The elephant in the room with regard to the Care Act is the continued postponement of the second part of the Act, addressing changes to the social care means test and a cap on lifetime social care costs.
Ten years on however, it is my view that there were some solid foundations in the legislation with broad support, but that we have all been let down by a failure by central government to properly resource the aspirations of the Act, to trust and enable local government and its partner agencies to deliver, and in the continued erosion of support for local government in providing the backdrop to sustainable and vibrant communities.
In local government we have long understood that you can’t legislate for wellbeing without properly understanding and nurturing the drivers that help to create it.
Success in delivering social care will hinge on a government that understands and respects the complexity of local delivery and is prepared to support it in both word and deed. In local government, we broadly welcomed the Care Act’s reform and consolidation of a disparate range of social care statutes. We were no strangers to the ‘wellbeing principle' in the Care Act, and already recognised our role in meeting our local population’s needs, rather than just commissioning services.
We understood our role in helping to shape local care markets, the importance of prevention, support for carers in navigating the complexities of assessment, delivery and payment for services. However, we have seen a reduction in central government financial support of over 70 per cent since 2014, and a relentless redistribution of taxation (partly through the Adult Social Care Precept) from national to local. This has placed an unsustainable burden on councils to fund a demographically driven increase in demand and complexity of care, at the same time as managing a reduction in resources to support complementary services, such as libraries, parks and open spaces and culture.
The elephant in the room with regard to the Care Act is the continued postponement of the second part of the Act, addressing changes to the social care means test and a cap on lifetime social care costs. In many ways, the postponement is not the issue – the issue is a failure to recognise that properly funded councils are essential to supporting a complex system that has wellbeing at its core and relies on the interaction of a great number of policies and partnerships to deliver.
In Plymouth, the Labour administration championed the creation and adoption of The Plymouth Plan 2014-34, a ground-breaking plan looking ahead to 2034 which set a shared direction of travel for the city, bring together a number of strategic planning processes into one place.
We understand that the city’s economy, transport, housing, environment, education and cultural plans interact with health and wellbeing to contribute to the life of the city and its citizens and must be coordinated and driven forward together.
In a state of perpetual financial uncertainty, with single year financial settlements from the government, continued austerity and no prospect of local government financing reform – the environment for delivery of our aspirations for the city has never been tougher, but we continue to deliver.
The COVID-19 pandemic had a devastating and disproportionate impact on those needing or in receipt of adult social care, and no doubt there will be lessons to learn both locally and nationally from the Inquiry about how to address similar challenges in the future. Recovery from the pandemic continues to impact our wider health and care system as NHS services struggle to meet demands. This disproportionately draws on social care resource, reducing our opportunities to work within our communities in the way the Care Act intended. It is a tribute to local delivery in Plymouth that waiting times for care are reducing, safeguarding outcomes are improving and numbers of those in receipt of direct payments are holding.
We are operating, however, in an environment where the provider market is incredibly fragile despite careful interventions and continued dialogue with providers. With very nearly half of the council’s annual net revenue budget committed to the provision of adult social care services, Plymouth typifies the consequences of fragmented reform.
The Care Act itself is not the cause of the troubled state of adult social care – in fact I’ve seen it described as a solid legal framework that has been let down by implementation. Fair funding for local government, acknowledgement that the burden of financial support for an ageing population is also central government’s responsibility, and an understanding of the broader contribution of well run and properly funded local services’ contribution to wellbeing will be needed from the next government if we are to address the aims of the Care Act 2014.
