COVID-19 and Social Care: My Story
Charlie was 81 when he had his stroke. He was standing by his front door watching the stars as he did every evening before he went to bed. It was a cold autumn evening; this fact saved his life. He was found by his neighbour the next morning, he had hypothermia and was close to death. Kath was visiting her daughter; she was 85 and had led a full and active life and had enjoyed a good quality of health for many years. Her stroke took place during the night, it was a violent assault on her which left her speechless and incapacitated; her daughter found her close to death the next morning. She suffered another stroke in the hospital but managed to survive. John was 81 and succumbing to the slow and sure creep of vascular dementia. His body, worn down by a lifetime of manual labour, was losing its ability to carry him. Who are these people? They are my family, my grandparents, my stepfather. All three are now gone, all three went through the experience of adult social care. To resolve this issue, we need a cross party approach which is sustainable across multiple generations and we need to act now while the issues are so evident.
The pandemic we find ourselves facing has shown the weaknesses in our current system. We have all heard the great work of the NHS staff of all disciplines who have bravely treated COVID-19 patients and they should all be praised. There is another story in the Care Sector, however.
As at 24th April the Office for National Statistics confirmed the number of COVID-19 deaths recorded in Care Homes was 5890[1] with an increase between week 17 and 16 of 595. Professor Angela McClean, the UK’s deputy chief scientific adviser updated these numbers on the 5th May with the grim news that in the week ending on the 24th April 2,794 deaths had occurred in care homes. She made the point that ‘“I think what it shows us is there is a real issue we need to get to grips with about what is happening in care homes.”[2].
While the debate on the effectiveness of the Government response to this pandemic continues and will do for some time it is perhaps pertinent to reflect on the reality of adult social care specifically the provision of residential care home services. Even before COVID-19 the Local Government Association[3] highlighted the crisis in adult social care:
‘Adult social care is in crisis, with councils pushed to the financial brink and forced to make difficult budgetary decisions as they try to plug the funding gap. The LGA estimates that care for the elderly, disabled and some of the most vulnerable people in society faces a funding shortfall of at least £2.6 billion (by 2019/20). Extra council tax-raising powers will not bring in enough money to alleviate the pressure.’
Within Bracknell Forest[4] the current budget of £21.1 Million is forecasted to be £23.2 Million, an overspend that the Council can ill afford. As the Council states this:
“This is a volatile area, dependent on number of clients, complexity of care, health funding and the availability and capacity of local providers and [the Council] has identified the following as budgets that can pose a risk to the council’s overall financial position, principally because it is vulnerable to significant changes in demand for services.”
The reality of care provision in the UK is that much of it is provided through the private sector and its provision is means-tested. If you are fortunate to own your own property it will be taken into consideration in whether you receive funding to support your care needs. The reality is that self-funded care home residents in effect subsidise council funded residents in the same home which cannot be acceptable. The financial thresholds for social care in England are 12% lower in real terms in 2018/19 than they were in 2010/11, fewer people are eligible for publicly funded care. In addition, the Competition and Markets Authority[5] has calculated that:
‘care homes that have more than 75% of local authority funded residents are most at risk of failure and a quarter of UK-wide care homes fall into this category.’
The cuts in central government grants to local authorities have resulted in them paying on average £14.66 per hour for services against a cost of £16.70 for providers5. This is unsustainable. COVID-19 has highlighted the precarious situation that adult social care is in.
As a Liberal Democrat I believe that we, as a country, should fund our care services appropriately. The vicious circle of cuts seen over the last decade has left our adult social care providers badly placed to deal with the ravages of the SARS-COV-2 virus. Many of our care workers have not had the training or provision of PPE to deal with such a disease. Isolating residents, preventing infection, putting in place enhanced hygiene and screening methods are practical steps which a sector facing extreme financial pressures has found difficult to cope with. The death of many care home patients has left many families devasted, communities gutted and care workers distraught.
Once the worst of COVID-19 passes through we must look again at how we can provide adult social care. The Liberal Democrats[6] will work with all parties to create a sustainable solution, we believe in providing the funding and structures needed to greatly improve this most important of services. Health and Social Care need to be one set of services, managed, and funded accordingly. We will advocate for a cross party health and social care convention to identify how this most generational of challenges can be met.
Charlie, Kath and John were all looked after by caring, compassionate and talented people. I saw true acts of thoughtfulness such as Kath’s care workers sending her postcards while they were on holiday and providing Charlie with his favourite pickle when he had cheese and crackers. I saw care workers who knew the reality of palliative care and made my loved ones passing as pain free as possible. I also know that there was always a struggle to square the care needed with the resources provided. COVID-19 has highlighted the struggle, we can make this better.
[1] ONS – https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending24april2020
[2] https://www.theguardian.com/world/2020/may/05/deputy-chief-scientist-we-need-to-get-to-grips-with-coronavirus-care-home-deaths
[4] https://www.bracknell-forest.gov.uk/council-and-democracy/strategies-plans-and-policies/service-planning-and-performance/people-directorate-quarterly-service-report/budget-position
[5] https://www.health.org.uk/sites/default/files/NHS-70-What-Can-We-Do-About-Social-Care.pdf
Mike Forster is the Chairman of the Bracknell Forest Liberal Democrats and a passionate campaignger on improving health & social care.
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