The State of Care

Two people holding hands and doing hand on hand signing.

On his first day in office Prime Minister Boris Johnson promised “we will fix the social care crisis once and for all”. Nearly three months later we’re still waiting for a solution. This week the Queen’s Speech to Parliament, which set out the Government’s plans for new laws and policies, only made a vague promise that “Government will bring forward proposals to reform adult social care”. Meanwhile more disabled people and their families are reaching crisis point without the right support.

In the State of Care report published this week, the Care Quality Commission (CQC), who are responsible for regulating health and care services, concluded that many people are struggling to access the care that they need. The State of Care report analyses CQC inspection data, as well as service user experiences and focus groups to provide an annual picture of health and care services. Although the quality of many services remains stable, there are considerable challenges around people navigating the system.

The report demonstrates that struggling A&E departments are usually located in areas with insufficient social care services. The absence of low-level community based support means that more people are reaching breaking point with nowhere to turn but emergency services.

This is particularly the case for services for people with learning disabilities and or autism. The CQC has concluded that these services are inadequate and failing the people that need them.

10% of inpatient services for people with learning disabilities and/or autism were rated inadequate, as compared to 1% in 2018.

Too often people are reaching crisis point, unable to access the support they need they are at risk of being in inappropriate settings like in-patient units in hospitals, sometimes this is far from home and people are unable to return to their local communities due to a lack of care packages.  

Since October 2018 the CQC has rated 14 independent learning disability hospitals as inadequate and placed them in special measures. One of the key factors identified by the report for this decrease in quality of care is staff training. There are insufficient numbers of appropriately skilled, experienced and qualified staff to support people with complex needs in specialist services. The CQC has called on Government to implement a workforce plan with a specific focus on ensuring that there are enough skilled staff to provide care and support to people with complex disabilities.

For the CQC the solution lies in better and more community social care services. Support with everyday tasks like washing, dressing and toileting can make a significant difference to dignity and well-being, but for many working age disabled adults their needs extend beyond the basics of personal care. Social care is also about the support needed to tackle loneliness, develop independent living skills and access work or the community. These are the essential services which prevent crises and reduce pressure on emergency healthcare.  

At Sense, we completely agree with the CQC that we need to see better and more community based social care support which focuses on the lives that people want to lead.  Sense provide community based social care for people with complex disabilities. We specialise in person centred care focused on outcomes for the individual. This is achieved through learning about a person’s communication needs, so that we can support someone to express themselves and make choices about their care.  By taking this approach, we see the positive impacts that this has on the people we support; people like Martin who had been living in an inappropriate care setting and hadn’t been outside for 16 years, but who now regularly visits his local shops and enjoys accessing the community.

For working age disabled adults like Martin, good social care is more than just basic personal needs, it’s the support to live the life they want to lead.

It is essential that working age disabled people are at the heart of any social care reform programme, so that they are given the opportunity to shape a system that reflects their needs and experiences. As the CQC says, we need the right care, in the right place, at the right time.

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