EXCLUSIVE: Minister for Care previews social care Green Paper

Minister for Care, Caroline Dinenage

In an exclusive interview ahead of this summer’s Green Paper, Minister for Care Caroline Dinenage tells CHP doing nothing is not an option

How are you consulting with care home providers on this summer’s Green Paper on social care? What other organisations are you consulting with? How will the views of care home providers be included in the Green Paper?

We won’t find effective solutions to the provision of high quality care without the lived experiences and insights of compassionate and committed care home providers. The run up to the Green Paper as well as the consultation itself is an opportunity for us to canvass their views as commissioners, managers and care home staff.

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More broadly, we will be working closely with local government, the NHS, the voluntary sector, care providers, and individuals and families receiving care and support. When the Green Paper is published our consultation will seek their combined wisdom and concerns.

What are the priority areas the Green Paper will be focusing on?

The Green Paper is guided by seven principles which seek to address the main challenges and responsibilities facing the sector. These include: quality, integration, more individual control – for example through Personal Health Budgets, workforce, supporting families and carers, finding a sustainable funding model and delivering security for all.

What do you say to those who say ‘another Green Paper’ nothing will come of it?

Our Secretary of State has been clear: we have to do much better on social care. It’s been a long and difficult path but, given the mounting pressures facing the health and care system, doing nothing is not an option.

This Green Paper will build on previous debate as well as looking beyond statutory services to the wider networks of support within our communities. Part of this means embracing new technology, innovation and workforce models to deliver better quality and value right across the piece.

We hear constantly of a sector on the brink of collapse. Does the Government acknowledge the urgency of the current situation and when does it aim to introduce legislation to address the sector’s key challenges?

The Green Paper will set out a long-term blueprint for social care reform but we are also working with the sector on a range of measures to improve quality and sustainability in the short term. This includes Quality Matters – a shared agreement published last year to deliver high quality adult social care that is person–centred, safe and responsive to individual needs. This joint commitment, created by commissioners, providers, staff, national bodies and people who use services remains a great example of our collective endeavour to make quality personal.

We also know that the social care system faces significant financial pressures as a result of our ageing population. We have provided an extra £2 billion funding to the sector and recently announced a further £150 million for the next year, but the Green Paper will look at how we can agree a long term financially sustainable approach to funding the whole system.

There is a great deal of variation across the country in how much health and social care services are being integrated. How does the Government intend to make sure integration is carried out across the country?

Care home providers have long understood that whole-person integrated care is the way forward and have been active participants in making it happen.

To help foster even closer cooperation between health and care services we have announced new pilots in three areas. Over the next two years everyone accessing adult social care will be given a joint health and social care assessment or support plan, where needed. It’s time to translate this common sense approach into best practice across the system.

The Green Paper will also examine whether we can build on the learning from independent Ofsted-style ratings for providers to spread best practice to commissioners as well. This will help to reduce unacceptable variation in performance between local authorities highlighted by recent CQC reviews.

LA care home fees also vary greatly. What does the Government plan to do to prevent the emergence of a postcode system where care quality levels are determined by the fees LAs are prepared to pay and also to prevent the growing gulf in care quality between the public and private sector?

Whilst the Government has no say in local care rate negotiations, councils have a duty under the Care Act to promote their local provider markets and make sure they deliver sustainable, high-quality services for all local people.

It’s encouraging that 80% of services are rated as good or outstanding by the Care Quality Commission. However, the 20% still struggling need support and encouragement, not just from their local authorities but from those providers already demonstrating best practice.

The Department has published statutory guidance setting out how councils should meet these new duties when commissioning, including the consideration of the actual costs of care and support when negotiating fee levels. We have worked with ADASS, LGA, the care sector and other partners to produce a wide range of guidance and support about commissioning, market shaping and contingency planning, published on GOV.UK.

How is the Government seeking to address the recruitment crisis facing the sector?

The Department continues to work in partnership with Skills for Care and key stakeholders to develop tools and techniques for employers to support effective recruitment practices and improved retention of the care workforce, including continued professional development.

This year we launched a consultation with Skills for Care on the adult social care workforce with the aim of meeting the aspirations of current and future professionals so we can expand, enhance and diversify the care workforce in England.

Part of this endeavour involves not only recognising and respecting the compassion and dedication of care workers but also the incredible range of skills they have, while finding better ways to promote social care careers as varied, rewarding and life affirming for both givers and recipients of services.

How do you intend to address the shortfall in nurse applications as a result of Brexit?

We’re working across Government to make sure we have enough staff with the range of specialisms needed to deliver the high quality services upon which patients rely. We can take reassurance from the latest NHS Digital figures which show there were over 3,200 more EU nationals working in the NHS in September 2017 than before the referendum result.

Work is also underway to maximise our domestic supply of nurses. We have 13,900 more nurses on our wards since 2010 and we’ve also announced an increase of more than 5,000 extra nurse training places from September 2018.

How will the Government help make social care a more attractive career path?

In order to grow and retain a quality care workforce, care workers must be afforded the same respect and motivation as those they are tasked to help.

Recruitment must be based on positive shared values, skills, professional development and the promise of career progression. New technologies and approaches to care have also created the opportunity to transform care roles and offer workers enhanced roles and responsibilities.

The forthcoming health and care workforce strategy will take these considerations forward, alongside the Green Paper.

What alternative personal care funding models is the Government considering to provide a sustainable future for the sector?

The greater control people have over their care, the better their outcomes and the lower the cost. We are therefore currently consulting on extending Personal Health Budgets to include those with the greatest ongoing social care needs. Have your say here: https://surveys.quality-health.co.uk/Questionnaire/Anonymous/PHIBUR18/

Does the Government believe people are ready to contribute more to fund their care?

It is only right that, where possible, we should contribute to our care costs in later life. We do have work to do to build greater awareness among the public of how the current system works, and ensure that people appreciate the need to plan for their future care needs.

However, the present system can seem unfair as different conditions incur drastically different costs. For example, if you require long term residential care as a result of developing dementia, you will have to use a big chunk of your savings or the equity in your home to pay for it. But if you require long-term cancer treatment, the NHS will cover most of your costs. There has to be some personal contingency in the system, but we also need an element of risk pooling. We will bring forward ideas as to how to do this alongside their potential costs in the Green Paper.

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