Campaigners are calling for greater efforts to provide care in the community for people with severe learning disabilities. Photograph: AA Pix/Alamy
I have for years been saying that funding for social care is extremely important, but until recently I feel no one has been listening. That is certainly true about this Government for even now they are not listening and when it comes down to the facts, it is because, in reality, they do not even care.
I therefore support this legal challenge in every aspect.
To remedy the funding situation this Government needs to immediately refund to all Local Authorities (LAs) all the money withheld by Austerity Cuts and fully refund all the COVID costs LAs have had to encounter.
Only then will there be any chance that social care could be improved and in doing so relieve some of the burden the lack of social care has been causing to the NHS and the resulting effects on health care.
But there are also other measures this Government could do, one of which to immediately allow more non-UK citizens the enter the UK so they can be employed in social care for this would go a long way to ensure more persons would be available to work in social care. But also to ensure funding is sufficient to LAs so that care providers can be able to pay their care workers a more reasonable salary, to the extent of at least £14 per hour rather that the current National Living wage of £8.91or even the Real Living wage of £ 9.90 out of London (£11.05 within London).
But others need to be improves which includes
realistic sick pay rates
travel rates
unsocial hours rates
working conditions
and more
Social care is just as important as the NHS as both are inter-reliable on each other.
On the face of it this reorganisation of Health and Social Care is good, but we have yet to see the ‘fine print’, which could hold further dangers.
Another could be the regain of central held control for will one in an isolated London, know what is required ‘North of Watford Gap’, for that is a massive area for London held control to manage.
Yes, it appears that some control will be handed over to the 42 Integrated Care System (ICSs) areas, which are much less than the 135 Clinical Commissioning Groups (CCGs) in England. A much larger area for ICSs to administer, when, even CCGs did not get it all right.
Will the bureaucracy really be reduced or just remain the same in a much larger administration area.
The apparent move away from having to tender services when there was nothing wrong with the services, should be welcomed, thereby allowing the services to plan more ahead. But will the larger administration areas mean a slower system for change and a change in one area of a ICS may be good for some parts of that area but not for other parts of the same larger area.
A big if, will it mean funding is better spent and channeled to where it is most needed and will it be better for additional funding, especially in respect of Social Care.
There are so many, ifs and why will this be better than all the other Government meddling in Health and Social Care.
Senior fellow at the King’s Fund analyses what Sajid Javid’s one-year spending review means for adult social care
It is a marker of how complex the funding streams for adult social care have become that it takes a fair bit of work to decipher the effect of last week’s spending round statement.
The statement promises a roll-forward of grants which were due to end this year, along with an additional £1bn grant (for both adults and children), £500m of spending power through an extension of the social care precept and confirmation that the minimum clinical commissioning group (CCG) contribution to the Better Care Fund will increase by 3.4% in real terms.
Overall – dependent on local decisions taken by councils – we estimate that amounts to growth of about £1bn for adult social care. That’s obviously welcome but it is around the minimum required to patch things over until 2021, given that demand for adult social care is not static but increases by an average 3.7% a year.
Nor does the nature of the funding alleviate any of the fundamental problems facing the sector. In fact, in some ways it entrenches them.
The social care precept is a fundamentally regressive funding mechanism, both for the individual paying it and the councils who raise money with it: the local authorities with the highest need have the least capacity to generate income (so it’s critical that the distribution of other social care funds allows for some equalisation between need and spending power).
The extra money via the minimum CCG contribution to the Better Care Fund is welcome but continues to create tensions between local authorities, who have the legal duty to meet social care need, and NHS organisations with often narrower objectives around delayed discharge. And, of course, the joint grant for children’s and adults’ services will continue tensions of a different sort within local authorities as to the most pressing priorities to meet.
Personal health budgets (PHBs) are the NHS equivalent of personal budgets in local authority social care and are designed to give people more choice and control over how their healthcare needs are met and help them to live more independently.
The NHS in England has been targeted with significantly expanding the number of people with PHBs over the next two years and many will have social care needs and so already be known to adult social services. In light of this, it is important for practitioners to understand how PHBs work, including who is entitled to them, how they may interact with social care personal budgets and the role of health professionals in managing them.
PHBs are mainly intended for people with long-term health conditions, complex needs and disabilities, enabling them to live more independently, take control of their own care and support, and improve their chances of staying out of hospital. PHBs were introduced in England – they are not available in Wales – as a mainstream service in 2014, when adults eligible for NHS continuing healthcare and children and young people eligible for continuing care were given the right to have a PHB.
They are designed to be used flexibly, but it should be remembered that PHBs are not new money – they are about using existing resources/budgets in a different way, to enable people to achieve their health and wellbeing outcomes. The service user’s clinical commissioning group (CCG) must grant a request for a PHB unless this is an inappropriate way of providing their healthcare.
Service users with local authority personal budgets who move on to continuing healthcare have sometimes found it easier having a PHB because the NHS then takes funding responsibility for their social care as well as their healthcare needs, which can both be delivered through a PHB.
Some 3 years ago I and 2 other Learning Disability Family Carers agreed to help a University of Sheffield student with her thesis for her PHd. A post was created on one of my other blogs 61chrissterry re the initial stages of this project where we used the principles of Co-production and the post can be found here.
Since that post was issued we met regularly and we analysed the information obtained from the various workshops at our event on 20 October 2017. From this analysis we eventually created a number of documents which we all felt would improve communications between Learning Disability Family Carers and the range of Service Providers.
In order to ensure the documents we created could be used we met with a range of service providers.
Initially we arranged a meeting at Sheffield City Council with Learning Disability Commissioners and representatives of Sheffield Adult Social Services, who viewed the documents and suggested some minor alterations for our consideration.
We then had a similar meeting with some home carer and Supported Living Service Providers, who also made some minor alterations for our consideration.
Over a few weeks we considered the suggestions mentioned from these 2 meeting and made adjustments accordingly.
By this time a meeting had been arranged with some representatives from Sheffield Clinical Commissioning Group and at this meeting they asked if they could use these documents with their ‘For Pete’s Sake’ campaign they were launching, to which we agreed.
In addition they offered us a 15 minute presentation slot on their ‘Assisted Technology event on the 28 June 2018. While our documents had nothing to do with assisted technology we did accept their kind offer and did attend their event and gave our presentation.
At the start of this co-production Rachael enquired through Sheffield Mencap & Gateway for carers of persons with Learning Disabilities to work with her on her PHd project. During the last 18 months we have had regular meetings at the University of Sheffield on how we would proceed with this project and what our initial outcomes would be. Initially through general discussions, which Rachael was recording, it became clear that the recurring situations was around carers communications with the range of Service Providers. Within the context of Service Providers it included Sheffield Adult Social Care through Sheffield City Council, various health providers ( being GPs, Sheffield Teaching Hospitals, Community Health, and many other health areas) together with the independent Care Providers including charities, voluntary and private independent providers.
So that we were not restricted around our own views we decided to create 2 surveys, 1 to be completed by LD carers reflecting on their interactions with Service Providers and the other survey to be completed by Service Providers reflecting on their interactions with LD Carers. The surveys were created on Survey Monkey and during their creation we had a number of meeting to discuss how these were to be formed, the number of questions to be included and the specific questions. When we were all satisfied with both surveys they went live on Survey Monkey and electronic links were disseminated through our various range of contacts within Sheffield, UK.
We also discussed how we wished to to use the information from these surveys in addition to the original outcome for Rachael’s thesis. and decided we would wish to do this in a form of a presentation. We looked at possible dates and venues and obtained costings and also viewed each venue and then using co-production decided which venue to book and how we would advertise the event and provide a means for LD Carers and Service Providers to book to attend the event, which we did through Eventbrite and agreed on a format for a flyer and a website (Carer Voice) and the event title being Carer Voice Working Together.
Carer Voice ‘Working Together’, The Presenters from left to right, Chris Sterry, Judith Gwynn, Rachael A Black and Kate Chapman
Carer Voice ‘Working Together’, Presenter Rachael A Black Stating the Principles of Co-production
Carer Voice ‘Working Together’ Carers and Service Providers working together
Carer Voice ‘Working Together’ Presenter Judith Gwynn answering questions at the end of the Presentation
Carer Voice ‘Working Together’ Presenter Kate Chapman answering questions
Carer Voice Final Notes
Thank you for coming today and now you have seen the presentation and been involved in the workshops in which carers and service providers have worked together. This is how it should be for we are all here for the same reason, to ensure vulnerable persons, be they be our relatives or not, have provision to ensure their needs are met and they can then led their own lives.
Communication is but one key, but an extremely important key and without it all that is there can fail.
With this in mind I facilitate a support group LD Carers Butty Group, also known as Central group or Butty Group, where there is also a website LD Carers Butty Group and a mailing/distribution list. There are other support groups and details of these can be obtained from the Carers Centre and from Cathy and Kirsty from Sheffield Mencap & Gateway (Sharing Caring Project).
If you wish to be included in the mailing/distribution list please advise your email address. While this was produced with carers in mind, it does not mean that service providers cannot be included. Information sent will include areas relating to disability both local and national as well as notes for the support meetings.
Lunch is now ready and there are some leaflets from a selection of providers please view and take away and continue to network throughout lunch.
Do not forget to put on a post it the message you are taking away from this event and an evaluation form will be emailed to you, please return with your comments.
Our thanks to
University of Sheffield, Department of Human Communication Sciences for funding the event
Sheffield Central Fire Station for the room
Healthwatch Sheffield for the pens
Carer Voice ‘Working Together’, Chris Sterry giving the closing statement
After the Carer Voice : Working Together event we sent the following email to everyone who attended the event and also to those persons who could not attend but did express an interest in the event.
“We just wanted to get in touch to give you an update on the work we are doing following the Working Together Event in October.
As a group we have met once to go through the feedback and will be meeting again in December. Where we will start drafting some standards and guidelines for communication between family carers and providers of service based on the information you gave us.
In early 2018 we will email these to you for your feedback. If you would not like to receive these emails then please do let me know and I will remove your name form the mailing list.
We are also planning to pull together a small working group in the New Year to ensure the standards are accessible and practical. If you would be interested in being in this group, please do let us know. It will consist of 2 to 3 meetings at the University of Sheffield.
Please also find attached some information about care workers in the independent and charity sector and the flu vaccine which we hope will be of use to you.
If you would be interested in receiving a copy of the presentation we gave on the day please do get in touch and I will send this to you.
We have now met in December and have started drafting some standards and guidelines for communication between family carers and providers of services based on the information given to us during the Carer Voice : Working Together event.
The draft documents were produced.
So we could enage with service providers we held 3 meetings.
Intialy we met with representatives of Sheffield Adult Social Carer and Sheffield City Council Commissioning who viewed the documents and made some comments regarding some minor alterations.
The second meeting was with some service care providers who also made some contructive comments.
The final meeting was with representatives of Sheffield Clinical Commissioning Group, who also welcomed the documents and wished to use these in conjunction the their ‘For Pete’s Sake’ campaign’ and offered us a 15 minute presentation slot in the Assistive Technology event on the 28 June 2018.
Chris gave the presentation at the event and it was very appreciated by the atendees.
Carer Voice 