It was in the summer of 2022 that the East Anglia Bylines Spotlight team began its investigation into the emerging crisis in social care in the region. Boris Johnson was Prime Minister, the Secretary of State for Health and Social Care was Sajid Javid, and the Head of State was Queen Elizabeth II.
It seems so long ago.
The Head of State is now King Charles III, and we have our third Prime Minister this year and our fourth Secretary of State for Health and Social Care.
A persistent crisis
Despite all the changes in political office, the crisis in social care in East Anglia remains.
It can be presented as statistics or tragic examples, but the inevitable finding is one of a shortage of trained staff and managers to support those entering the industry.
The Spotlight investigation found that, across East Anglia, more than one in five of the care homes were not classed as Good or Outstanding. The majority were described as Requires Improvement, others Inadequate, and many others had not yet even been inspected.
The same was true of the ‘home care’ or domiciliary care sector, where trained staff visit and provide care in a person’s home. Here, more than one in five of the service providers do not meet the Good or Outstanding standard.
While these statistics are concerning, it is the human cost that is far more brutal. Lambert House in Bowthorpe, for example, which was run by Autism Anglia, has closed. The main reason cited was difficulty in recruiting senior management. That is scant consolation to the families left scrambling to find alternative care. In Essex, the care provider Ashley Care was deemed by the CQC to be Inadequate in terms of the time available to staff to visit individual clients in their own homes. The main reason? Too many clients and not enough staff.
Vulnerable people left at the mercy of market forces
A Plan?
The current plan – from the previous Health Secretary – to assist with care provision is for 13,000 additional beds across the nation to help reduce pressure on the NHS. This does not come close to replacing the 25,000 beds cut by the Conservatives since 2011 but it does address the problem of backlogs in Accident and Emergency departments. Those beds will be provided in the community and will be the responsibility of local authorities and local NHS trusts, not the Department for Health and Social Security.
Cause
In July 2022, the Association of Directors of Adult Social Services (ADASS) reported that an average of six hundred people are added to the waiting list for care every day. Their waits are because of chronic staffing shortages; ADASS also cited funding as a primary issue.
“Contrary to claims,” said ADASS chief executive Cathie Williams, “social care is not being fixed and we need decisive action and funding now to get us through the months ahead and to start to build the foundations of the reformed system that we all want to see.”
This assessment was echoed by the House of Commons Select Committee on Levelling Up, Housing and Communities (LUHC), which highlighted that the “message rang clear throughout our inquiry: the adult social care sector does not have enough funding either in the here and now, or in the longer term”. The report notes: “we received concerns that Brexit and the points based immigration system would exacerbate staff shortages, not just directly but also in indirect ways” before citing examples of competition for staff from the hotel sector.
Inaction
With all the changes in ministerial portfolios and prime ministers, with all the U-turns and policy shifts, announcements and retractions, it is easy for things to get lost in the reshuffle. Yet, despite the changes, one thing remains the same: the lack of action.
Previous ministers suggested that rather than go on strike nurses should just leave the profession. The concern is that despite the wide-scale reporting of the crisis, it is easier for government to change the minister than to change course.
Research by J. J. Jackson, Wendy Boother, and the East Anglia Bylines Spotlight team.
