Change is possible. Change is essential. It may be 10 years’ old, but the Care Act is still our north star on our journey to achieve that change.
What do social care leaders make of the Care Act ten years on?
It’s good legislation. It has driven hugely positive changes in the way I and every social care leader approach our work, and the care and support people can access. Ten years of austerity, and political failure to respond to the long-term changes in the care and support that our communities need, have tempered that impact. But we have a plan to turn that around, and the principles at the heart of the Care Act are driving that plan.
There was a lot of good will and optimism about the new Act when it passed in 2014. Most felt it was the right framework for adult social care for the next 20 to 30 years. Most still believe that. The positive changes it has driven, despite the challenges we’ve faced, demonstrate that.
Our enthusiasm for the Act was built not least by the exemplary consultation undertaken by the then Department of Health in framing the legislation, having first achieved a solid understanding of the key issues, and in planning implementation. Its inclusive approach was widely seen as a model for future legislation. It’s gratifying to remember how ADASS members and associates were enabled to make key contributions based on their knowledge and experience.
The Act’s focus on promoting wellbeing and prevention, giving people choice and control of their care, its recognition of the vital role of unpaid carers and their own support needs, the acknowledgement of the potential of asset-based work in communities and the specific inclusion of the concept of co-production in statutory guidance – these were all seen as hallmarks of a new era in care and support.
We implemented the Act with a sense of excitement and energy. Directors of adult social services’ duties to sustain the care market, engage with care providers, focus on quality and ensure there is capacity where it’s needed came to the fore during the coronavirus pandemic. They continue to drive our work. These priorities are a big part of what I spend my week on. That may not have been the case were it not for the Care Act. We support people to move to secure placements whether they fund their care or not. We work with providers to support them to improve. We have grown home care support to enable people to leave hospital in the face of a care worker shortage.
The Care Act established new rights for carers. That was critical in shifting social care teams’ focus to what support carers need. Carers now have access to assessment and support - though we need more investment and reform truly to fulfil the rights the Act established. In the past six months the ADASS Carers Challenge (in partnership with Carers Trust and Carers UK) has been encouraging people who have developed new ways to provide the support carers need to share their learning. More than 70 evidenced submissions have been made so far, the best of which we’ll publish in an online resource in April to help drive improvement.
People do have more choice and control. We’ve seen social work practice evolve. We focus more on what strengths and assets people have as well as addressing the challenges they are facing. And throughout the pandemic we had the principles about safeguarding that the Act formalised at our heart. Our partners now have a real commitment and focus on safeguarding that would not be there were it not for the Act.
But clearly, we have been hampered by the failure of government to provide the long-term, sustainable increases in investment that we need to build a care and support system that genuinely meets the changing needs of people in our communities as the Care Act envisages.
We’ve had three delays in implementation of the funding reforms in Phase 2 of the Act and austerity measures drove £7.7 billion savings by adult social care departments between 2010 and 2020, with further savings since then. Our most recent survey of ADASS members in councils across England, last autumn, found that they were expecting in 2024/25 to have to make almost £1 billion of savings in already threadbare budgets – the highest level of savings since 2015/16. More than eight in 10 were set to end the last financial year in deficit.
Alarmingly, the survey found that the numbers of people awaiting assessment of their needs, or care and support to start, or allocation of a direct payment was running at almost half a million – up 8 per cent on numbers five months previously. Of these, one in two was awaiting assessment, which effectively disguises unmet need.
All this means we’ve not been able to shift more resources into providing care closer to home so it is there when people need it and to avoid crisis.
But as I said at the start of this article, we have a plan to change this: Time to Act, a roadmap for reform of care and support commissioned by ADASS and published last year. It has been widely welcomed as a blueprint to transform care. It has the principles of the Care Act beating through it. We’re committed to working, with others, to make its vision a reality.
Although the Act’s vision is only partly realised, the examples of where it has changed things show what social care can be like at its best. In Time to Act, we highlighted exciting innovative models such as integrated neighbourhood teams in Manchester, a therapist-led ‘rehabilitation first’ approach in Coventry and self-managing teams in extra-care housing in Camden, north London – all of which embody true Care Act values reflected closely in eight key themes identified in the roadmap.
Now ADASS is seeking, with others, to help create a movement to transform social care that will raise awareness of its importance to communities, to society and to the economy. Over the next couple of years, we want to do what those architects of the Care Act arguably failed to do to back up their flagship legislation: that is, tell the stories that will build such understanding of the vital role of care and support among key stakeholders and the wider public that politicians will no longer be able to duck the issue of full, transformative funding.
We have started with three key issues: ensuring proper rewards and career opportunities for people who work in social care; making the case to shift resources into care closer to home that will prevent many more people needing hospital or residential care; and highlighting the imperative of better support for unpaid carers.
Change is possible. Change is essential. It may be 10 years’ old, but the Care Act is still our north star on our journey to achieve that change.
