A new report investigating the state of social care through the eyes of individuals and families reveals a system struggling to cope.
The Real Lives report, published by the Richmond Group of Charities in partnership with the British Red Cross and the Royal Voluntary Society, sets out the real life experience of seven individuals and families using social care services today.
The report concludes: 'Six consecutive years of budget reductions to publicly-funded care, increasing demand, increasingly acute levels of need, workforce pressures, provider failure and market exit are all converging to create the perfect storm.
'The net effect of these pressures is now clear: social care in its current form is not sustainable and requires both immediate investment and long-term reform to prevent crisis and meet the aspirations of the Care Act 2014.'
The Real lives report tells the human stories behind a major report, Social care for older people: Home truths, published today by the King's Fund and Nuffield Trust.
The Richmond Group of Charities and their partners commissioned the King’s Fund and Nuffield Trust to produce and write Real Lives as a companion report to shows just what this really means for the lives of the people who rely on the social care system to get by.
Difficulties accessing high-quality care when councils are raising eligibility criteria and increasing fees and charges, and the strain this places on individuals and carers who can end up feeling like they are battling the system.
Susan George, who lives in London and cares for her husband Bruce, who has dementia and Parkinson’s disease, explained: 'Just before we got the help with care it was making me very ill. I had infections and I was very low – lying on the sofa wondering how I was going to cope with the rest of the day.
'It has been a long battle from having no care. You feel like you want to scream sometimes when trying to find help – it is out there but finding it is like a maze.'
A lack of support for family carers who are not necessarily receiving the help they need or are entitled to under the 2014 Care Act.
Fred has struggled to find high-quality respite care for his wife who requires constant support because she has little short-term memory.
'It [respite care] would help me because I would be able to continue with it [caring duties]. If I can find some sort of relief which would let me retain some sort of life of my own, then the future would not look quite so bleak for me.'
Care packages that are not personalised to the aspirations and needs of individuals.
Ann cares for her husband of 54 years Cyril, who has dementia, in Oxfordshire. The relationships that make up Cyril’s care aren’t traditional roles of ‘carer’ and ‘cared for’. They are family relationships and friendships. But Ann found the council’s approach to care options was inflexible and the package offered would not help her in maintaining these relationships.
'When I was in hospital, I wrote to the local authority and said, ‘look, can I have £300 to give to the lady who’s coming in during the day to look after Cyril, and can I have £100 for my grandson?’ They said ‘no’; I said, ‘okay then, you send somebody in. It’ll cost you £165 a night, for someone to sit in my sitting room and do nothing.’ They moan about lack of money but I mean…it’d be making the most of the support we have, making sure they can keep helping us.'
She remains on crutches and says: 'I became very depressed. Very, very depressed, very weepy. And that’s not my nature. That’s not my nature. I just felt nobody cared.'
Serious doubt about the sustainability of the social care provider market when local authorities are freezing or cutting the rates they pay. The report notes some care homes and home care providers are either closing or only accepting clients who pay for their own care. This disrupts the care provided to vulnerable people.
Robert has received care from hundreds of carers from 8-9 agencies since the first of two severe strokes 13 years ago.
Pointing to his head, Robert says: 'I’m still active up here but I’m at their mercy…I felt very badly handicapped by having different care workers every day.
'They (one agency) changed their name four times while I was with them. The management changed every six months and that made it difficult for you to communicate with the managers if things went wrong... All of a sudden, without any warning, they decided they wouldn’t deal with disabled people. So they just sent us back to the council.'
The need for a high-quality, trained and motivated workforce that provides continuity of care.
The pressures facing care providers means they are finding it increasingly difficult to recruit and retain high-quality staff. This directly affects the quality of care people receive.
Susan George, who we heard from above, said of home care staff from one agency: 'They didn’t know what they were doing. It seemed like they’d never cared before. They turned up at five o’clock in the afternoon to put my husband to bed. Or they turned up at ten once I’d already helped him to bed. Absolutely awful.'
The continued failure to integrate health and social care – which is both inefficient and leaves people trapped in hospital beds awaiting social care packages when they are medically fit to go home.
When Susan George’s husband, Bruce, was admitted to hospital with a trapped nerve he remained there several days after he was medically fit to go home while health and social care professionals organised a new care package to meet his increased needs.
Susan says: 'Nobody was speaking to anyone else, social workers weren’t speaking to the care agency, and neither of them were speaking to me. They blamed each other.'
Tom Wright, CEO of Age UK and Chair of the Richmond Group said: 'It's when you see how serious the impact is on real people's lives that the true nature of the social care crisis hits home.
'We have become so used to headlines about problems like the large numbers of care businesses closing that it is easy to forget that it is hundreds and thousands of older and disabled people and their families who ultimately pay the price - together of course with the care staff who do vitally important work for pretty low pay.