BASW England repeats call for long term funding solution for social care
The Institute of Government Performance Tracker 2023 is part of the annual Institute for Government/Chartered Institute of Public Finance and Accountancy (CIPFA) public services stocktake. Chapter 3 focuses specifically on the performance of adult social care services that are funded by the state.
In an otherwise excellent report analysing the data on performance in adult social care, the explanation of how local authorities manage cuts in funding is simplistic and misleading.
The report points out that the government has “cut grant funding by more than 30% since 2010, without enough of an increase in locally raised revenue to offset those cuts”. It asserts that this must result in rationing, although noting that “few local authorities would admit publicly that they ration long-term care”.
The evidence that this analysis relies on is the 2022 Annual Report from the Local Government and Social Care Ombudsman, which states: “a common theme is councils failing to provide care, or limiting it, and justifying this because of the cost”. The Institute of Government report concludes that this means “local authorities are effectively using subjective judgments about need to further ration care to adults”.
Decisions have to be made by local authorities about if and how an individual’s needs are to be met, and this requires judgements to be made. BASW believes that the impact of financial constraints is less on whether an individual has eligible needs, but more on how these needs will be met and funded.
The Care Act 2014 specifies that judgements in determining eligible need about whether an individual’s difficulties and inabilities have a 'significant impact' on their wellbeing. In addition, judgements have to be made in deciding the funding to meet agreed needs, to ensure that it is ‘sufficient’. Subjectivity is inherent in any judgement. The key questions are whether the opinions expressed, and decisions made are reasonable and transparent and that the professional judgement of social workers and OTs has been properly considered.
There is always going to be a tension to be managed between professional judgements that incur expenditure and ensuring that the public body in question keeps within its budget.
BASW England has addressed this in its guidance “An Ethical Approach to Meeting Needs in Adult Social Care”. The sub-title is “How the BASW Code of Ethics can help social workers to improve application of the Care Act to decisions about resource allocation”.
Also useful is the NICE Guideline (NG216) “Social work with adults experiencing complex needs”. This recommends that social workers should ensure when writing and reviewing care plans that they “record any eligible needs which are unlikely to be met or only partially met, the reasons they cannot be met or only partially met and any potential actions that would allow them to be met in future.”
The Institute warns that without serious action to address the chronic funding shortfall and the recruitment and retention issues across social care, there is a very real risk of the perpetual state of crisis, staff burnout and inability for services to take the best long-term decisions.
In the wake of yet another report highlighting the funding shortfall and under investment in social care, BASW England reiterates it’s call for a sustainable long term funding solution for social care.
More on the findings from this report can be found here.