person wearing red jacket
Photo by Jack Finnigan on Unsplash

The cost of social care currently is around £23.3 billion, although this may seem a lot, the Government has been cutting the social care budget over many years, leaving local authorities underfunded and unable to provide anything other than very basic essential care.

Even simply providing essential care, local authorities struggle to find agencies who will charge within their budget. Many local authorities will not pay over £11 per hour for social care. When this care is being provided by an agency it means that often the care staff are on minimum wage and the agency does not always have the money to provide full comprehensive training and support for its workers. It also means that often the time for each care visit is reduced to its minimal of 15 minutes to allow travel to the carer’s next appointment. This means the correct level of safe and required care is not always given.

Although some people receive Personal Independence Payments or Attendance Allowance, to help cover care costs, if you have high care needs this only covers the smallest amount of essential care, so again often the right amount and level of care cannot be purchased. We need a secure larger social care government budget, given to local authorities based on the numbers of those requiring care in their area.
If you are financially able, you can purchase private care from an agency or organisation, for yourself. With this you have some choice about the hours, the cost, and the services you want and receive.

If, however, you do not have financial ability then you are totally reliant on social services local authority support.

The local authority does an assessment with you. decides what you need, and how many hours and how much money they can give towards your care. Many local authorities will work on a co-funding principle which means that, depending on your means tested income, you may have to pay a small amount towards the care provided.

If as someone who needs care, you are fortunate enough to qualify for the Governments ‘Direct Payments Scheme’ you may have a larger say in what you need and can perhaps have more choice in how the budget is used as it is often given to you to manage. You may still have to contribute to this but have more control.

Carers are chosen by agencies tendering social services for contracts. So social services approach the companies they have a list of and ask if they can provide the care package they have put together. If there is more than one agency who can provide the care, then the person needing care may get to choose which agency to use. This will depend on the costs per hour that social services are prepared to pay, or if you are using the Direct Payments Scheme.

You often do not have a choice of which individual carer you have as it will depend on a rota. However, if you have the money and have a personal assistant agreement with an individual rather than an agency (you can also do this through the Direct Payments Scheme), you can choose to have a specific individual you trust and the option of respite or support when your carer takes holiday time.

The one negative of the Direct Payments Scheme is that often you cannot nominate a family member or individual who lives in the same property as you to be the registered carer being paid with your Direct Payments budget. There are a few exceptions to this rule, but it means that it limits the choice and often those needing care will end up with an unpaid carer who is a friend or a family member that the individual trusts.

There are currently around 13.6 million unpaid carers. The care allowance that some family members can receive for the time they give is minimal and around £67.60 per week. A carer must care for an individual at least 35 hours per week to receive this carers allowance top up. They are often not given the right support or any chance of any holiday or respite from their duties.

Currently around 43 per cent of people who request support receive some form of service, a further 28 per cent receive advice or signposting, and 29 per cent receive nothing.

When there is no Government/council money to pay for social care, it often falls on charities and the individual or their families to come up with the money for care.

An alternative to this would be that you could potentially have an insurance model, to allow individuals or families to pay premiums into insurance policies and claim funds to meet social care costs if they have a need for care.

Within this model we could potentially have a situation where an individual paying a policy dies and has surplus funds remaining in their policy. In this case the remaining funds could, with correct legislation, be permitted to be transferred to another individual’s nominated by the deceased.

Some of the ideas are that, if you have a family policy, that the incentive for younger people to contribute is that they are helping their parents or older generation as well as building up for their own future.
Secondly, if the last member on a policy dies and there is no more family to take on the remainder in a fund, it could go in to an ‘orphan’ fund. This, unlike with other insurance companies, could then be there to provide for those individuals who are young people in care or others who do not have family and are unable to provide for themselves financially – either initially in the beginning of their adult life or permanently.

There could be a tax incentive, such as the tax relief on premiums paid like that given to pension contributions.

Even with this model suggestion we would either need it run through co-operative means or through the Government. There would always be a requirement for some level of Government funding to hold up the social care system.

Voluntary services provide a certain level of social care. Often this social care reflects more around befriending, shopping and sometimes assistance to get to hospital appointments. This is still a post code lottery, as are most of the current care services. However, the charity sector and their voluntary services have been filling in the short fall from Government services for many years. Covid 19 has seen these organisations really struggle as they have not been able to fund raise or have so many volunteers visit those needing assistance. This has exposed the true deterioration of our social care system and how much work there is to be done to fix and rebuild it into a better and more sustainable model.

Co-operative care is where the person who needs the care and support, as well as their family, carers, and possibly those giving access to leisure and community activity, are all involved in providing a fully inclusive package that allows each individual to have a life of choice, integration in their community, and a chance to make the most of their abilities. Any bespoke package must promote the individual living in a place they call home, being able to be with those, and do, the things they love. This will enhance their physical and mental wellbeing. Also having an impact on the wellbeing of their family, friends and those unpaid who are providing support and care.

Co-operative care also means that each of the above-mentioned people and individuals have a voice in the decisions and putting together of any package. This readdresses the imbalance of power that currently occurs with local government care where decisions are often made on behalf of a person needing care, rather than with that individual.

Government care often involves existing designed packages that are expected to ‘fit for all’ even though each person may have totally different abilities and needs.

Co-operative care overcomes this by focusing first on the individual and building the care around them rather than expecting them to fit with a pre-prepared package.

Co-operative care could mean that the care is provided by a co-operative of individual carers who have come together to bid for care contracts. This could be a worker’s co-operative and would mean that all resources are shared between each of the workers within the co-operative. It also encourages a sharing of skills and knowledge between the carers.

The second option of co-operative care could be a user led co-operative. This could be where those using the care services are paying into the co-operative and that all of the services are purchased from other co-operatives, such as care co-operatives and the alternative payment model discussed earlier in this blog. There could also be the option for the user led care co-operative to bid for contracts outside of their main income as any other business would. Any profit made from non-member purchases would go back in to dividends for the co-operative members.