James Scott 26th October 2016 Blog Health and Social Care Share Tweet This week Gareth Thomas MP, Chair of the Co-operative Party and Shadow Minister for Communities and Local Government, pressed the government on the latest report that the adult social care sector in England is at a ‘tipping point’. The independent Care Quality Commission pointed out recently that the Government’s huge funding cuts have left services for England’s elderly and vulnerable at a tipping point. With the social care crisis across England getting worse week by week, when might we expect the Secretary of State to act?’ Sajid Javid’s response noted the impact of the Better Care Fund and the social care precept. But these funds will be insufficient for plugging the large funding hole in the social care sector, and will fail to incentivise the innovation needed to solve the care crisis in the future. In their 2015 annual budget survey, the Association of Directors of Adult Social Services found a £4.6bn gap between care provision and demand in England. This is the situation we face today and the starting point for any consideration of future care funding – local authorities unable to provide the basic support services to their older and vulnerable residents to the tune of £4.6bn. And how is this gap between provision and demand expected to grow in the future? In evidence to the DCLG Select Committee inquiry into adult social care funding, Sarah Pickup from the Local Government Association said there will be an additional £1.3bn shortfall by 2018/19. And that assumes that all local authorities choose to levy the 2% precept each year for the rest of this parliament. So, while the investment associated with the Better Care Fund and optional precept are welcome, they neither plug todays funding gap nor account for future increases in demand for care services. This government also lacks a reform agenda that will build a sector that can adequately meet our future care needs. Where will innovation emerge? Where is the promotion and support for new models of care? How will the government create efficiencies without negating on quality? The CQC was clear about what creates high quality care. Services that were rated good and outstanding engaged well with people who use services, their families and carers, and the community to design care plans, facilities and activities that meet people’s diverse needs and preferences’. In our Taking Care report, the Co-operative Party argued that those who receive, rely and provide care should have a voice and a stake in the governance and ownership of services will boost quality. This requires more than tokenistic ‘consultation’ of care workers and those receiving care, but an ownership revolution so that workers, care recipients and the wider community take control of their care. Social care co-ops would be driven by the interests of their member-owners rather than the maximisation of shareholder returns. Surpluses would be reinvested into services, improving staff retention through training and the quality of care, rather than siphoned off by shareholders. This is happening in in North East Dartmoor, where NED Care was established by people in the local community to match freelance care workers with those needing care services. Such innovations in England should be supported, as they have been in Wales by the Labour and Co-operative government there. To drive this agenda forward the government should establish a ‘Right to run’ that puts care workers on the boards of social care providers, and a ‘Right to own’ that let’s care workers and the wider community take over private services facing closure. In immediate terms, such measures would begin to put the care sector on a more sustainable financial footing by tackling profit leakage. And by investing surplus back into staff training budgets, rather than lining the pockets of shareholders, would make the sector more cost effective at the same time as delivering higher quality provision. Co-operation can provide a path through and beyond the crisis now facing the social care sector.