A cross-party group of MPs and peers has warned that the Government has not fully thought through its social care reforms and that without greater integration with health and housing, and a focus on prevention and early intervention, the care and support system will be unsustainable.
A report by the Joint Committee on the Draft Care and Support Bill also warned that restricting support and care to those with the highest levels of need will become entirely self-defeating, because it shunts costs into acute NHS care and undermines interventions to prevent and postpone the need for formal care and support.
Some of the key recommendations in the report included:
• An obligation on the Secretary of State to take into account the draft Bill’s wellbeing principle when designing and setting a national eligibility threshold
• Stronger measures on safeguarding, including explicit responsibilities for local authorities to prevent the abuse and neglect
• Independent resolution of disputes over decisions about care and support – and costs that count towards the cap – through a Care and Support Tribunal.
Paul Burstow MP, chair of the Joint Committee on the Draft Care and Support Bill, said: “We need care and support to be more focused on prevention and more joined up with health and housing. There is much in the Government’s draft Bill to welcome; it cuts through a complex web of arcane legislation that people struggle with. But there is room for improvement.
“The Government must take stock of its funding for adult care and support and think seriously about whether the transformation we all want to see can truly be delivered without greater resources.
“There is a growing imperative to join-up services so they fit around people’s lives and make the best use of resources. The whole system must shift its emphasis away from crises and towards prevention and early intervention. The draft Bill helps, but we believe it could do more.”
Learning disability organisations have given a guarded welcome the Joint Committee’s report. Steve Scown, chief executive officer of social care provider Dimensions, said: “With the most significant reform in decades, there is a great opportunity to transform an outdated, reactive, process-led system into a social support network that works in partnership to deliver support that is personal and actively focused on what people can do not what they can’t. But this requires a complete shift in commissioning culture, social care delivery and earlier and better engagement of people requiring support and their loved ones.
“People we support with learning disabilities and autism have told us how important having choice and control over their lives is to them and articulated this in a charter they produced. They want to have a voice, to have control over their support funding, be able to participate in the community and enjoy greater independence.
“Ministers, regulators and social care providers are all well aware of what’s not working – as the latest CQC [Care Quality Commission] report shows. We remain concerned that reforms, even where legally binding, will not achieve the radical change required without the genuine ownership and empowerment of everyone involved in designing and delivering social care. There is still far too big a gap between ambition and reality.”
Sarah Lambert, head of policy at The National Autistic Society, agreed that the Government must listen to the Committee’s recommendations for improving the social care system.
“Evidence cited in the report highlighted the problems with setting social care eligibility at substantial or critical needs. Consequently the Government must set it at moderate needs if they plan to honour their commitments to disabled people.
“People with autism and other disabilities, who have been assessed as having ‘moderate’ needs, are still likely to require help with everyday tasks such as cooking, cleaning and getting out and about.
“Failing to provide care for this group could mean over 100,000 vulnerable people are left unable to access support that meets their basic human needs.
“For adults with autism this could have a profound and devastating effect, resulting in people developing more serious mental health problems that will ultimately be at greater cost to the public purse.”
