Good morning. Can I add my welcome to Manchester and this year’s conference. I had the honour of delivering one of the opening speeches in Bournemouth last year and I so wish I was not doing so again. Many of you will know that this year’s ADASS President, Harold Bodmer, very sadly and suddenly passed away just over 3 months ago. Today I want to begin by paying tribute to Harold, then move to the issues we know he cared so deeply about and would have wanted to reflect upon with you today. I realise I could never do so with Harold’s unique wisdom and insight and style, but ADASS are determined to continue working on the priorities Harold set out in his memorable opening speech in April, so first what we want to say about Harold and then what we think he would want to say to you.
When news broke of Harold’s sudden and untimely passing the volume and warmth of tributes was truly remarkable to quote his son Joel at the funeral, “Dad was trending on twitter, (not that he would have known what that meant”). Comments about Harold’s wisdom and expertise but most of all of his sheer humanity and humility echoed throughout those tributes. I want to take a moment to thank David Brindle for his exceptionally written obituary for Harold, that has been reproduced in your conference programme. If you have not already done so, I urge you to take a couple of minutes to read it.
Like many people here I was in Norwich Cathedral for Harold’s funeral. His wife Julie and their family shaped such a thoughtful, moving service, Harold’s deep affection for his native Zimbabwe was honoured through the colourful choir of the local Zimbabwean Community Association he had helped to found. The Cathedral was packed out by family, friends, the Council and people of Norfolk and countless leading national and regional figures from social care, all united in their warmth of feelings and admiration of as so many people said “such a nice man”.
His humility was such that he would not want me to be making this fuss and I risk him looking down on me and suggesting he might ‘get a little cranky’ if I don’t get on to talking about the important issues he cared about so much. So Harold we thank you for all that you were and for all that you did to lead, inspire and challenge us to make a real and lasting difference to the lives of those we seek to serve.
His inspiration was never more apparent than during his opening speech in April when he set out his priorities for the year, they were:
- Funding, the current gap, the longer term shortfall and getting the ball rolling on the campaign for greater and wider understanding about social care before the next CSR
- Integration: making sure that social work and social care don’t get lost in the medical model and NHS drivers, and our role in leading and shaping this
- Social Work Reform, safeguarding people’s rights and working with individuals in families and with community assets
- Market sustainability and quality through a real emphasis on the home care workforce
- Responding and contributing to the new National Carers Strategy
A social movement for social care
At this conference we will spend a lot of time sharing understanding about and the means of tackling a range of pressures and risks in relation to needs, funding, provider quality and failure. At the ADASS Spring Seminar we spoke about this too. Things haven’t got better in the last six months and we know that unless things change, Adult Social Care – and more especially the people who need it, will face increasing challenges. In the Spring, we resolved to work ever more closely with partners across the sector to address this issue in the longer term. We have worked closely across the sector in recent years (by and large we have stopped blaming each other!) , but famously it has been said that ‘you don’t fatten a pig on the way to market’. So we are working with partners to build a long term social movement for social care. Ultimately it is the public who determine our governments and it is their concerns that influence politicians as well as those of us in national organisations. For many people the need for social care seems a high but distant risk. So we all put off thinking about it until we have to – usually in a crisis. We want to change that and to harness the experiences and commitment of those using and working in social care and a much wider group of people to secure greater recognition of and resourcing for social care.
Already we have had interest from a much wider group than just the sector: we are talking to former Ministers, the Women’s Institute, the Civil Service Pensioners Alliance and others. We want to move this on during conference in a co-produced way. We need you to join us! Do come to our open discussion tomorrow afternoon.
Last year’s spending review provided some helpful acknowledgement of the growing financial challenges facing social care, the government announced £3.5bn of additional funding for social care by the end of the parliament. The ADASS response was to welcome the recognition but warn that we were fearful it was too little and unequivocal that it definitely comes too late.
Much has been said about the inequalities the precept exacerbates and the over statement of the amount that it raises, but all bar 7 Councils have taken it up. I was more concerned about the treasury’s assertion that the Spending Review provided for the full cost of the living wage. Despite repeated requests government declined to share the impact assessment or calculations that lay behind that claim. We now know from the ADASS budget survey that the Living Wage, together with additional NMW, alone cost £612m and the only new money available to Councils this year was through the precept which raised £380m Even before we allow for any other demand or price pressures the situation gets worse this year, compounding the £5.5bn real terms reductions in adult social care budgets since 2010.
ADASS has just contacted all Councils to check the position for this financial year. Over 80% responded, 3 out of 4 Councils are overspent to a tune of almost £450million nationally, before winter hits, making the ongoing funding gap even bigger.
September’s hospital performance figures still show the majority of delays being nhs related but worryingly also record levels of delays associated with home care packages; even where there is funding there often isn’t the workforce. More of this later.
When the UKHCA published their recent report Home Care Deficit, I had the “pleasure” of a John Humphries interview on the Radio 4 Today Programme. He began by asking me if this was a crisis. I am learning that news journalists like to cut to the chase. A couple of weeks earlier on the publication of the CQC State of Care Report Alistair Stewart opened our exchange with “so are you saying these people are going to be left to die?”. Maybe this is typical media fodder or maybe they too are wondering what needs to happen for a serious, sustainable solution to come forward for the financial crisis that envelops social care today.
This week the Health Select Committee, recently the Kings Fund, The Nuffield Trust, and many more respected independent voices have clearly evidenced the growing problem and I want to say thank you to David Behan, Andrea Sutcliffe and the CQC, I think it takes some considerable fortitude for an independent regulator to so clearly say to government that more resources are urgently needed.
But perhaps it is most telling that Stephen Dorrell (former conservative health minister) now Chair of the NHS Confederation and Simon Stevens, Chief Executive of the NHS, have both said if there is any money give it to social care. I thank both for their candour, but when the NHS says give the money to someone else it says much about how bad things are for social care.
I could go on much longer on this subject, but the evidence is irrefutable: social care desperately needs additional funding brought forward in the Autumn Statement (the ADASS submission clearly evidences that £1.6 over and above what is already announced is needed simply to stand still in 2017/18). If that money is not forthcoming, the consequences for Councils, for care providers and the NHS are deeply distressing but most of all it places the wellbeing of over a million people currently receiving state funded long term social care and their carers at greater risk.
I believe that across government there is an awareness of and genuine concern about this issue. We know there is a largely new Cabinet and we should all seek to work with them to find a fair and sustainable answer and to encourage them to act decisively on these concerns.
We have been embracing the delights of what most perceive to be NHS led Sustainability and Transformation Plans. Please don’t give up in the face of the process. Our voice is essential as without social care, social work and the social model complementing health, the whole system is at risk. All of us in local government know that place matters and that people who understand and are invested in their local communities know how to make things work with and for local people. Councils bring an unparalleled understanding of, and respect for, what really matters to our residents, I believe we have a crucial role to play in ensuring meaningful co-production across the health and social care system in an increasingly devolved and integrated future.
My own Council is one of those, along with our neighbours in North London, with Birmingham and others who have chosen to publish their STP plans, we believe local people deserve early and full engagement in the future planning of their health and care services.
I hope we will hear some helpful examples of thought leadership and best practice on this crucial issue over the next few days, for when we get it right, there is no question it makes a positive difference to people’s lives.
Social Work Reform, safeguarding people’s rights and working with individuals in families and with community assets
A big up here to the Adult Principal Social Workers Network, the group of leading social work professionals coming together, to challenge and improve social work. We should already be looking to the strengths in our communities but the way in which the age structure of our population is changing so profoundly in coming years must surely drive a growing need to better understand and work with the assets, in individuals, families and communities. This is entirely in keeping with the finest traditions of social work.
Similarly the work we do with partners to safeguard adults at risk of, or who have experienced abuse, is arguably the most important of all our duties, the contribution of social work practice in the most complex of situations often saves lives, yet is rarely recognised.
The Social Work reform agenda was really important to Harold, he felt strongly that the additional recognition and status intended for the profession was justified and welcome. But we shared a concern about how the detail is to be shaped. Every social worker recognises the right of others to make an unwise decision, yet they offer information and expertise to reduce the risk of harm that might otherwise ensue. I suggest to those involved in this DfE led work that it would be unwise not to more extensively seek early engagement across the profession.
Directors have the privilege of leading a wide range of very talented and committed people across many disciplines beyond social work, together with many in the voluntary and independent sector they make a very real and personal difference to the lives over a million people in our country, today and every day we should say thank you.
The sustainability of the care market is under threat. Our mini survey that care home closures and the handing back of domiciliary care contracts is accelerating: 62% of councils have had one or more care home close in the last six months and 57% have had a home care contract handed back.
Of all of the challenges facing the social care market, it was the home care workforce that Harold said kept him awake at night. The living wage is hugely welcome. Anyone who sees what care workers do for themselves understand it is the very least they deserve. Harold challenged us to go beyond that. How often do we see workers from a care agency as part of our multi-disciplinary team? Are they able to talk to palliative care specialists when worried about how best to support someone in their care? The simple truth is that we have to profoundly change the way care workers are valued in our society. How else can we hope to recruit, train and motivate enough people with the right skills and behaviours to support the exponential growth in the numbers needing care support in coming decades?
The people who need to lead that change are in this hall today. My challenge to you: think about what your individual contribution could be to shaping the future of home care and the people working in it in your area. If they don’t already, someone in your family is very likely to need care at home in coming years. If not for them, then please those of you who knew Harold, he really wanted to make a difference to home care during this year, perhaps the greatest way we could collectively honour his legacy would be to come together in a sustained effort to deliver real and lasting change to the way we provide care and support to those people who need it to remain live at home.
We all share a hope that the New National Carers Strategy is more than just the next iteration in government policy. It needs to be a “game changer”: strong on the wider economic implications of caring, driving the right behaviours from employers, thoughtful incentives from the state and most of all improved recognition and support for the 6 million carers contributing some £132 billion of value to our economy.
Grainne Siggins and the ADASS Carers Network have worked tirelessly to champion these issues and are ready to help shape and implement this crucially important new strategy with Carers UK, the Carers Trust and many more.
In my role as Vice Chair of the Transforming Care Delivery Board I am often humbled by the willingness of parent carers to provide constructive challenge and to support improvement. For me it is a source of motivation to continue to do all I can to help better understand and address the difficulties many areas are experiencing in making the amount of progress we would all wish to see. Please keep trying to find solutions, be it about the money, the supply of housing, the spread of Positive Behavioural Support, or the expansion of services available in the community to reduce risk of readmission. We still have much more to do. One key point of learning in recent months has been the need for greater focus on the lives of children and young people who might be at risk of admission or living in 52 week schools. We all know how crucial transition is. A quick plug to my colleagues from Enfield leading a workshop sharing best practice across Adults’ and Children’s services at 12.30 today.
Sadly there isn’t time here to say as much as I would like about the welcome growing emphasis on mental health that we are seeing across government and society more widely: so much more to do, but we welcome the momentum. This week’s programme has a number of sessions highlighting mental health: local government is a key champion for it. Or to share the early thinking emerging from my role co chairing the meaningful care strand of the Prime Minister’s dementia challenge. Nor to rehearse the post Brexit risks to the workforce supply for social care, all of which will be covered elsewhere in the programme.
I want to move to a few thank yous, to Cathie, Amanda, Andriana and the ADASS team who do so much with the LGA and ADCS to make this event a success every year, to Margaret Willcox, ADASS Vice President and Gloucestershire’s own National Treasure who with the gracious support of the County Council has agreed to pick up the Presidential reins from January. A moment to congratulate Glen Garrod from Lincolnshire on his election as Vice President.
But I want to end with a very personal thank you to Harold Bodmer, for enriching the world of social care, long may your wisdom, your humility, integrity and humanity be reflected in those of us that were fortunate enough to have known and worked with you.