Relaxing immigration rules for overseas careworkers in 2021 was the govt’s single most effective action on #socialcare. It brought down vacancies. Tightening the rules again is a real risk because, while vacancies have fallen, they are still higher than before COVID-19. This level of vacancies is not ok. It may not be at the crisis level of 2021/22 but it still means that in many places, at many times, providers can’t recruit. That has a huge impact on people using services, on families (who have to step in) and on existing, overworked staff.

Today's @thefabians report on a National Care Service offers thorough analysis of #socialcare problems and wide-ranging proposals for reform. It was commissioned by @UKLabour, perhaps the next govt, so should command attention. But it has issues. A thread. independent.co.uk/news/uk/home-n… The report is comprehensive and, in the main, detailed. There are 48 major proposals, grouped in 10 sections: structure and identity, workforce, co-production, rights, carers, access, models of support, providers, affordability, money.
FOUR big proposals stand out to me...

Why do #socialcare workers stay in their jobs despite low pay? Really valuable report from @resfoundation suggests a) they like their jobs (the caring, autonomy) b) few other jobs offer the flexibility they need. Short thread… resolutionfoundation.org/publications/w… Here’s the evidence on job satisfaction. #socialcare may not do better than all work but it does better than the other low-paid work with which it competes. (The difference isn’t huge but it’s there).

Today’s @skillsforcare report paints a seriously grim picture of the #socalcare workforce situation. It’s not just bad, it’s the worst it’s ever been and may well be deteriorating further. A thread…

skillsforcare.org.uk/Adult-Social-C… First, the vacancy rate. After 2 years of small improvements, look at the huge jump in vacancies between 2020/21 and 2021/22. Then look at the further increase (light green bar) to August this year. This is a problem that isn’t going away.

The plan announced today by @theresecoffey to support #socialcare falls far short of the measures needed to ensure people get the support they need this winter and beyond. It was also, alarmingly, saw social care entirely through an NHS| lens. A thread. gov.uk/government/pub… There were 3 measures announced, of which only one has real resources - a £500m fund to support hospital discharge. Details are scarce but it looks like targeted reinstatement of parts of the hospital discharge fund and recruitment/retention fund, both scrapped earlier this year.

We’re expecting a statement from @theresecoffey on hospital discharge today. It certainly needs urgent action but a thorough plan will require more than just short term £££ and a focus on more than just #socialcare. A quick thread with some stats. Historically, delayed discharges have not been mainly been due to #socialcare. Before COVID-19, it was responsible for only a THIRD of delays (the biggest issue: home care packages). The rest were due to NHS issues. There are no recent stats on this NHS/socialcare split though.

Another damning report on #socialcare today, this time from @CommonsLUHC: “The Government currently has nothing more than a vision [for social care], with no roadmap, no timetable, no milestones, and no measures of success.”
A thread on some key points…
committees.parliament.uk/committee/17/l… The MPs commend the Government for “introducing reforms to the sector where previous Governments failed to act”. But they say it has “not come close to rescuing #socialcare, and needs to be open with the public that there is a long way to go.” So, a long way from being ‘fixed’.

Top line on today’s @1adass survey of #socialcare directors? Funding isn’t sufficient to meet increased DEMAND and increased COSTS. But if that sounds familiar, this year there are a few important, COVID-related twists. A thread. adass.org.uk/adass-spring-b… Let’s look at DEMAND first. Partly, this is demographics - it’s a familiar story that there are more older people, living longer; more working age people with disability, including LD; and more mental health issues. Directors think these will add 4% to budgets this year.

I spent two days last week with social services professionals from 40+ countries at the @ESNsocial conference in Hamburg. A quick thread here on some key #socialcare themes. Very impressionistic and not always evidenced so take with large pinch of ‘salz’. essc-eu.org/about-essc-202… Increasing demand for services seemed a consistent issue, forcing at least some countries to evaluate what they do and how. One Icelandic delegate said its country’s approach was ‘moving from a right to have services to a need to have services’.

Lots of interest today in @TheKingsFund @NuffieldTrust findings about public satisfaction with the NHS. But the findings about #socialcare are no less remarkable. Only 15% say they are satisfied - the lowest of all services asked about. 50% are dissatisfied. A short thread… This year, the survey asked WHY people are satisfied (or not). The main reasons are staff pay, unmet need, unaffordability of #socialcare and lack of support for unpaid carers. Lack of integration between health and care also gets a look in. These are familiar problems…

This is an important analysis on the implications of @DHSCgovuk 'fair cost of care' reform, which has received less attention than the 'cap' but involves an unprecedented, potentially risky intervention by govt in the #socialcare market. Quick thread:
countycouncilsnetwork.org.uk/new-analysis-w… 'Fair cost of care' basically involved the government funding local authorities to pay more for the care home places/homecare they commission. Why is government bothered about that? Two, related reasons...

Though it has some good measures, the govt’s white paper is lightweight and underfunded to deliver real reform of adult #socialcare. A rapidly written thread on how the WP sits alongside the Health and Care Bill, Build Back Better and the spending review. gov.uk/government/pub… First, a reminder of key stuff already announced:
- @CareQualityComm to oversee council delivery of #socialcare
- more generous means test
- £86k cap
- £500m for workforce wellbeing
- a promise of a ‘fair price of care’ to ensure selffunders pay same as publicly funded clients

This has profound implications for #socialcare. EU workers currently make up 1 in 11 careworkers and, from January 1st, they will not be replaced when they leave. So social care will have to find more British nationality workers. 1/6 bbc.co.uk/news/uk-politi… 1 in 13 jobs (122,000) in the sector is already vacant, far higher than the average in other industries (and rising). Unemployment is low so, without EU workers, #socialcare employers will have to entice these staff from sectors like retail. 2/6