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Social care is not fit for purpose – here’s how to fix it

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Social care spending is still lower than 10 years ago. Care workers and society’s most vulnerable are bearing the costs of government inaction.

The Covid-19 pandemic is showing us just how essential social care workers are to the fabric of our society.

Like too many of the country’s key workers, this mostly female and disproportionately migrant care workforce is undervalued, underpaid and often exploited.

7 in 10 care workers earn less than £10 an hour, one quarter are on zero-hours contracts, and many home care workers are not paid for travel time and overnight visits, pushing them below minimum wage levels.

Too often carelessly categorised as “unskilled,” it is this workforce - alongside the millions of unpaid carers, whose sacrifice and difficult emotional labour is seldom acknowledged – who are propping up a broken system, starved of funds and neglected for years by politicians.

They have gone above and beyond to care for our most vulnerable, who have been particularly exposed to Covid-19 thanks to long-term structural weaknesses in the sector compounded by bad government decisions.

Increase spending to help councils and carers

Government spending on social care is too low and creates a postcode lottery.

Our analysis shows that overall spending on social care in England is £600m a year lower than it was in 2010, the equivalent of an 8 per cent reduction. But this reduction differs across regions, from 18 per cent in London to 5 per cent in the South-East, the East Midlands and the East of England.

Current funding levels are insufficient to meet current demand, let alone future demand – there is predicted to be a 49 per cent increase in the population aged 65 and over by 2040.

This reduction in government funding forces councils to tighten eligibility thresholds, meaning only those with critical or substantial levels of need can access publicly funded care.

More and more people are forced to rely on informal care from family and friends, many with care needs themselves. More funding for social care is desperately needed.

Structural problems laid bare

A boost to funding alone won’t automatically mean more money for care workers and better services. Most care homes are privately run for profit and the commissioning model prioritises profit over quality care. This directs public funds away from service users and squeezes pay and conditions for staff for the benefit of shareholders.

Wider benefits

The benefits of fixing our social care system will be far-reaching.

In the face of a looming unemployment crisis, unlocking the 120,000 current vacancies in social care, recruiting additional staff to meet rising demand, and ensuring that every social care job is on decent pay and conditions will provide an important source of decent jobs and help build a stronger economy.  

We need action now

We can and must build a better system. Social care needs long-term, sustainable funding that provides value for money to the public purse while meeting the needs of individuals and communities. And we must show our appreciation of care workers through decent pay and working conditions, rather than through tokenistic applause or badges. We need the following:

  • A new funding settlement, fully offsetting the cuts of the previous decade and committing to future rises at a level which allows local authorities to meet rising demand and improve pay and conditions for staff.
  • Immediate funding to fill all social care vacancies, providing a steady source of decent jobs in all areas of the country. The government should act now to unlock 120,000 existing vacancies, to help those losing their jobs.
  • Fair pay and conditions for care workers, including a sector minimum wage of at least £10 per hour. There must be an end to the zero-hours contracts, and poor or non-existent sick pay that put social care workers at risk during the pandemic. All social care workers must have guaranteed opportunities for training and progression linked to fair reward.
  • A national Social Care Forum, to bring together government, unions, employers, commissioners and providers to coordinate the delivery and development of services, including the negotiation of a workforce strategy.
  • A reduced private sector role, by strengthening rules to prevent financial extraction in the care sector. This should phase out the for-profit model of delivery, so that all public funding is used to deliver high-quality services with fair pay and conditions for staff.

The changes above can be made right now. Longer-term, the government should make social care a universal service, free at the point of use and paid for through general taxation to ensure high-quality social care can be quickly accessed by everyone who needs it, in every part of the country, without any variation in cost and qualifying rules.

Read the TUC’s new report: "Fixing social care: better quality services and jobs" here.

 

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