Brexit uncertainty is leaving the social care sector particularly exposed
In Hft's Sector Pulse Check, research has revealed that providers said that if their financial situation did not improve, they were concerned that this could lead to a reduction in the quality of care for the people they support.
It is widely recognised that there is a funding crisis in the adult social care sector. A toxic mix of central funding cuts to local authorities, combined with an increased demand for social care services, means that the sector now faces a funding shortfall of £3.5bn by 2025.
Since 2016, Hft has run the It Doesn’t Add Up campaign. As part of our ongoing advocacy, Hft has worked with independent economics and business consultancy Cebr to produce our annual Sector Pulse Check report, which provides an annual snapshot of the financial health of the social care sector over the past year and an indication of how providers anticipate the next twelve months will progress.
Our 2017 survey showed that the number of providers operating at a loss had more than trebled from 11% in 2016/17 to 34% in 2017/18. We warned then that, without a sustainable funding solution, the government was putting the care of some of the most vulnerable adults at risk. Sadly, our calls have gone unheeded, and we are now witnessing a worsening outlook for the sector.
More than half (59%) of all providers have told us that, due to increasing cost pressures, they have had to hand back contracts to local authorities over the past twelve months. Looking ahead, 68% say they will need to do so in the near future. Service closures are culturally at odds with the way most providers operate, particularly when an individual has been supported by that provider for the majority of their adult life.
More worryingly, this was the first Sector Pulse Check where providers told us that, if their financial situation did not improve, they were concerned that this could lead to a reduction in the quality of care for the people they support. This is a real red flag for the future of social care.
For any provider within the social care sector, the wellbeing of those vulnerable adults that they support should be of paramount importance. Indeed, at Hft, our Fusion Model of Support places the people we support at the heart of everything that we do. For providers to now be expressing concerns that further cuts will lead to deteriorations in the quality of care for those supported by the sector should be an urgent wake up call for a government or local authority of any political colour.
Recruitment also remains a challenge. 80% of providers cited low wages as a major hurdle to recruiting and retaining staff. This is only compounded by the news that the number of providers saying agency costs was their biggest financial pressure has skyrocketed from 13% in our 2017/18 survey to 63%. With providers having to spend increasing amounts on agency staff to fill rotas in the short term, we are hindered in our ability to retain permanent staff, and invest in the future of services.
However, not all of our findings are negative. When asked why they pursue a career in social care, 85% of new applicants say they want to make a difference to the lives of vulnerable adults. While staff turnover across the sector remains high, staff often move on to other social care providers or similar roles in the NHS and other healthcare settings. For many of us in social care, enabling vulnerable adults to live the best life possible is the reason we go to work each day. Such dedication deserves to be rewarded with a fair wage, delivered in a way that is financially sustainable to providers.
We know from experience that, with the right investment and with hard-working, motivated staff, the sector can achieve outstanding results for the people that we support. The forthcoming social care green paper and the Department for Health & Social Care’s national recruitment campaign must work together with the sector to ensure that social care is seen as a valued career, with clear career progression and a decent and competitive wage, allowing us to recruit and retain the best staff possible.
Our Sector Pulse Check also allows providers to reflect on the year that has passed. The ongoing debate around sleep-ins saw some movement when the Court of Appeal ruled in favour of Mencap in July 2018. But with a possible Supreme Court appeal still pending, it is perhaps unsurprising that 72% of survey respondents were not confident that 2019 will offer a decisive end to this issue.
Brexit also looms large over the sector. While the number of providers that told us they had not yet begun to prepare for Brexit fell to a quarter (26%) – down from 43% in 2017 - only 4% of respondents said they had completed all of their preparations. With the Brexit date looming, and the nature of our withdrawal far from certain, the social care sector remains particularly exposed.
Our 2018 Sector Pulse Check has laid bare the cost of government inaction. With the long-awaited green paper on social care now promised to us “within weeks”, we urge the government to be bold in its proposals, and offer a fair and sustainable funding future for the sector that works for commissioners, providers, their hardworking staff, and the vulnerable adults they support.