CEO of the Association of Mental Health Providers (The Association) and chair of the Care Providers Alliance (CPA), Kathy Roberts, urges government not to forget the needs of supported living and mental health services during the COVID pandemic and beyond.
In her dual leadership roles as CEO of The Association and chair of the CPA, Kathy has championed mental health services and the care of working age adults and older people in supported living and communal residential facilities, and in the community.
“There hasn’t always been an understanding of the wider role of social care and how absolutely essential it is for people living in communities and the role of support to see beyond illness,” Kathy told CHP.
“It’s about people living lives and really valuing those lives and supporting those lives, offering care where appropriate and in some areas treatment, because that all comes within social care.”
Having started her career as an occupational therapist in the early 1980s working with older people in the NHS, Kathy has since specialised in mental health. She moved into the community sector in 2005 with a focus on mental health development and then took on her role at The Association, which was previously the Mental Health Provider Forum, in 2012, before also becoming chair of the CPA in September 2020.
“I have been working in social care both within local authorities and commissioning right the way through to the voluntary and community sector,” Kathy noted.
“I have a particular interest in the provider and also ensuring the perspective of people’s lived experience is brought into the commissioning of social care.”
The Association is the only national representative body for voluntary community and social enterprise providers of mental health services.
There are around 2 million people supported through the voluntary and community sector mental health services through NHS contracts and well over 4 million via local authority contracts. Additionally, there are around 585,000 people in social care providing mental health services.
“The Association understands the breadth and complexity of the mental health providers’ sector and the role its offering in supporting, treating and caring for people with mental health needs,” Kathy said.
“Its remit is vast and complex and ranges from independent hospitals, crisis care, complex needs support, step down services, psychological therapies and a range of support focused on the wider determinants around supported accommodation, including residential, access to employment and meaningful occupations advice, and counselling and advice services. We are well placed to represent all mental health providers.”
Kathy highlighted the importance of understanding the local and regional role of organisations in reaching out to people who are disproportionately affected by mental health issues such as disadvantaged communities.
The Association leads work programmes such as the Mental Health Consortia in the VCSE Health and Wellbeing Alliance, and Mental Health Sustainability and Enterprise Development programmes.
“The Association is about really appreciating the provider sector, highlighting its role and value, and what it brings to mental health,” Kathy highlighted.
The representative body has around 200 members, many of whom provide a residential element such as independent hospitals and supported living where people with mental health needs are supported within their accommodation.
Additionally, the body has associate members as well as partner organisations such as the Race Equality Foundation and Agenda – working collaboratively to consider how race, gender and other areas intersect with mental health.
Additionally to her Association role, Kathy chairs the Care Providers Alliance (CPA), which provides a collective and national voice for adult social care providers.
Comprised of 10 national associations, the CPA supports the full range of people with long term conditions such as physical disabilities, mental health, learning disabilities, autism, older people, people living with dementia and the providers who care for them.
Working collaboratively it co-ordinates responses around the sector and informs and influences policy makers.
“We work in partnerships to improve care and build awareness of the care provider sector,” Kathy explained.
“The CPA’s vital role is in how it can influence policy. There’s so much expertise and knowledge and experience within the sector.”
The CPA has played a key role in getting the voices of providers heard during the COVID-19 pandemic.
The body sat on the Department of Health and Social Care’s Social Care COVID-19 Task Force with Kathy co-chairing its Mental Health and Wellbeing advisory group, which also made recommendations to the Task Force based on learnings from the sector and the perspectives of people with lived experience.
Other members of the CPA led on the workforce, learning disabilities and autism advisory groups and the body played a key role in the development of the accompanying Social Care Winter Plan.
Kathy now sits on the Social Care Stakeholder Group, which monitors the wellness component of the Winter Plan.
Additionally, she now sits on the Mental Health and Wellbeing Policy and Oversight Group which has put the 12 recommendations of the Mental Health and Wellbeing Advisory Group into gap analysis and will be working with the LGA and others on an improvement plan.
“The national Winter Plan is very much focused around elderly residential care and its recommendations are being implemented around testing, infection prevention and control, and vaccinations,” Kathy explained. “It monitors all of those key recommendations.
“There are people who have been very much affected and continue to be affected by the pandemic so we need to be able to look at those areas and recommendations and how best to meet their needs.
“We identified gaps very early on and the CPA worked very closely with partners and all stakeholders such as NHS, LGA, ADASS, CQC and others, to make sure that we could work together to be able to respond and work together with the same aims and objectives.
“We are all diverse in our approaches but we all have the same stake in the future sustainability of the sector and keeping people safe and making sure that service users and the workforce are supported.”
When looking at the government’s response to the pandemic, Kathy stressed the importance of addressing the needs of service users and staff in all residential services and not just those for the elderly.
“Learning disabilities and autism and all different kinds of residential settings such as supported living and extra care have had to play a lot of catch up during the pandemic as the focus has been very much on elderly residential care,” Kathy highlighted.
With the government having reached its target of offering vaccinations to all care homes for the elderly, Kathy stressed that testing, PPE and vaccination of service users and staff working in supported living communities must be a priority.
“The supported living communities also need those protections,” Kathy stressed.
“It’s something that we have been pushing for as the CPA and was an area that was picked up through the Task Force as well as through the Learning Disabilities and Autism workforce and Mental Health and Wellbeing Advisory Group recommendations.
“Residential and settled accommodation is about all ages and it’s about making sure there is the right approach to supporting those people and their workforce who have been absolutely magnificent.
“It’s very important as people who have existing health needs such as schizophrenia have a high mortality rate so we are very keen that people with severe mental illness have their vaccinations as soon as possible.
“As well as the workforce in social care, we also need to focus on the other key areas that intersect with health such as criminal justice, homelessness and rough sleepers. It’s about making sure all vulnerable people are safe.
“There has been tremendous media interest in older people during the pandemic as the impact has been catastrophic in some areas but it has also shone a light on the fact that social care is much wider than that.
“There are people with long term conditions living in communities who are being supported and are very vulnerable. In residential settings I would hope that there is an understanding that this covers supporting people of all ages.
“It is around looking at learning disabilities, autism, physical and sensory impairment and
As well as seeing that no vulnerable service users were left behind during the pandemic, Kathy said government had been initially slow to recognise the whole social care workforce.
The CPA have acknowledged that ensuring the whole care workforce was vaccinated remained a challenge. Providers have acted swiftly when asked to gather colleagues to access the vaccine, often with 24 hours’ notice and only a small minority of the workforce have been refusing jabs.
“We need to make sure that information gets out about the benefits of the vaccine and that we can ensure that information is shared which responds to concerns people may have,” Kathy stressed.
“We know that within community groups, such as those disproportionality affected, people may be worried about the vaccine and you have got providers who are well placed in that community setting to give that information and work with grass roots organisations.
“It’s really important that the vaccine gets across the country to those who are very vulnerable and those who are supporting them,” Kathy said.
“It’s part of the workforce strategy to support the workforce through this and there are some concerns still out there for people. We would add that when considering the workforce, we really need to also look at unpaid carers who are supporting vulnerable people but may not automatically fit in the cohorts outlined.”
The care leader said the mental health of service users and the workforce must be a key priority during the pandemic and beyond.
“We have to understand the pandemic has affected each and every one of us to a greater or lesser degree,” Kathy said.
“It has impacted on jobs, homes and families. It has been very difficult for people’s mental health and wellbeing.
“And then you have people who are managing pre-existing mental illness which has manifested as severe anxiety.
“The media hasn’t helped sometimes because sensationalism can make managing a situation very difficult and trying to manage your own way through this pandemic is very tough.”
The care leader also warned that the expected ‘tail’ of the COVID pandemic would cause anxiety for many people.
“We will need to manage the situation through things like helplines, especially looking at support services that are culturally appropriate considering the high levels of deaths in some communities, but we also need to be there in the future for the workforce that has worked tirelessly throughout the last year – and this goes beyond the health and social care sectors because key workers from all areas are being impacted physically and mentally,” Kathy observed.
The CPA chair also noted the problems caused to delivering mental health services during the early stages of the pandemic.
“We had some real problems in delivery of mental health services with people being supported and feeling as though their care plans had not been actioned and they had no single point of contact, along with difficulty of access to advocacy in crisis, supported services and a lot around digital poverty and all about communities being disproportionately affected,” Kathy noted.
Service delivery issues were part of the 12 recommendations that went back to the Social Care Task Force for further action.
“We have had feedback from people who said the NHS response to them being COVID positive was better than the response to their mental health needs and it’s key that we are able to support people’s mental health to the same level as we do their physical health,” Kathy said.
Isolation has also been a big issue for people being supported with mental health needs during lockdown.
“Quite a few people have felt quite forgotten,” Kathy said.
“Supported living providers have been very mindful of the risk of isolation during the pandemic and face to face meetings are not stopping.
“There is a wellbeing check that is happening within those services particularly for people living in
“For providers it has been about ensuring that someone’s mental health is not further compromised.
“It was part of what we looked at on the Task Force in terms of establishing a single point of contact, being able to get out information about what is available and where they can go. For example, our frontline offers round-the-clock, one-to-one support, by call or text, from trained volunteers, plus resources, tips and ideas to look after your mental health.”
The Association head said a lot of learning had taken place during the first part of the pandemic which was now in place to support people.
When asked by CHP what action government should take to improve mental health service delivery, Kathy highlighted the importance of a cross-department approach.
“Policy needs to be costed across a cross-government approach, particularly when you are looking at mental health and other conditions,” Kathy noted.
“Mental health crosses the mental health and social care portfolios. Joining up the system has been really important in understanding social care’s focus on people and communities.
“There needs to be a bit more understanding about that.”
Looking at the bigger picture going forward, Kathy highlighted the urgent need for social care reform as the sector emerges from the pandemic.
She highlighted funding and the workforce as key areas to be addressed.
“There needs to be adequate sustainable funding of the sector,” Kathy highlighted.
“The sector brings in £41bn into the economy. That’s a phenomenal amount. We have said through the Health and Social Care Committee that the sector needs about £8bn to just stand still.
“If you look at mental health only and added £1bn it would only take us back to the level of funding in 2013. There is a real financial shortfall that urgently needs to be addressed.”
The CPA chair highlighted equality and inclusivity as an area of concern in ensuring that all parts of the social care system are adequately funded, including for profit and not for profit providers.
“There needs to be a better settlement in the spending review and better understanding of what the components of social care are and what it gives to people and the role of social care,” she said.
Kathy illustrated the need to examine different funding models and highlighted how mental health had been a leader in this area by delivering services through social enterprise and trading models.
She also stressed the need to find a sustainable solution for the social care workforce, which faces enormous structural stresses due to historically high turnover and vacancy rates that have been exacerbated by the pandemic.
“At the moment you have a workforce that can get the same financial benefits from working elsewhere,” Kathy noted.
“You have got people who really want to work within the social care system and support people. That’s why we welcome the government’s Call to Care initiative.”
Kathy highlighted the CPA’s role in pushing the government to deliver the £120 million Workforce Capacity Fund that was announced in January to help ease recruitment pressures on care providers.
“We need to have a structured, costed 10-year plan for social care and within that there has to be the People Plan,” Kathy stressed.
“You can’t do one without the other. We know that the pandemic has had a huge cost to it, and I would like to think that does not reflect into contracts and commissioning moving forward for the sector.
“Social care providers, particularly in mental health, have not had the year-on-year uplifts needed to support those services. There needs to be funding uplifts in the coming year and beyond in order to be able to continue to do that.
“We are hoping that contract negotiations are not fraught with difficulties.
“It’s about the need to continue to commission services appropriately despite financial difficulties caused by the pandemic.
“A lot of providers have used a tremendous amount of resources to get through the last year and not everything has come back through payments from the government.”
As social care finally emerges from the worst ravages of the pandemic, it looks like Kathy’s work in championing all parts of the sector has only just begun.