A financial impact assessment report, commissioned by members of the Care Quality Commission (“CQC”) Market Oversight Scheme, has revealed that independent care and support providers are reaching a financial tipping point which risks denying people with learning disabilities and autism their right to decent, fulfilling, and stable care.
Three quarters of those surveyed expect to make losses or at best break-even this year. For the last five years, financial settlements haven’t kept pace with increases in costs, putting considerable pressure on the finances of these organisations.
The report reveals how providers are being forced to stop supporting people, handing back responsibility to Local Authorities due to consistent losses on the day-to-day operation of services. All Chief Executives interviewed for the research believe that these contract hand backs will accelerate over the next 18 months, with a direct impact on the quality of life of people whose support has become unaffordable.
Due to consistent underfunding over many years, the report reveals that care and support providers are struggling to pay employees the full UK Living Wage or higher. Just four providers involved were able to pay staff as much as 2% above the Living Wage.
With higher paying jobs elsewhere, such as in comparable roles in the NHS, thousands are leaving their permanent contracts. This is giving providers no choice but to use agency staff who are by definition unable to cultivate long-term relationships with the people they support. Without a long term understanding of the individual ways each person communicates, their likes and dislikes, and the agreed, personalised manner in which to support them, those in need of support are at high risk of low-quality care should the dependence on agency staff continue. Furthermore, the report estimates a rise in agency costs by 157% over the next year, rising from £56 million in 2020/21 to £144 million 2022/3. If this trend continues, agency staff costs are likely to increase between £175 million and £220 million by 2023/24.
Unless providers can increase pay for permanent care and support staff, they will no longer be able to recruit the right people. The current national approach to the commissioning of adult social care must be reformed or risk collapse. There is a broad consensus amongst care providers that care and support roles must now be benchmarked against NHS bandings and funded accordingly.
The CQC’s Market Oversight scheme was set up to protect care and support recipients from the impact of a Southern Cross-style collapse that put 30,000 people’s care at risk in 2015. Though this background is very different, this report from members of that scheme should make clear that in the absence of direct action from central government, there is a clear risk of repeat. And the consequences will fall directly on those who have a learning disability and/or or autism, and their families.
Rachael Dodgson, Chief Executive at Dimensions, commented: “For too long we, the people we support, and the social care workforce have been bearing the consequences of a broken and underfunded system.
“There has been no escaping the impact of the recruitment crisis. Increased use of agency staff is not a solution, it’s part of the problem. Not only is this a drain of money providers don’t have, but it also leaves many autistic people and those with learning disabilities without familiar and trusted care and takes away their choice of who enters their home to support them.”