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Money, money, money

Dissatisfaction at social care services among those who have had to deal with them has spiralled to “unbelievably distressing” levels, according to Britain’s most comprehensive study of the public’s experiences.

Two-thirds of people who have used or had contact with social care – for themselves or someone else – were dissatisfied, an analysis of the British Social Attitudes survey has revealed.

And among the public as a whole, only one in seven British people are satisfied with social care services, according to the survey, which is regarded as the gold standard for measuring public opinion.

The findings, revealed by leading health thinktanks the Nuffield Trust and the King’s Fund, show that unhappiness has been growing since 2018, and come against a background of continued complaints that the system is underfunded, that low pay makes it difficult to retain staff and that a promised cap on costs has been delayed until after the next election.

Apparently social care is shit because it doesn’t have enough money. Rather than, say, social care being shot because it’s run by government? For that is something e need to consider. That it is the management system, not the cash infusion, that matters. Without considering it we’ll never be able to decide whether we should shoot the management system or not, will we?

10 thoughts on “Money, money, money”

  1. Having recently taken my mother to a social care assessment for dementia (which is only rubberstamping what is obvious to anyone spending five minutes with her) at a Memory Clinic and receiving the report of same, littered with spelling and grammatical errors and complete inaccuracies as to what she and I said, I can only agree.

    Oh, and the GP referred her for this in June.

    June 2021, that is..!

  2. Social care and the health care (NHS) are too interlinked to have such differently managed budgets. There is also no reason other than politics why they don’t together operate as a very much smaller “insurance” type organization that pays for competing private sector businesses to provide the actual services.

  3. If there is a single person in Britain who is satisfied with any area of public service they must work for the State. Then they know the shit everyone has to put up with. It’s not austerity or lack of money that’s the problem. It’s the allocation. I always think of the appalling NHS, that Lefty organisation that occasionally indulges in some healthcare, if it’s not too inconvenient.
    What must it be like as a nurse, flogging your guts out, when a diversity adviser or lived experience manager earns 5 times what you earn for doing absolutely fuck all, apart from dreaming up useless courses or rules you have to abide by to avoid offending someone.

  4. If it’s free it must be crap. That’s the logical thing to think.
    The surprise is that a third think it’s OK.

  5. “complaints that the system is underfunded”: but such complaints happen all the time for all activities paid for by any arm of government.

    Why can’t the police arrest people for non-hate crime incidents? Underfunding, guv, somefink terrible.

  6. Maybe, but the truly bad experience with driving license or other agencies doesn’t bring out books, newspapers, tv/radio and politicians calling for more funding for them. Why not?

  7. Anonymouse Cowherd

    At the risk of exposing myself to enemy fire … I think it is far more complex than “government rubbish at organising things”. I’ve vicariously seen two sides of things – as a service user, and as an employee.

    An elderly relative gets social care – some of it paid for by the state, some of it paid for privately. We use a local company, who possibly fit into the category of “perhaps not my first choice, but the alternatives have a worse reputation”.
    It’s well known that the whole care industry, and especially private social care, is chronically short of staff. A big factor in that is that wages are “poor”. Wages are poor because there’s limited scope for raising prices to make them “not poor”. There’s limited scope for raising prices for a number of reasons : various elements of “the state” won’t pay more, and self funded users generally can’t afford (much) more, being two main ones that come to mind. As an indication of just how “poor” pay can be, staff at one service company took their employer to the employment tribunal to argue that their pay was only minimum wage because the employer ignored travelling time – the tribunal agreed that travelling time between clients counted as work time, and hence they were paid below minimum wage. So there are two types of carer in the system – those who will move on (either to another provider, or out of the industry) as soon as they have the hint of a better offer, and those who sort-of tolerate the low pay because they treat it as a vocation rather than a means to make a good living. The latter type also has subtypes …
    Of course, if we could shake the magic money tree and inject more money, then wages could rise, and fewer people would leave to stack shelves at the supermarket (to pick a stereotypical job move) for an easier life.

    There are care providers that do work “up market”(ish). One relative used to work for one such business, but the supply of people needing their services and who could afford it was somewhat limited, and so even though they were off the bottom of the pond, you couldn’t really say they were near the surface. And they got few public funded clients due to the conflict between low rates for public funding and the need to make enough profits to pay staff an above-industry-norm rate. But even generous (relatively) wages doesn’t insulate the business from the problems caused by paying peanuts.

    Another relative also does care – but in a different sector. They love their clients, and mostly like the work. But the pay is rubbish, and their management worse. They want to leave, not necessarily for more money though that would be a driving factor, mostly to get away from the dire management – again, pay peanuts, get monkeys. But what keeps them from doing so is that they would have to abandon their clients, some of whom are emotionally attached to them (and vice-versa). But because the pay is so poor, and their management worse, they will do absolutely nothing to help out the business if it isn’t directly of benefit to their clients – so poor management supported by non-supporting employees.
    I have another relative who quit care altogether for much the same reasons of poor pay and management – they now clean holiday homes for better pay plus less stress and hassle.

    Yes, it’s complex, but bluntly, giving the magic money tree a good shake would make a huge difference. For that to happen, the rest of us will need to pay more tax, and take less in benefits (such as retiring later to reduce the pension bill). And as I think we all know, such policies are a great vote winner so the politicians are falling over themselves to announce it !

  8. @ Anonymouse Cowherd
    Yes, but with the manager my local CC Social Services Department has got, more money will just feed his ego and do little to solve the problems (of which he is one).
    I’ve never worked in Social Services (partly because I find empathising difficult, but primarily because I was worth a lot more doing difficult sums) but three members of my immediate family have been involved (and I’ve analysed the accounts of some care providers) so I’ve picked up some info. When I was young nursing was a vocation, not a way to get a middle-class standard of living, and for most social workers their job is still more about caring than earning money.
    Most private sector providers of social care cannot raise wages to a decent level because most of their clients are funded by stingy local authorities who brutally demand that residential care providers charge them below cost and rely on cross-subsidies from “self-funders” who have sold their house and/or have/had some wealth; there are a few care homes that make a fat profit from overcharging the NHS for nursing care or by providing four-star hotel accommodation to the frail elderly rich. I regret to say that increasing taxes will not, by itself, improve the situation. You need to change the system for determining the rate that Local Authorities will pay for residential care (or domiciliary care) to make it reflect the value provided and free it from County Hall internecine departmental budget battles.
    If CQC or a parallel body was to set the rates for individual homes/domiciliary care organisations and those costs were passed on 100.0% by the LA to the Treasury, it might (should, but …) help.
    I agree that we need to pay more for the deserving poor who end up in care homes but not for the rich who can easily afford their 4 star hotel residential care or those gaming the system.

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