Social care in the firing line

adult social care trickOver the next two weeks there will be a series of consultation meetings called by the Council to present their budget for 2014-15. Further cuts of the order of £119m are to be made from next years budget. These proposed cuts must be opposed in their entirety.

The meetings will take place
Tuesday 10 December, 5.30pm – 7.30pm, The Lighthouse Suite, St Barnabas’ Church, High Street, Erdington
Wednesday 11 December, 6pm – 8pm, South Yardley Library
Thursday 12 December, 6pm – 8pm, Nishkam Centre, Handsworth
Wednesday 18 December, 6pm – 8pm, Bournville College, Longbridge
Adults and Children’s social care services form a significant part of the Council budget and have been deeply affected by past and present cuts to the Council’s budget. Birmingham against the cuts has set up a Social care working party for service users, carers, workers and anyone else who is interested.

The next meeting of the working party is to take place on Wednesday 15th January at 5.30pm (more details to follow)

The working group has produced two short briefings on the cuts to social care with some ideas for people to use at the budget consultation meetings.

A short Briefing on the Adult’s social care: 3 key points for the Budget consultation

1. Birmingham as a commissioning authority – stop the race to the bottom

a. Background

‘Restricting the funding available to local authorities to provide care services at a time of increased need, successive governments have forced local authorities to generate ‘efficiencies’ through contracting with the lowest-cost operators in the independent sector.

This competition between providers to win contracts from local authorities on a lowest-cost basis has driven down the quality of care in many instances to the ‘minimum quality level allowed’. Indeed the current Care Minister, Norman Lamb, has acknowledged that the current system ‘incentivises poor care, low wages and neglect, often acting with little regard for the people it is supposed to be looking after’.

(The future of the NHS? Lessons from the market in social care in England. October 2013. The Centre for Health and the Public Interest)

Birmingham Council has moved from being a provider to a commissioner of social care services, a large proportion of services are now provided by private companies and third sector organisations in the city.

b. Points for the consultation meetings

The Council should take action to:
End care auctions and tendering for care services on the basis of which private sector organisation offers the lowest price.
Ensure that all Care contractors with the Council should pay the living wage to their workers, recognise trade unions, and that domilcilary contractors must pay workers for travel time while at work.
BCC should take urgent action to review and end the use of zero-hour contracts by private care companies that it contracts with.
BCC should only contract with Private providers assessed by the CQC to be ‘compliant’ with the statutory care standards and should introduce contractual terms that would enable it to end contracts with those found to be ‘non-compliant’ within the period of a contract.
BCC should endorse the UNISON Ethical Care Charter for Home Care.
2. The crisis of care provision

a. Background

The lesson from social care markets is clear – if the contracting-out of care services to the private sector and the development of a competitive market based largely or solely on price occurs at a time of austerity and budgetary restrictions, with the aim of seeking to keep costs under control, the quality of care is likely to suffer.
(The future of the NHS? Lessons from the market in social care in England. October 2013. The Centre for Health and the Public Interest)

From Southern Cross to Winterbourne View to there is an effective crisis of care for many vulnerable people requiring services, and the basis of this crisis is the role of the market and virtually complete privatisation of social care provision.

b. Points for the consultation meetings
The Council should give a clear and positive committment to retain all remaining Council provided care services ‘in-house’ including it’s specialist care services and respite provision.
The Council should retain expertise and capacity to directly provide care services.
It should also give a commitment to excellence in its provison.
3. Cuts to Preventative services

a. Background

The updated Adults and Communities Green Paper proposals include cuts to preventative care services provided by the Community and Voluntary sector and to stop commissioning services provided under the Supporting People housing programme:

Commissioning Services from the Third Sector

Generally, commissioning from the third sector may need to be cut, reflecting the fact that these services are usually not aimed at people with substantial and critical needs.

However, many of these services provide early intervention or a preventative approach.They ensure that individuals are less likely to present with substantial or critical needs at a later date, placing additional more expensive demands upon the council at that point. Therefore, the impact of any reduction or removal of such services needs to be carefully monitored.

Budget Saving: £8m over three years

Supporting People

The Supporting People provision has already been considered in the Successful and Inclusive Communities green paper. Contracts are already in place for these services until April 2015. The proposal here is to cease all long term support services after that, but retain short term support services linked to accommodation, for example, domestic violence refuges, and homeless direct access hostels.

This proposal would have an impact upon client groups with learning disability and mental health issues. Whilst Supporting People is not a statutory function, national and local research has identified the “invest to save” benefits of these services in terms of avoiding more costly interventions in the future.

This could lead to additional financial pressures upon statutory services, which would need to be carefully and closely monitored.

Budget Saving: £12.8m over three years

b. Points for the consultation
These are large cuts which will have a significant impact of community and voluntary sector organisations in the city. These cuts make a nonsense of the ‘Standing up for Birmingham’ initiative which claims that it will ‘give residents and organisations further opportunity to contribute by taking over council services and assets or by identifying other opportunities of contributing to the wellbeing of the city and local neighbourhoods.’
These cuts are false economies as cutting preventative services often leads to an escalation of people’s needs and a demand for more expensive services at a crisis point for the individual.
In regard to the Supporting People’s services the Government recently published its Social care outcomes, with the statistics showing that proportionately more people with learning difficulties and mental health problems were without secure accommodation in Birmingham than other local authorities, Birmingham Council was ranked 149 worst out of 151 and 120 worst out of 150 respectively for the two groups.

A short Briefing on the Children’s social care: 3 key points for the Budget consultation

1. Birmingham’s Comparative spend with other Local authorities

a. Background

The review has revealed that current funding to children’s social care is significantly less than comparator core cities.

(BCC GREEN PAPER: SAFEGUARDING, SUPPORTING AND EDUCATING YOUNG PEOPLE)

We note that the Council’s planned spend per head on children’s social care for 2012/13 was considerably below the comparator group average.

Given the issues highlighted with regard to the protection of vulnerable children the Council should consider whether its inadequate arrangements are the result of insufficient resources or are the result of other management, staffing or governance failures.

(The Annual Audit Letter for Birmingham City Council -Year ended 31 March 2013)

The Annual Audit letter is directly questioning as to whether the Council’s underspend on Children’s social care has contributed to the failure in its safeguarding responsibilities.

b. Points for the consultation meetings
The council should as a priority increase its overall spend so that its per capita spend on children’s services, including social care, brought up to the comparator group average.
This increase should apply to all Children’s social care services not just ‘safeguarding services’ as they are inter-related and impact upon each other.
The track record of previously failing authorities shows that without urgent new investment there is little likelihood of any improvement in critical social care services.

2. Retaining social workers

a. Background

However, social work caseloads remain high. There are around 7,200 open cases to social workers in Birmingham, including around 1,000 child protection cases and nearly 2,000 looked after children. The average allocated caseloads for each social worker is 29, which is high.

(BCC GREEN PAPER: SAFEGUARDING, SUPPORTING AND EDUCATING YOUNG PEOPLE)

Social workers told the inquiry that rising referrals has led to increased caseloads, stretching the capacity of each practitioner to unsafe levels. The evidence reinforced BASW’s findings in May 2012, when 77% of respondents to its State of Social Work survey said caseloads were unmanageable.

(Inquiry into the State of Social Work report of the All Party Parliamentary Group on Social Work December 2013)

b. Points for the consultation meetings
The retention of the social work workforce is the lynchpin to any effective improvement of safeguarding children at risk of significant harm.
BCC should give clear committments and specified timescales to a graduated reduction in caseloads for all groups of qualified social workers and practitioners.
Addressing the conditions of work, including workloads, should be the number one priority for the Council in stabilising and then improving Children’s social care services in the city.

3. Savings from spend on Agency social workers and Consultants

a. Background

Millions of pounds have been spent on using agency social workers to cover for vacant permanent social work posts, the primary beneficiaries are the Recruitment agencies. The costs of employing Agency practitioners has increased this year due to competition between neighbouring authorities for a scarce pool of agency social workers which has led to the rates increasing to nearly £45 an hour.

Senior Managers have been brought into Birmingham on a consultancy basis and have not been formally employed by the authority.

All this money paid to private agencies and consultants could alternatively have been spent on services for children and families and on improving the working conditions of permanently employed social workers.

b. Points for the consultation meetings
All Senior Managers should in future have permanent contracts of employment with the City Council.
There needs to be effective and co-ordinated action by Social work employers in the region to control and reduce spend on agency workers and to reduce the hourly rate.

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