Social care tsar condemns 'failed' system but change might take decade

Andy Burnham’s social care tsar has described England’s system as “failed”, accusing successive governments of being “asleep at the wheel”.

Baroness Louise Casey issued the stark assessment alongside research highlighting the deep fragmentation of social care provision across England.

She said a new settlement was possible, built around “decency, contribution and a duty to care for our neighbours, our loved ones and ourselves”.

Lady Casey also welcomed Labour’s proposal to consider watering down the state pension triple lock in order to release additional funding for social care.

However, recommendations from the Whitehall troubleshooter’s review are not expected until next year. The Prime Minister has also indicated that an NHS-style national care service may not be fully operational until the mid-2030s.

Addressing social care leaders in Liverpool, Lady Casey is expected to refer to the Covid Inquiry’s conclusion last month that the sector had been treated as “an afterthought” and was not adequately protected during the pandemic.

Baroness Louise Casey delivered the brutal verdict as she published research laying bare the 'fragmentation' of provision in England

Baroness Louise Casey issued the stark assessment as her research exposed the deep fragmentation of social care in England

Speaking at the National Children and Adult Services Conference (NCASC), the peer will say: “The Covid-19 Inquiry dismantled the claim that a ‘protective ring’ had been placed around care homes during the pandemic.

“Many older people died without their loved ones at their side. Many care workers left the profession because of what they had witnessed.

“It is a national shame that this was allowed to happen. It must never happen again.

“Successive governments have been asleep at the wheel. The research we are publishing today makes clear the absence of effective stewardship across social care. No one is ultimately in charge.

“Together, we can create a new settlement for care, founded on values I still believe this country shares: decency, contribution and a duty to care for our neighbours, our loved ones and ourselves.”

The report, commissioned by Lady Casey’s team and produced by the Nuffield Trust and the Institute for Government, found that adult social care in England is “a complex system” in which responsibilities are divided among central government departments, arm’s-length bodies, national and local authorities, and a vast network of private and voluntary providers.

It continued: “Decision-making processes can be opaque, while there is no single point of responsibility for overall oversight and stewardship.

“The consequences of this complexity and lack of clarity became clear during the Covid-19 crisis. Although the pandemic prompted some positive changes, the system remains fundamentally fragmented and lacks a coherent sense of direction.”

The report notes that more than 1.5 million social care workers are employed by roughly 19,000 organisations. Yet England is the only one of the UK’s four nations without a compulsory register for care workers.

Private providers now “dominate” the sector, a situation the report says has developed in a largely uncontrolled and unintended manner.

Unlike NHS treatment, social care is not free at the point of use. For some families, the cost is so high that they are forced to sell their homes to fund essential support.

Those with savings above £23,250 generally do not qualify for help from their local council towards the cost of care.

The report also warned of “poor transparency” over the fees paid to and charged by providers. On average, self-funding residents pay 40 per cent more for the same care than those whose support is arranged by a council.

It said reform would require “political will and bravery” to make the choices needed to establish a new national care service. The report added that the “prominence and level of priority” given to the issue by Mr Burnham must be sustained.

Mr Burnham announced plans to downgrade the pension triple lock at the Labour conference.

The Government said changing the policy after the next election could save £15 billion a year in cash terms by 2039-40.

Andy Burnham committed to overhauling social care at Labour conference this Autumn - but not until after the next election

Andy Burnham pledged at Labour conference this autumn to overhaul social care, although implementation would not begin until after the next election

However, the Prime Minister suggested in interviews that putting the reforms into practice could be delayed until funding becomes available.

Asked by Sky News whether tax increases would be needed to raise more money, he replied: “No, because there’s a different way of doing it. If you delay the date of introduction and introduce a national care service progressively.”

Mr Burnham said his pledge would “allow preparation to start now for a national care service”.

Lady Casey said the proposed change to the triple lock represented “a very significant win for adult social care”, particularly in developing services for people she believes are currently underserved, including frail and elderly residents.

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