“There were a number of respondents who
raised concerns over the business ethic of the care homes they worked for.
These respondents felt the organisation and/or general management were driven
by profit, rather than providing high-quality care” RCN – Persistent Challenges
to Providing Quality Care 2012
If there is
to be any resolution of the current care crisis and to ensure the provision of
quality care for the most vulnerable adults in our society then the BIGGEST
elephant in the room has to be tackled or, at the very least, talked about
openly.
The majority
of social care provision is delivered by private sector companies who do so in
order to make a profit. Direct public sector provision has dwindled and
continues to do so as more local authorities look to close or sell care homes.
The reason
for this is relatively simply – it’s cheaper. By outsourcing care services
local authorities save on administration costs yet more specifically the save
on wage costs. Private companies are less bound by conditions that local
authority employers have to abide by, particularly in terms of pensions and the
myriad of different companies delivering social care means the workforce is
fragmented, largely un-unionised which has allowed care worker wages to remain
low at a national average of £6.71 per hour (Skills for Care NDMS Data).
Undoubtedly the poor pay and conditions associated with working in social care
contribute to the continual recruitment and retention problems which, in
themselves, have an impact on the quality of care provision.
Now there is
no doubt that what local authorities have paid in fees for social care
provision has dropped, in real terms, over the last few years firstly by lower
than inflation increases and more recently by totally freezing fee increases
and there is equally no doubt that social care needs greater investment.
There is also
the additional fact that many of those who have to pay for their own care
provision are forced to pay a higher amount in order to ‘make up’ for the low
fees paid by local authorities despite receiving exactly the same quality of
care by the provider.
Yet the issue
that has to be addressed is what guarantees are there that increasing fees will
drive improvement in the quality of care or workers’ pay rather than line the
pockets of those who run their companies for profit?
One solution
by a respondent to the RCN survey was to suggest a cap on the amount of profit
that could be made ensuring the rest was reinvested into the care of residents.
But to flip
the argument a little, most people go into business to make money and any threat
to the profitability of the care sector would discourage people entering it.
With the demographics indicating increasing amounts of social care provision
being needed there will be a demand for more suppliers. So what happens if the
suppliers are not there? There will then be pressure for local authorities to
take responsibility for providing care at the higher costs associated with the
public sector.
There is no
obvious or easy solution to the dilemma but it is one that has to be recognised
as a major part of the debate on social care.
It is also clear that savings are made in the quality and quantity of training. Appropriate levels of staff supervision and support are also expensive and are likely to be reduced in private provision. These factors combined with a lower level of pay and poorer conditions of service led to less than satisfactory staff.
ReplyDeleteI agree with Slardack that in times of austerity, savings are made in the quality and quantity of training. The irony is that, when times are hard, there is an even greater need for staff to have excellent skills, attitudes and empathy and to find ways to make money go further. The best teams work closely with service users and with other professionals to come up with creative (often inexpensive) solutions, rather than retreating to their silos. A Catch 22 potentially, but one which forward-thinking organisations are avoiding by thinking outside the box and investing in their staff!
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