The government has published their long awaited white paper on Adult Social Care reform. The white paper, People at the Heart of Care sets out an ambitious 10-year vision for how the adult social care sector will transform support and care in England.
The government’s vision for Adult Social Care puts people at its heart and revolves around three objectives:
1. People have choice, control, and support to live independent lives.
2. People can access outstanding quality and tailored care and support.
3. People find adult social care fair and accessible.
Person-centred care is a key theme running through the vision. Genuine choice and control about personalised care and support can enhance quality of life and promote independence in a way that matters to individuals.
The Care Act 2014, particularly its focus on wellbeing, provides a strong foundation for the white paper however the Government also recognises that the ambition of the Care Act has not consistently been achieved in the way they would have liked. New measures currently going through Parliament will strengthen how care and support is delivered and ensure care is delivered to both the letter and the spirit of the Care Act.
The document sets out a range of policies that will be implemented over the next three years. These include:
- At least £300 million to integrate housing into local health and care strategies, with a focus on increasing the range of new supported housing options available. This will provide choice of alternative housing and support options.
- At least £150 million of additional funding to drive greater adoption of technology and achieve widespread digitisation across social care. Digital tools and technology can support independent living and improve the quality of care.
- At least £500 million so the social care workforce have the right training and qualifications, and feel recognised and valued for their skills and commitment. We want the workforce to also have their wellbeing prioritised.
- A new practical support service to make minor repairs and changes in peoples’ homes to help people remain independent and safe in their home, alongside increasing the upper limit of the Disabilities Facilities Grant for home adaptations such as stair lifts, wet rooms and home technologies.
- Up to £25 million to work with the sector to kick start a change in the services provided to support unpaid carers.
- £30 million to help local areas innovate around the support and care they provide in new and different ways, providing more options that suit peoples’ needs and individual circumstances.
- A new national website to explain the upcoming changes and at least £5 million to pilot new ways to help people understand and access the care and support available.
- More than £70 million to increase the support offer across adult social care to improve the delivery of care and support services, including assisting local authorities to better plan and develop the support and care options available.
These proposals are backed by the new Health & Care Levy announced in September this year, of which £5.4 billion is being invested into adult social care over the next three years. Beyond the next three years, an increasing share of funding raised by the levy will be spent on social care in England.
Why 10 years?
The government recognises that some of the challenges in social care cannot be quickly fixed. Therefore, over the months and years ahead, they will continue working with a range of voices from across the care and support landscape to deliver the changes that we all want to see. This will include working closely with local authorities and supporting them so they have the right tools and capability to deliver the right care and support that puts wellbeing and personalised support front and centre. They will also engage with a diverse range of organisations and people, including those who draw on care and support or provide unpaid care, to consider how we can measure success of our 10-year vision.
This is a journey
Commenting on the White paper, the Right Honourable Sajid Javid, Secretary of State for Health and Social Care said, “I stress that it is a journey. The proposals outlined will not solve all of the problems, but they are a significant step in moving us towards a new vision for social care that the whole of government is committed to.”
“To deliver on this vision I want to encourage investment and innovation right across the sector, to shift away from a reliance on residential care and offer people genuine options for drawing on outstanding care at home and in the community. The new funding for our workforce, housing and innovation are just a handful of the proposals that will start to make our vision a reality.”
“This vision is a shared vision shaped by national and local government, care providers, care staff, the NHS, and those who draw on care and support and their carers. I am immensely grateful for the input and support that these groups have provided in developing our vision and the policies within this white paper. I look forward to continuing to work with these groups over the months and years ahead.”
Reactions from the Social Care Sector
The white paper, People at the Heart of Care, should be seen as a first but highly significant step on a journey of transformation, according to ADASS, a charity whose members include directors and other senior staff in local authority adult social services departments.
Stephen Chandler, ADASS president said: "I am really pleased to see this publication, it represents a foundation stone for which we have been waiting for 20 years or more. By its own admission the white paper is just a starting point and I look forward to continue to work with government to make its ambitions a reality”
“This is going to be a 10-year programme of transformation and its success will depend on the continued and growing involvement of groups representing all those who commission, provide and, most importantly, draw on care and support,” Chandler said.
“The white paper sets out strong values and principles and has great ambition. But there is much detail to fill in and much more funding to find. Clearly the sums identified so far can be no more than pump-priming.
"The white paper paints a promising picture of a more professionalised care workforce in the future. What we urgently need now is a bridge to that brighter future, to address the immediate crisis and ensure that everyone gets the care and support they need this winter."
Jane Townson, CEO, Homecare Association believes the aspirations within the white paper are great however she has said, “These aspirations will, however, remain just aspirations unless the vision, plan for implementation, and investment are aligned. And this is where our concerns lie.”
Dr Jane Townson CEO, Homecare Association also said: “It is very encouraging that home-based support and care is at the heart of the vision for social care articulated in the Adult Social Care Reform White Paper. This is what we wanted to see.”
“Building on the principles of the Care Act 2014, the paper talks about listening to people receiving support; personalisation; prevention; choice and control; information to help navigate the health and care system; support for informal carers; support for the professional workforce; innovation and technology; and oversight of the system.”
“All of these are great aspirations that resonate with those receiving and giving support and care. We are grateful for the widespread consultation and opportunity to contribute. It is our genuine hope that this vision will become a reality over the next 10 years.”
“Whilst the proposals contain welcome additional funding for a range of areas, including housing (£300m); innovation (£30m); technology (£150m); informal carers (£25m); workforce (£500m); and testing new ways of providing information (£5m), which will be valued by many, they do not address underlying systemic issues.”
“Government continues to pour billions into the black hole of NHS acute hospitals. There’s no sign of a meaningful shift in investment towards supporting people in the community, addressing inequalities or tackling the social determinants of health. Homecare receives only 4% of the amount invested in the NHS.”
You can read the Homecare Associations full response here.
“The Government has been ambitious with its vision and now needs to match this ambition with the necessary funding, to turn it into reality.” - Cllr David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board
Cllr David Fothergill, also said: “This much-anticipated white paper sets out a positive vision for the future of adult social care and it is right that it has been co-produced with and alongside people who draw on care and support. It is also encouraging to see the Care Act is the foundation upon which these reforms will be built, particularly the emphasis on housing, greater recognition of the workforce and skills, and prevention, action on all of which will improve the quality and experience of people who draw on social care.
“We need to balance the aspirations and expectations set out in this paper against the wider reality of the funding backdrop against which councils and care providers are operating, which is insufficient to meet current and rising demand. While councils share the Government’s ambition and want nothing more than to deliver it, they will need a substantially bigger share of the new Health and Social Care Levy for that to happen.
“Addressing unmet and under-met need, tackling rising pressures, retaining hard working care staff, and investing more in prevention are all areas which need investment now, if we are to significantly bolster core services. This is the essential platform which is needed to fully realise the long-term positive vision set out in this white paper.
“Unless these can be urgently addressed as an immediate priority, any long-term proposals for social care – including those in the white paper backed by funding to kick-start change and innovation – will be set up to fail because core services themselves will not be available or sustainable. Without such investment, public expectations will be unfairly raised.
“Questions also remain about whether the funding allocated for the various major charging reforms, including for the introduction and running of the care cost cap and councils paying providers a ‘fair rate of care’, will be enough. Funding shortfalls impact directly on those who draw on care and support now, as well as those who will do so in future. The Government has been ambitious with its vision and now needs to match this ambition with the necessary funding, to turn it into reality.”
Professor Martin Green OBE, Chief Executive of Care England, said:
“This top level visionary White Paper sets out the Government’s direction of travel for the reform of adult social care. Care England stands ready to help the government deliver this strategy by identifying and dismantling some of the barriers standing in the way of delivering this vision.
“Delivering this White Paper is going to be very difficult because of some of the major challenges facing the care sector, but we are all committed to starting on a journey that will deliver better outcomes for citizens and long-term sustainability for social care providers”.
Skills for Care CEO Oonagh Smyth said:
“Much of the workforce elements in the white paper are measures we and others have been asking for. The commitment to invest in our workforce’s professional development, and in our key leaders like registered managers is something we have been talking about for some time, and I am sure will be welcomed by employers and those who work for them.”
“There is no doubt that the last couple of years people who work in social care have had really rewarding experiences and built great relationships with the people they support but they have also been through some incredibly tough times. This white paper is the start of recognising that people who work in social care are skilled, compassionate professionals and we look forward to working with the government on what future investment will look like, and to support making the ambitions set out in the white paper a reality.”