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10.11.16

Counties: STPs not silver bullet to sustainable social care

Over three-quarters of county adult social care directors do not believe their local sustainability and transformation plan (STP) will deliver sustainable care, according to a new survey from the County Councils Network (CCN).

The survey said that 77% of respondents described themselves as not very confident that the STPs would deliver their stated aim for local services to ‘evolve and become sustainable’ by 2020.

When asked what they thought was key to successful STPs, 65% said strong system leadership, and 62% said sustainable financial settlement or integrated place-based budgets.

However, just 58% said their local authority had been actively involved in the development of their STP.

A PSE investigation found that less than a third of councils were involved in appointing their STP’s leadership, leading to concerns that local government is being excluded from the reforms.

Cllr Colin Noble, the CCN’s spokesperson for health and social care, said: “The government’s ambition is to integrate health and social care by 2020, but as our survey shows, directors have little faith that STPs are the silver bullet for sustainable services.

“Delivering sustainable integration will be hampered by the extreme financial pressures and misaligned incentives and funding, unless the government looks into solving these issues now.”

The survey also showed that 88% of county directors of adult social care describe their financial situation as ‘severe’ or ‘critical’.

Cllr Paul Carter, chair of the CCN, wrote to chancellor Philip Hammond and health secretary Jeremy Hunt urging them to bring forward at least £700m of the Better Care Fund from the end of this Parliament to 2017-18.

“If we proceed on the current trajectory, I fear the impact on frontline social care services in counties will be terminal,” Cllr Carter said. “This will potentially leave some of the most vulnerable people in our society without the care and support they need to maintain their independence and dignity.”

Complaints about home care increase by 25%

Separately, the Local Government Ombudsman (LGO) published its annual review, which showed that complaints and inquiries about home social care have increased by 25% in the past year.

The LGO received 372 complaints and inquiries in 2015-16, compared to 297 in 2014-15. Common complaints included care workers being late for or missing appointments, not staying long enough and not treating patients with dignity.

Complaints about residential care also increased by 21%, from 497 to 599. In total, there were 2,969 complaints and inquiries about adult social care, a 6% increase from the previous year.

The report noted that adult social care faces “significant and increasing pressures” due to problems with recruitment and retention of staff, funding shortages and the impact of the national living wage.

“Maintaining quality service provision in these circumstances is challenging and the increase in complaints we receive about home care, combined with a high rate of complaints being upheld, may be indicative of the pressures the sector is experiencing,” it said.

Of the complaints that went on to receive a serious investigation, 58% were upheld, with the number rising to 65% for complaints about home care.

The United Kingdom Home Care Association has warned that social care providers are not being paid enough and face a £500m funding shortfall.

Dr Jane Martin, the LGO, said the increase may be due to the sector’s work in signposting people towards the Ombudsman, but that “too many” complaints were being upheld.

Penalties for providers for an upheld complaint include requirements to apologise to the patient or their family, pay compensation or refund fees, and review their services and brief staff on the improvements needed.

Dr Martin also said that there could be more home patients “suffering in silence” because they were less likely than residential home patients to have access to advocacy.

Cllr Izzi Seccombe, chair of the LGA community wellbeing board, explained that the number of complaints was “small” compared to the millions of people receiving services.

She added: "However, we are concerned that despite care workers' best efforts, complaints could become more frequent as the combined pressures of insufficient funding, growing demand and extra costs mean that councils will have less money for essential social care services.”

Cllr Seccombe called on the government to use the Autumn Statement to address the funding shortfall for social care, which the LGA estimates will be at least £2.6bn by the end of the decade.

A Department of Health spokesperson said: “It is right that older people get high quality care wherever they live and it is encouraging to see that more people are speaking out when they encounter an issue.

“The government is continuing to make it easier for people to complain and for their complaints to be resolved sensitively.”

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