Social Care Alliance Haringey

- for the dignity and rights of people in need -

 

BRIEFING ON SOCIAL CARE FOR OLDER PEOPLE

MAY 2018

 

Older people are a growing proportion of Haringey’s population. Like elders nationally, they are living longer and spending more years in poor health with attendant care needs. But they are not getting the care they need. Nationally Age UK estimates that 1,200,000 people over 65 in England have unmet care needs. For a population the size of Haringey’s this implies over 3300 elders with unmet care needs. It could be more, due to Haringey’s ‘deprived’ nature and the high proportion of people born overseas, whose children and younger siblings, if any, may not be living locally. More detail is available here.

Whilst the number of the over 65s and especially the over 80s are growing in Haringey, the number of users over 65 receiving council services is falling, partly because of improving health but also because the council has been rationing services for this group by a deliberate strategy of ‘demand management’ (See Briefing on Adult Social Care elsewhere on this site).

In the last few years we have seen major scandals about the quality of domiciliary care in Haringey. The borough was highlighted in a Channel 4 expose of poor care quality amounting to neglect of adults at risk  April 2016).

Another Haringey scandal in February 2016 involved neglect of a dementia sufferer by the Extra Mile Agency - see www.express.co.uk/news/uk/645514/care-shame-dementia-sufferer-squalor-carers-blowing-whistle Alerts in the area of "neglect and acts of omission" in domiciliary care services tripled during 2011-15.

The Council needs to press for inner city levels of funding for the over 75s, just as it pressed for inner city funding levels for the schools. We understand that in 2014 inner London boroughs got £1957 per resident over 75 and outer London only £816.

In Haringey over the last 8 years we have seen some very serious effects of cuts in the social care sector:-

  • Closure of 7 day centres for people with autism, older people, disabled people, people with dementia as well as several drop-in centres and luncheon clubs, in support of ‘building-less’ policies, as well as the closure of residential homes. – a total of 18 centres in all. This throws extra burdens onto family carers and deprives users of much needed social opportunities, with as yet no clear picture for many of them about what the alternative provisions will be after months of consultation and waiting for assessments.

  • The ‘transformation’ of day opportunities has been highly undemocratic with inadequate consultation of users, sudden changes as well as uncertainty over an extended period. Reduction of specialised transport to day centres, creates burdens for carers and considerable difficulties for many users

  • Cuts in individual care packages and delays in assessment for new care packages

  • Serious problems in the quality of domiciliary care exposed in relation to Sevacare and Extra Mile agencies. This suggests inadequate monitoring of the home care services and pressure on service quality arising from the council’s need to push for the cheapest possible unit costs when commissioning care

  • Case reviews have not kept pace with the social care caseload.  There is a shortage of advocates with growing waiting lists

  • It is commendable that the council has now adopted the Ethical Care Charter (https://www.unison.org.uk/news/press-release/2017/09/protecting-haringey-home-care-workers-new-charter/ ) But funding this will be a challenge and the council should not dig itself into a hole where the amount of care provided has to be restricted further to meet a commitment to fair working conditions. Thankfully the outgoing Council agreed to raise the social care precept by 3% in 2018-19. A similar rise may be needed in 2019-20, and commentators nationally are saying that even the maximum precept will still not be enough. Costs can be reduced by scrapping agency contracting-out and bringing care back ‘in house’ or through a non-profit enterprise. The latter would offer good pay with good quality care, and democratic control, by stripping out private profit. On our web site, you will find a proposal about how to do this.  [See Gordon Peters’ paper 'A New Model of Social Care', in the 'articles' section of this web site ]

  • Care should not just be seen as a cost. It’s also a major employment sector and capable of job-creating growth. Some good analysis about how this is being planned in the West Midlands comes from the New Economics Foundation – see http://neweconomics.org/2017/08/social-care-local-economic-solution-west-midlands/. And in Somerset, many non-profit enterprises are being created in social care on a substantial scale, involving several hundred new jobs (see https://www.theguardian.com/society/2017/apr/26/old-disabled-people-homecare-micro-providers-somerset and https://www.communitycatalysts.co.uk/creative-community-care-in-somerset/

SCAH’s demands (See also SCAH Constitution and Manifesto):

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  • - There is a need for more extra care housing; the easiest way for the new Council to provide this (and much additional general social housing) would be to help the St Ann’s Redevelopment Trust buy the St Ann’s Hospital site and implement its carefully developed community plan jointly with housing association partners.

  • -The new Council should urgently develop policies to increase mutual aid, volunteering for/with/by older people and to reduce isolation and loneliness, which lead to ill-health and extra demands for social care. This means a need to fund advocacy/voice groups like Haringey’s Over 50s and ensure adequate advice networks and ‘befriending’ services.

  • - financial and logistic support (e.g. free meeting places, free publicity, funding or in-kind support for ‘core’ admin functions and web site maintenance) should be found for advocacy/voice groups working with adults at risk, like DP14H and SASH.