Social care green paper must address the needs of all, not just older people | Alison Rose-Quirie

The government appears to have finally accepted the dire state of social care funding with the announcement of a new green paper. Whichever party takes power after the general election, social care funding should get the attention it so desperately needs – but will that be true for all aspects of the sector?

I’m concerned that the debate on the future of funding is dominated by elderly care services. While the need to provide these is essential, they are not the only demands on scarce social care budgets.

As the chief executive of a social care provider that supports individuals with learning disabilities, autism, brain injuries and a host of complex and challenging conditions, I know there are many people who need support for their entire lives – not just in the final few years.

These are some of the most vulnerable members of society and there is a real possibility that their needs will be ignored while the services they depend on continue to be starved of cash.

So how can the green paper best serve the needs of people with learning disabilities, autism and challenging behaviour?

Crucially there can only be real progress in the efficient delivery of social care if we achieve full and meaningful integration with the NHS. We cannot continue to treat these two systems as separate; to do so perpetuates the bureaucratic nightmare that denies people the opportunity to manage their own health in ways that supports their choices and independence.

Often, people using adult social care services also have lifelong health conditions that need regular monitoring and treatment. Under our antiquated dual system approach there are often disputes between health and social care as to who pays the bill, meanwhile service users suffer through endless delays. Increased access to joint personal budgets would put individuals’ needs first and reduce unnecessary distress.

Policymakers must also understand that there are vast differences in the needs of the many groups who use social care services and, therefore, the funding they require. Individuals with learning disabilities, autism and challenging behaviour will often require lifelong support by highly skilled staff. Such training costs money, but in the long run it is an investment with a high return.

Service users get access to leading edge therapies with increased quality of care and positive outcomes. This then leads to greater levels of independence and less reliance on costly state-funded care. Everyone wins.

And what of the additional funding – how much is enough? Much has been made of the £5.3bn Better Care Fund set up in 2013, as well as the social care precept announced in late 2016. Yet the former has, in many cases, not made its way to the frontline and the latter will just exacerbate regional differences in the quality and quantity of care provision.

I also worry that with such intense competition for funding, the learning disability community will be last in line for any additional monies.

Until recently, budgets have been reasonably well protected as the lifelong nature of a learning disability was recognised. But with the current funding crisis we are being targeted as a high cost service, and budgets are often arbitrarily reduced, which impacts on individuals’ quality of life.

There is the argument that we will all grow old and should plan for our needs in old age. But we are not all born with a learning disability or autism – it is not a lifestyle choice. The most vulnerable need protecting.

Finally, the green paper must explore ways to professionalise social care as a career to attract the brightest and best. The skills required to work with a young man with challenging behaviour are vastly different to those required in elderly care, and we must ensure that we create a system that rewards and celebrates both. The green paper should recognise that labelling all care workers as one homogenous group does them a disservice, undermines their status and leads to a poorer adult social care system.

I would like to see care workers given more training in specialisms relevant to certain client groups, similar to the division of skills we see among nurses in the NHS. These specialisms, in learning disability and autism for example, would have their own nationally recognised qualifications and professional membership bodies. These measures alone would start to create a parity of esteem between health and social care.

The green paper must be bold enough to recognise the needs of all social care service users, especially the younger people who are too often ignored. This should not be a competition for funding. We need a fair and lasting deal for all.

Dr Alison Rose-Quirie is chief executive of Swanton Care and Community

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