The first reference to social care that I could find in statute was the Elizabethan Poor Law of 1601. The law refers to people in need of health or domestic care, housing or employment. The “care” in question pertains to financial hand-outs, food, apprenticeships, boarding or referral to a workhouse. The first reference to any systematic approach to care is about the problems caused by the poor. Much of the legislation that followed over the years reflects similar themes “The Chronically Sick and Disabled Persons Act,” “The National Assistance Act” etc.
The “Archway of Tears” at the entrance of the former Birmingham Union Workhouse
Fast forward to 2014 and the Care Act unpacks some of the rights and expectations citizens can have about Social Care. Councils are now required to offer a range of support to carers and self funders and offer both preventative and personalised care. The balance (in law at least) is beginning to move the way of people. There is much of the legislation to be proud of. The challenge is now to ensure human experience of care and support mirrors those hard won rights and entitlements.
In contrast to the layering of new responsibilities and statutory duties for adult social care funding from Government to Councils has decreased (according to the Association of Directors of Adult Social Services 2014 budget survey) by 26% over the past four years (or £3.53 billion) and an incredibly steep trajectory of cuts lies ahead. Public expectation and funding are on a collision course.
There has been a tendency over the past twelve months to either attempt to recycle funding across a distressed health and social care economy e.g. the Better Care Fund. A range of additional duties and expectations of the system have arisen that have not been resourced as yet; such as the tenfold increase in the need for Deprivation of Liberty Safeguard cases as a consequence of the Cheshire West judgement. We cannot ignore the debate about the future of adult social care any longer.
My Nan, Kathleen (Kath) Bowsher who died recently having experienced fantastic care in her own home.
Skills for Care estimate over a million of us work in social care and over 1.27 million people access state funded care and support. The number of self funders and informal carers make both the preceding figures look tiny. Why is it then that when the impact and reach of social care touches the lives of so many people that it appears to have such a low profile? A general election is five months away and as yet there are no signs social care will play a part in it.
Finally and much more positively, credit and credence must be given to the many voices that have challenged the system and demanded greater transparency and candour. Decreasing resources are no excuse for a lack of honesty and openness. Public services must be held to account by the people they serve. There are too many individual voices and organisations to give full credit to but the #107days campaign has been creative, challenging and powerful. It has made me reflect deeply about what it is to be part of a system and how easily the voices and needs of people who use care and support can stop being centre stage.
In this context my (lofty) hopes for 2015 are as follows:
1) Cross parliamentary debate on the Kate Barker Report; with a clear consensus about the future funding of social care
2) The #LBBill becomes law and usage of treatment and assessment centres becomes unwelcome and unacceptable in all quarters
3) There is tangible evidence the Care Act has been implemented to positive effect
The roots of the social care system may be intertwined with dependency, asylums and workhouses; the future must be the opposite.
Happy 2015 to you all