Social Care 2018: ‘Plus ca change’

Social care for nh blog

Nigel Henderson looks back at the major issues which have affected the social care sector in 2018

TFN Guest's photo

17th December 2018 by TFN Guest 0 Comments

As we moved into 2018 there were numerous predictions of ‘social care crisis’. As yet the social care system is intact but just like the polar ice cap there are bits that are falling over. The big issues for the sector this year were: Scottish Living Wage, sleepovers and HMRC, managing recruitment and staff turnover and commissioning and procurement.

It is fair to say that I could have written this list at any point in the last three to five years. Some of the issues would have had more significance but they have all been constants in the sector over this time. Actually, for some of these issues I could have said 15 years!!

Nigel Henderson

Nigel Henderson

The year of young people certainly helped put mental health and wellbeing of children and young people in the spotlight.

This year, sustaining the Scottish Living Wage (SLW) across social care has been made more difficult as we struggle to see where the money allocated to IJB’s has been spent. Within Penumbra we have always paid at a level above the SLW but this has been made more difficult for us to sustain as the annual increases run at about 3% which has narrowed the margin for us. This is compounded by the fact that many commissioners will only allocate the additional funding they have received to those providers who are paying under the prevailing Scottish Living Wage. A sort of perverse incentive.

With the Scottish Budget for 2019/20 just announced we have been looking hard to see what allocation has been made for SLW uplifts- whilst it is mentioned in the narrative we can’t find an actual number.

Perhaps one of the biggest surprises this year has been the ‘Mencap’ ruling on sleepovers where the appeal court found in favour of Mencap, declaring that sleepovers are NOT working time. Before the appeal ruling HMRC introduced the Social Care Compliance Scheme in late 2017 to ensure that providers were paying national minimum wage for sleepovers with providers expected to self assess their liability dating back 6 years. Many Scottish care providers were invited to join this scheme by HMRC, who in turn must have been expecting many hundreds of thousands of pounds in additional tax payments as part of this. The success of the Mencap appeal means this matter is on hold for now…. but a further appeal from Unison is pending. Looking forward most providers in Scotland are now paying a rate for sleepovers that is compliant or close to compliant with the SLW which is markedly different from the situation in the rest of the UK, where some local authorities are expecting providers to return to simply paying a nightly allowance of around £30.

In relation to Commissioning and Procurement, I note that in 2018, we decided not to tender more often than we have tendered for services. The reason for this is that many local authorities issue framework tenders for Care at Home/Housing Support with a capped rate. This rate applies for the next 3 years. Our decision not to tender is based on the rate not being sustainable or compatible with maintaining the SLW or a good quality of service. Overall Commissioning still follows a competitive, time and task, hourly rate approach. As a sector we have begun to see some changes and we hope that more collaborative approaches to commissioning and procurement might be on the horizon (ask me next year!).

Whilst I am fully supportive of the move to ensuring the SLW for all social care staff, it perhaps has not had the impact on recruitment and retention that we had hoped. We still experience difficulty in recruiting staff in a number of parts of the country and equally experience a fair degree of staff turnover as they move to further study, similar (but better pay and conditions) posts within the NHS or Local Authorities or out of the sector altogether. Brexit further compounds this where 12% of our workforce are EU nationals and many of them express anxiety about the current proposals on their right to stay.

So were there any highlights for social care in 2018? I hear you ask. Well the year of young people certainly helped put mental health and wellbeing of children and young people in the spotlight. The Programme for Government confirmed significant extra funds and a taskforce to ensure better mental health and wellbeing for children and young people. Another highlight is the continuing ability of the Third Sector to deliver high quality, person centred services in spite of the financial, recruitment and commissioning challenges. Care Inspectorate reports continually highlight the ability of the sector to deliver above and beyond.

Onwards and upwards to 2019 ‘mes braves’

Nigel Henderson is chief executive of Penumbra