmark legislation on wages.

“I cannot stress how desperate the national warning is, but for the Midlands it’s not just care and nursing homes at risk; it impacts massively on those offering learning disabled and community care packages.

“Our impact analysis suggests the Osborne wages regulation will add £23 per week to the care cost of every Midlands person in a residential care setting. But we need to add to that figure a further £50, the current average weekly operational deficit on council-funded places.

“If the corporates – HC-One is one of our members – are predicting at best only a two-year survival rate under current economies, what chance have my other members, who have much smaller homes and much-depleted resources?”

Ms Le Quesne added that the care business community feared the promised autumn Government Spending Review would be too little, too late.

Residential care occupancy levels throughout the Midlands are averaging 97 per cent. “There’s not a member in the association who is not anxious about the future wellbeing of those requiring care.

“Of course providers deserve to make a living and have successful businesses, but the most vulnerable across the whole social care spectrum are our raison d'etre and we owe it to them to be diligent in securing a viable rate that will safeguard futures for provider and client.

“What’s more, all of my members would happily apply the living wage, but there is no financial sleeve left in their business models to do so. Care home companies are not just crying wolf. Care is a minimum wage industry and profit margins are extremely tight, especially where council referrals are the main income.

“For the last nine years fees have fallen below the viable cost of running a care home.

“Over the last five years, for example, Dudley Social services has given rises totalling 8.9 per cent while the Consumer Prices Index is at 11.6 per cent, the Retail Price Index at 15 per cent and wage rises hitting 12.3 per cent.”

Sandwell Council’s cabinet meets on Wednesday (September 2) to respond to a WMCA call for a fees increase of 16 per cent – residential care from £378 per week to £438.46; dementia care from £428 per week to 496.48; and residential nursing care from £490 per week to £568.00.

Latest figures from Industry analysts LaingBuisson (cor) reveal English councils pay £91 a week less than what is needed for fully compliant care.

In 2013 Birmingham City Council commissioned accountants and analysts KPMG LLP to establish the true cost of care through the Open Book initiative where care providers were asked to submit their accounts.

Some 380 homes were targeted and the results showed to meet escalating costs commissioners would need to pay £460 per week. 

Two years on, and not including the implications of the living wage, Ms Le Quesne said It would take an l increase of six per cent to bring homes to the minimum figures used by the Association of Directors of Adult Social Care (ADASS) as the threshold for safe care announced this spring. An extra three per cent would allow homes to cover increases in operational costs.

 

Ms Le Quesne added: “If a major employer were to make this kind of warning there would be huge interest over the potential loss to the economy. What we have here is a bunch of businesses across the region that create about 125,00 carer jobs for adult social care.

“That dwarfs the employment stats of say Jaguar LandRover and it’s deeply worrying that few of these jobs are secure under present funding models.

 “Council do have choices what to do with funds, they need to stop hiding behind government austerity and the care sector must now become a priority.

“Because of the regulatory body [Care Quality Commission] there is a legal limit to which we can cut staff and all our small care homes have already made those economies. There is nowhere left for them to go.

“I would call upon our local councilors to make decisions of conscience on funding that will directly impact on the most vulnerable people in the electorate they serve.

“It is a fact that a dog walker can earn more than we can pay our carers. There is something radically wrong.”

On CCGs . . .

The hospitals bed blocking crisis in the West Midlands can only get worse, care industry chief Debbie Le Quesne has warned.

In June, figures released suggested that 11,000 days were lost in the region because step-down beds and community care package were not immediately available, or there were delays on securing funding.

Ms Le Quesne said: “Clinical Commissioning Groups need to understand the crisis we’re in and the impact it will continue to have on delayed hospital discharges. We need to see some of the £5.3bn from The Better Caring Fund aimed at integrating social care and health. So far, I have no evidence of it being spent on our sector in this region.” 

She added the delayed days run into thousands and a fundamental reform was needed which in the future “must involve ring-fenced monies for social care.”

Ms Le Quesne said she had already received reports that hospitals had been unable to find social care beds because local authority fees being offered were too low.

“CCGs can no longer tell us it’s not their problem and they need to engage on the issues of finance with the local authorities and with us,” she said.

On wages . . .

A WMCA impact survey suggests any benefits found with reductions in Corporation tax – a fall to 19 per cent in 2017 and 18 per cent in 2002 – will not plug an ever-widening chasm between realistic operational care costs and fees paid by local authority commissioners.

The study also notes that such advantages would clearly apply only if businesses were in profit.

Under the Chancellor’s plans, workers aged over 25 will get a minimum of £7.20 an hour from April next year, rising to £9 by 2020.

The government says this will mean a direct pay rise for 2.5 million workers of an average of £5,000 by 2020.

The last major care company collapse was Southern Cross, in 2011, Britain’s biggest care home operator with 750 homes.

 

 

2nd September 2015

Care Under Threat in Sandwell

At the Cabinet meeting on 2nd September you will be asked to make a decision about the Care industry in Sandwell.

Sandwell Care Providers have worked on very small margins for many years and the recession has hit Care Homes and Home Care Providers as much as the Council. Fees have not kept pace with increases in costs, particularly in Minimum Wages increases. Providers have hit the point where they can’t absorb the wage rises.

 

We sent information to the Council Officers illustrating the dire situation that Care Providers are in on June 2015

We have not received a response and we have been advised that a report is going to cabinet on 2nd September for a decision. Here is the link to the letter.

Since the information was sent the Chancellor has announced the new living wage which will mean Providers having to have a good luck at their business.

Unlike other business care provider have to provider a certain number of Care hours per person which cannot be reduced and this makes up approx 60% of their costs. With the Chancellors living wage that put the salary bill up by 10%. However Sandwell Providers were already unable to absorb the increase from Oct 2014.

We are not clear whether the minimum wage increase for April 2016 has been included in the report going to cabinet.

At an emergency meeting on 26th August with Directors and Association Members it was decided reluctantly that legal advice must be sort in order if a realistic response is not forthcoming.

We would urge you to take responsibility over the funding of care to sustain services for the most vulnerable people in Sandwell. Please would you make decision that would not only impact on business sustainability but the welling being of the people you represent.

 

 

 

 

August 25, 2015

Survival talks plea after big five warn of care home closures

News that a national care homes chain could fail within a year because of George Osborne’s radical living wage reforms has prompted fresh calls for speedy action on resolving chronic funding shortfalls in the sector.

Five care home companies with 1,200 properties between them have written to the Chancellor warning of impending disaster.

The big five – Four Seasons Health Care, Bupa UK, HC-One, Care UK and Barchester – look after 75,000 frail, old people.

They claim a major provider is likely to close within a year to 24 months – unless the Government throws a financial lifeline.

Struggling West Midlands care providers last month warned that the industry was at “breaking point” with the unexpected wage increases creating a financial meltdown.

Debbie Le Quesne (corr), chief executive of West Midlands Care Association (WMCA), which represents private and voluntary sector care providers, said: “I cannot stress how critical last week’s (Aug 20) warning is and for us it’s not just care and nursing homes at risk. It also impacts massively on learning disabled packages and community care operators.

“Our calculations suggest the Osborne legislation will add £23 per week to the care cost of every Midlands person in a residential care setting.

“If the corporates – HC-One is in our membership – are predicting at best only a two-year survival rate under the current economies, what chance have my other members, who have much smaller homes and much-depleted resources?

“Many of them have mortgages on their businesses and are personally financially entrapped by the costs of the care they deliver. It’s heart-rending to hear what’s happening and sadly the only way some will survive is to cut corners.

“No-one wants to, but it will happen if the Government doesn’t intervene by releasing extra funding that will enable local authorities buying beds to pay a figure that realistically reflects the price of care.”

The Association’s directors have called an emergency meeting next Wednesday (Aug 26)  to discuss the “desperate situation and to formulate an action plan,” added Ms Le Quesne.

A WMCA impact survey suggests any benefits found with reductions in Corporation tax – a fall to 19 per cent in 2017 and 18 per cent in 2002 – will not plug an ever-widening chasm between realistic operational costs and fees paid by local authority commissioners. The study notes too that such advantages would clearly apply only if businesses were in profit.

Under the Chancellor’s plans, workers aged over 25 will get a minimum of £7.20 an hour from April next year, rising to £9 by 2020.

The government says this will mean a direct pay rise for 2.5 million workers of an average of £5,000 by 2020.

Ms Le Quesne added: “How many times do we have to say there are no savings left to make? We are people of integrity and telling the truth. To be fair, the response from out local authorities has been heartening, with councilors and officers recognising we all in this mess together.

“But this latest warning really does hit home just how close to impending disaster we all are and I fear the promised Government Spending Review will be too little, too late.

“We are now literally begging council decision-makers and representatives, Clinical Commissioning Groups and MPs to come alongside and talk with us.

“Not one single body, I believe, has the answer. We must work together to survive in our businesses and, not least, for the benefit of the 26,300 West Midlands care home population and a similar number receiving community care packages.”

The last major care company collapse was Southern Cross, in 2011, Britain’s biggest care home operator with 750 homes.

 

July 14, 2015

Budget reforms put care homes at ‘breaking point’

Struggling West Midlands care home owners face a bleak and uncertain future following living wage Budget reforms announced by George Osborne.

Debbie Le Quesne (corr), chief executive of West Midlands Care Association (WMCA), which represents private sector care providers, warned the industry was at “breaking point.”

An impact survey by the association suggests any benefits found with reductions in Corporation tax – a fall to 19 per cent in 2017 and 18 per cent in 2002 – will not plug an ever-widening chasm between realistic operational costs and fees paid for care by local authorities.

Under the Chancellor’s plans, workers aged over 25 will get a minimum of £7.20 an hour from April next year, rising to £9 by 2020.

The government says this will mean a direct pay rise for 2.5 million workers of an average of £5,000 by 2020.

But although Ms Le Quesne and her members welcome initiatives to bring in better pay rates for carers, they estimate it will add £23 per week to the care cost of every Midlands person in a residential care setting.

“It will also mean there will be no pay differential between domestic staff will little responsibility and experienced NVQ Level 2 carers,” said Ms Le Quesne.

For those businesses offering community care, the association concludes there will be an additional £1.50 per hour cost for each member of staff. This figure does not include the additional expenses of travel time, which is not funded in the local authority rate.

“Mr Osborne’s Budget has done no favours to the care industry in the Midlands. Most domiciliary providers are on set local authority contracts which have seen next to nothing in increases over the past five years.

“They are still trying to work out how to find funds to pay travel time and now a second increase in outgoings looms.

“Calculations do not include external price rises we expect to see from our suppliers, who will also need to pass on their increased production costs,“ she added.

Along with other representative bodies, WMCA is calling on government for a financial lifeline to keep the industry afloat.

Ms Le Quesne said: “It’s a hugely complex situation with most of my members having local authorities as primary income generators in their businesses. Under the terms of which they work they are allowed to return profit margins on council contracts of between only five and seven per cent.

“There simply isn’t anywhere for extra savings to be made. Years of austerity have taken their toll and the creative thinking is through.

“Addressing living wage increases for council workers, the Local Government Association, which represents more than 400 authorities in England and Wales, said the cost of implementing the policy should be taken into account when council funding levels are set in future.”

West Midlands Care Association is making the same plea to government.

“Our calculations regarding the timing of and potential savings on Corporation tax just don’t stack up as an offset to this extra expenditure, over which members have no control.

“We’re in deep financial trouble and we know local councils are too. Central government must now heed the care industry plight if it wishes to see a diverse sector survive the next two years. We are at breaking point,” added Ms Le Quesne.  

Picked Up by The Guardian  and the Times

 

 

2nd July 2015

Latest calculations – the Budget impact on social care

I knew the Budget was bad news, but I’ve just read a piece from yesterday’s Guardian and I think I feel sick.

I’m trying to console myself with the fact that this publication does not align itself with the Conservative government, but I know some of the figures presented are credible.

The piece suggests that the care sector has been “invisible” to George Osborne. I agree. I cannot image any politician setting in stone anything like the national living wage knowing the impact it could have.

Let me quote: “Let’s suppose Osborne had done all his sums, however. In that case, the logical conclusion can only be good news for social care because he must have realised he would have to factor in a hefty bung of taxpayers’ money to meet the sharply rising costs of paying the NLW from next April. Any other way lies disaster.”

As the article says “there simply isn’t the money in the system to meet the costs without it.”

According to initial calculations by the Local Government Association, indemnifying care contractors against the new minimum would cost councils in England an extra £330m next year, rising to £1bn extra by 2020 (Guardian).

But rightly, as stated “at a time when, the association says, the funding gap in adult social care is widening by £700m annually.”

The article goes on: “The Resolution Foundation thinktank, which has carried out previous detailed analysis of the implications of ending the low-pay scandal in social care, puts the UK-wide extra costs to the public purse of Osborne’s plan at £1.3bn by 2020 – on top of another £1bn already pencilled in for increases in the original national minimum wage.

“In net terms, deducting savings to the exchequer after tax and benefits, the foundation reckons the additional costs to be £675m by 2020, or just over £1.2bn

Already we have seen hospital admissions soaring since the austerity measures began and a strong argument presented that social care funding cuts are to blame. I fear sores is to come, though there will be regional differences.

My Members and I in the West Midlands are particularly concerned over the issue and we are busy putting together figures to ensure that Councilors Local MPS and the Authorities are aware of the impact. The West Midlands is more dependent than other areas as the Local Authorities are the main funders and there is limited Self funders. The Authorities fees are calculated to give a very small profit margin which these wage increases will easily wipe out and there is no money in the pot of the West Midlands Local Authorities

I wonder how we will remember Mr Osborne: Will he be the one who has managed to unstick the whole fabric of social care in the UK, despite his government’s pledge that “social care is a priority.”