Is The Care Sector Really A 'Cinderella?'

Steve Scown
Much like fairytale Cinderella, the care sector is strikingly undervalued.

Some day, my prince will come...

Much like fairytale Cinderella, the care sector is strikingly undervalued. Care workers do invaluable work many in society wouldn’t do – yet so many of us rely on.

As the Chief Executive of a not-for-profit provider of social care for adults with learning disabilities and autism I know the social care sector is taken for granted and underfunded, year after year. The work my colleagues do is incredibly important and makes a real difference in people’s lives. I would love to pay our staff more – I don’t know any CEO who doesn’t have a similar wish. We have lobbied Government for years for the resources to be able to do so.

Yet they have not listened – funding remains inadequate – so it’s no surprise that care workers feel undervalued.

In many cases we deal with, individuals are assessed by local authorities or the NHS as requiring essential round-the-clock support. These overnight shifts are referred to as “sleep-ins”. Until a year ago, the government’s own guidance said that the National Minimum Wage did not apply to workers on sleep-in shifts.

Then a tribunal ruling changed that and government changed its guidance so all work, awake and asleep, must be paid at least the National Minimum Wage. Then HMRC stated care workers should be entitled to back pay of up to six years.

This unfunded liability is causing a crisis in the care sector. For those not-for-profit providers who can’t fund their liabilities – perhaps government is hoping someone will wave a magic wand?

Who can call-off the ugly sisters?

The position of our government is that despite following government guidance providers must now meet this massive liability themselves. So, like Cinderella’s ugly sisters, HMRC and the Treasury have swooped in to raid charity coffers to fund the statutory care required by the state. An independent study has estimated the total liability is £400m. The fact that roughly 30% of this will go straight into the Treasury’s own coffers is a point worth noting.

Let’s be clear – the Government decides who qualifies for support from the state, it prescribes the quality of that care and through taxation it funds care services through local authorities. Government has a responsibility to pay for social care services for citizens who require essential care and support. Yet they have not provided adequate funding for sleep-ins at the national minimum wage rate.

The Government continues to refuse to grant any additional resources to the social care sector. Many local authorities even now are refusing to acknowledge the change in guidance and the legally enforceable increase in pay.

But wait, surely we’ll be invited to the ball?

Much like Cinderella dreaming of being invited to the Palace ball, as the Autumn budget neared we got a little excited. It’ll be OK – the government has listened – of course they will do the right thing and solve this crisis.

Yet midnight came and went – no magic wand, no golden coach. No resolution to the sleep-in crisis and no movement to address the social care funding deficits - just window dressing trying to disguise more of the same. We – local authorities, providers and our staff - are all yet again left feeling undervalued facing an uncertain future.

How much can Buttons help?

Local authorities see the hard work of care staff and yet, they can only do so much to help our plight. It’s no secret that local councils are near breaking point. The news that Northamptonshire County Council has frozen all spending because of a massive financial black hole should worry us all. Even Surrey is no longer safe from cuts. We know the pressures local authorities have had to deal with. Demand for services is rising but funding has been cut. Seeing the problem first hand they want to provide essential services for their residents, but they simply haven’t been given the support from central government.

The extra £150 million for adult social care announced by the Government is just more window dressing. Anyone else noticed this is approximately the same as the windfall the Treasury is going to realise from its raid on our reserves? Is it welcome? Of course it is – but we all know that much more is needed to resolve the sleep-in crisis and avoid significant instability in a vital public service, let alone properly fund adult social care.

Who will be our Prince Charming?

The DH now has responsibility for social care. Is this more window dressing? Could it be a public statement that social care will get greater attention? A signal that funding will be provided to ensure the capacity and resilience of the sector?

That £400m has to come from somewhere – many organisations can’t fund their liabilities. If the sleep-in crisis isn’t solved some care providers will go under, others will hand back contracts. Some vulnerable people may well end up stretching NHS services further.

For those providers who won’t go under - not all of us will – we will be closer to a cash-flow precipice . We won’t be able to fund those new services much needed if government is to meet its Transforming Care targets. There will be restructuring and redundancies. Some services will close and the properties sold.

Ultimately, we will have to do what we have fought to avoid – turn skilled learning disability support into a minimum wage sector. Unless government recognises this is their crisis to fix, learning disability services in April 2019 will look very different from today.

Of course, I’m hoping for a happy ending. Jeremy Hunt MP - will you please be our Prince Charming?

Please recognise the invaluable work social care staff do. Please acknowledge providers have been providing statutory services that should be funded by the state. Please listen to our concerns about the future viability and capacity of our sector. Please fund social care properly.

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