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Call to focus on quality, not cost, in providing social care

12:00am | & Health

One of the things which clearly emerged from last week’s General Election was the need to address the emerging social care crisis in the UK.

Social care is care which is provided to people in their own homes. It can range from help with basic household chores through to more complex medical needs, including help with dressing, bathing, changing dressings or controlling medication.

Social care aims to enable people to remain living in their own homes, largely independently but with help as and when they need it. In the vast majority of cases it is provided for elderly people and is usually a more cost-effective and preferable option than moving into residential care. It is usually provided by staff working for private companies, which are awarded contracts by local authorities.

The cost of social care is usually met by a combination of funds from local authorities and the people receiving the care, depending on their ability to pay. In some cases, people pay for their care privately, or through insurance policies. But the demand for social care is growing rapidly, and in many areas outstripping supply. Social care businesses complain the highly competitive and cost-driven market for local authority contracts means they are forced to operate on a shoestring, paying minimum wage and struggling to recruit and retain quality social care workers.

Many care workers say that, although they are committed to the role, they cannot make ends meet and could earn more with less demanding jobs in other sectors, such as retail. The UK’s ageing population means more and more older people will need help to remain living in their own homes, but with the current system struggling to cope, the nation is facing a social care crisis – both in how it will be provided and who will pay for it.

The Welsh Government is already taking steps to address the crisis, proposing a curb on ‘zero-hours contracts’ for thousands of care workers across Wales. These contracts mean an employer is not obliged to provide any minimum working hours, while the worker is not obliged to accept any work which is offered.

In theory they provide flexibility for both employer and worker, but in practice many workers say they couldn’t refuse work as it might affect their future employability. Meanwhile they have no job security or ability to plan their own lives with any certainty of a guaranteed income.

It is estimated that anywhere between 60% and 80% of the social care workforce in Wales is employed on zero-hours contracts, enabling companies to minimise their operating costs and compete for social care contracts. Now the Welsh Government is proposing that after three months in the job, social care workers must be given a choice of continuing on a zero-hours basis or moving to a minimum hours contract.

The proposals also aim to separate out the time spent actually caring for clients and the time used in travelling between visits. This aims to stop so-called “call-clipping”, when care time is cut short. Meanwhile, private care companies want councils to substantially revise the way they commission social care services, shifting the focus away from the “lowest bid” and onto the quality of care provided. Only this, they say, will enable them to recruit, train and retain quality staff able to provide a consistently high standard of care to a wide range of clients.

Mario Kreft, chairman of Care Forum Wales, said there needs to be a root and branch review of social care provision and an end to the “economics of the lowest common denominator”. He said that zero-hours contracts were only one small part of a much bigger crisis facing domiciliary care in Wales, one which was putting social care companies out of business because the contracts offered were simply not financially viable.

Andy Rutherford, from trade union Unison, said the care sector had been starved of funding through UK government cutbacks, and zero-hours contracts were only a symptom of a much bigger problem.

“Yes, the Welsh Government is to be commended for taking action here,” he said, “but let’s look at the procurement process as a priority. Councils should not be allowed to pass the buck.”

The proposals are currently out to consultation, with the Welsh Government hoping to implement them early next year.

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