Good afternoon everyone, and thank you for your introduction.
Before I say anything else, I would also like to say thank you to Beverley, for all the work that you’ve done over the last year as ADASS President. It’s been a real pleasure to work with you, and actually can I congratulate you on the impact you’ve had.
I think your particular focus on unpaid carers has really made a difference and will continue to make a difference as the fruit of all your hard work comes through – and I also very much look forward to working with Melanie, whether we are on wearing the same suits which was a complete coincidence and was not planned but I’m delighted that we are indeed so much in sync today.
Now, around this room I look at you and I know that many of you are directors of adult social services or working with directors of adult social services and very much living and breathing adult social care every day. And I expect most of you like me spend many hours every day grappling with the challenges of the moment.
I suspect it often feels relentless and no sooner have you solved one problem than you are onto another.
How often do we get the chance to take a step back and think further into the future? Not often enough, I would bet.
But I’m going to ask you to take a moment now, and think about what we want social care to look like in 10 years time.
It’s a question which goes to the heart of the challenges that aging Western societies like ours face.
But we don’t talk about it often enough, and sometimes when we do, the debate can be oversimplified.
So for instance, at the one end, you’ll hear from people who think that social care should be nationalised. That it should no longer be the responsibility of local authorities that many of you are a part of. Nor should it indeed be delivered by independent providers. Those people call for a national state run service – sometimes they may even call it a national care service.
At the other end, you hear from people who think that care should be an exclusively family affair. That it’s not for the state nor anyone else to look after granny or grandpa and that when duty calls, relatives (and if I’m honest – it’s often but not always the female ones) should forgo their jobs, put their careers and their financial independence on hold, and sign up to an indefinite period of caring for a loved one.
Now as Care Minister, I actually often find myself arguing against both of these viewpoints.
Simplicity, ideology, and slogans grab headlines. But actually, as you will know, care is complex.
Social care supports so many different people with so many different needs, young and old, people living independently, living in residential care, living with families, living with support and a one-size-fits all approach is not the right answer.
We need a vision for care which recognises this, even if it’s harder to spell out, and even if it’s more complicated to deliver.
My vision is for a care system which first and foremost recognises what people who draw on care want and is organised to serve that.
So it must give people choice and control over their care; care that meets their needs; and care which they can rely on. Whoever they are and wherever they live.
My vision is for a care system which is joined up with the NHS – through data, shared care records, and the relationships of professionals who provide or organise care – but it is different from the NHS.
My vision is for a care system which is innovative and makes the most of technology, while at the same time cherishing the human relationships and compassion which are the essence of social care.
That’s why our care workers – care professionals – must be recognised for their skills and supported to fulfil their aspirations…
… aspirations not only to care for people wonderfully day to day (which I know motivates so many care workers I have met) but also to pursue meaningful careers in care.
And our care system must support unpaid carers – recognising that caring for a loved one can be a demanding and even lonely burden, while at the same time one of the greatest acts of love.
Even more than now, I want our future care system to help people live independently in their own homes for as long as they wish – supported by their community and carers they know and trust.
That’s why my vision for social care in the future builds on the strengths of what we have now; a care system rooted in local communities, and in which local government plays a vital and pivotal role.
And clearly, we need a care system that has the funding to make this a reality – where we as a society recognise the value of care, and invest accordingly.
But…this is not just a just a vision.
It’s what I have been working towards as Care Minister, both the first time I was in this post during the pandemic, as Sarah mentioned, and since my re-appointment.
And we’re making progress.
I’m going to run through where we’ve got to on some of these aims.
Workforce reform
I’ll start on our workforce reforms because these mean so much to me. And because social care is – at its heart – about people.
We know it can be hard to recruit and retain staff in social care – and a third of staff each year change jobs
Over the last year international recruitment has helped fill vacancies, but that is not the answer for social care long-term. We have to make social care jobs – and social care as a career – work for our own home-grown talent.
That’s why we are investing in training, recognition, and career progression.
In January we launched the Care Workforce Pathway. I am really excited about this because I’ve wanted care staff to have a career structure – like NHS staff do – since I first became Care Minister.
And it’s so important to me that staff in care have equal professional recognition to staff in the NHS, and a career structure is a crucial part of that.
The Pathway sets out a career path with progression for people starting out in social care, and helps more experienced care workers to be recognised for their skills.
To support care staff progress along this pathway, we are funding hundreds of thousands of training places.
In January I put £5 million into the Workforce Development Fund. And we’ll be launching a larger fund later this year.
Also in January we launched a new fund to train apprentice social workers. We’ve recently released nearly £8 million from this to local authorities – and in the Summer there will be another opportunity to apply to this fund, as well as a new fund for social care nursing apprentices.
So we have a new career structure, new accredited training and more routes into social care.
Care workers also need to be able to demonstrate their skills to new employers, so they don’t have to retrain every time they change job. That’s why we’re developing a digital system for care workers to formally record their qualifications – known as the digital skills passport – but in essence a register for care workers to log their skills and experience.
And finally there’s the question of pay – together with terms and conditions for care workers. All the data and the excellent work by Skills for Care tells us that pay and the wider employment package for care workers is a critical factor in recruitment and retention. Now you will know that the Government does not set pay for Care workers – nor indeed do local authorities in general. This is a matter for employers.
While increases to the minimum wage has done an important job of driving up pay for those at that level, a significant factor is the rates that Local Authorities pay for care. And those rates must be sufficient for providers to pay staff properly and employ them on fair terms and conditions. That’s one reason why the Government has increased grant funding to local authorities for social care and made up to £8.6 billion available for social care over last year and this. That’s why I have been clear to local authorities about the importance of paying a fair rate for care and commissioning care in a way that supports providers – both in what they pay and to put staff on contracts with guaranteed hours.
I’ve been really glad to see that making a difference. I’ve heard directly from Local Authorities that the shift we’re seeing to care workers being put onto contracts with guaranteed hours, and we have the data that tells us that the rates authorities pay for care increase by 9% on average – going hand in hand with an expansion of the care workforce by over 20,000, improved retention and with that of course, crucially, the improved supply of care.
Unpaid carers
Now as well as supporting the professional workforce, I also want to talk about what we’re doing for unpaid carers.
As I mentioned earlier, being an unpaid carer can be hugely rewarding, but it can also be one of the hardest things someone will ever do.
I’m sure some of you in the room will have caring responsibilities, as well as what you do in your day-to-day work and will know what that feels like.
Now in government, we can’t make being a carer easy. But what we can do, is make sure the support and respite that people need is available.
Last month we announced the first £20 million in funding from the Accelerating Reform Fund – which is our scale to innovate approaches to delivering care.
And can I say a thank you to those of you here who’ve been involved in putting together bids for that fund. These projects will make a real difference to how people and particularly unpaid carers, are supported by our care system.
On the day of the launch of that fund, I visited the home of Sarah, a shared lives carer in Wantage.
And at her home I saw what she does for people who spend time in her home, like Ruthie who has Downs Syndrome and goes there for short breaks and Sammy who originally came for a brief stay with Sarah and two years later is still there, because in Sarah she found the family she needed but never had before.
So when I talk about choice and diversity in social care and avoiding a one size fits all, I think Shared lives is one of the most brilliant examples of that.
And I’m delighted that 15 areas of the country are using their Accelerated Reform Funding to scale up Shared Lives Care.
Tech and innovation
We’re also backing innovation through technology. Because the potential for technology to improve care and help people live more independent lives is hugely exciting – and there is some brilliant innovation going on, but often in pockets rather than at scale.
If we take digital social care records as an example. Replacing paper care records with digital records is a no-brainer. It makes social care more efficient by reducing the time staff spend filling in forms and chasing information by phone. It can also mean better, safer care. Digital care records can alert the GP if their patient needs medical treatment, or it can alert staff if medication has been missed.
And with permission, family carers can see the records too and be assured that all is well.
Now a few years ago, only 40% of registered care providers were using digital care records. Now we’ve got that to over 60%, and we are on our way to reach our target of 80%.
And last month we also announced the allocation of funding for innovative projects backed by our £7 million Adult Social Care Technology Fund – and that is our fund to test, evaluate, and scale technologies that improve the quality and safety of care.
CQC assurance
Now I want to mention one other crucial part of our reforms, which I expect many of you have already been affected by – and that is our CQC assurance of local authorities’ delivery of the Care Act.
You will know how significant this reform is. The Care Act itself was a massive moment for social care. It was a huge step forwards. But there’s been a problem: who knows whether the Care Act has actually done what it was meant to do? Whether people are actually getting the care and support that Act says they should? To me this has been one of the big gaps in our system.
That’s why we have legislated for CQC to answer these questions.
These new assessments and ratings will mean that – for the first time – everyone will be able to understand how their local authority is delivering adult social care and how it compares to others.
I want to thank everyone involved in setting up and preparing for this landmark reform.
I know some local authorities have been concerned, particularly in the context of other pressures they are facing. But this assurance is really important.
It will shine a light on the brilliant work so many councils are doing.
It will mean those who are doing a great job will get the recognition they deserve.
And it will help councils who are struggling get the support they need to do better for their communities.
And for many of you DASSs here, in the off chance this might be helpful – it could also give you some extra clout in your councils too.
Winter
Before I conclude, there’s also another thank you I want to say – to all of you who have been involved in the work to speed up discharges from hospital and reduce unnecessary admissions over the last year.
I just had some great conversations at lunchtime, some of you have got some fascinating insights from those conversations.
Now look I want to assure you that I know social care is so much more than about discharges – but delayed discharges are often the reason social care is in the spotlight. And when people can’t be discharged from hospital, people can’t be admitted to hospital, Emergency Departments are going to overflow and ambulances are delayed.
And I don’t for a moment suggest we have it all solved, but I’m in no doubt that we’ve made huge progress over the last year.
I know that there has been fantastic collaboration between local authorities, NHS trusts and ICBs.
And I know that many of you have done huge amounts of work to plan and commission care in advance which has helped meet the demand during peak times like through this winter.
I know many of you are playing a vital part in Care Transfer hubs organising complex discharges.
And it really has made a difference; we’ve been able to help hospitals to admit and treat over 200,000 more patients over the last year – over 200,000 more patients have been admitted. And thousands more patients have been discharged, with an extra 10% of patient discharges having a social care support package.
So, I think you will have felt it, many of you, on the ground, and seen it and know what you’ve done and the impact you are having, but we also have seen it nationally in some of those figures.
We’re currently working with a number of local authorities and the NHS to learn the lessons from that work of the last year, and will soon be publishing an update for the second year of what’s called the Urgent and Emergency Care Recovery plan.
So before we embark on that – year two, I’d like to take this moment to thank you for all you’ve done as part of that great effort.
Conclusion
To wrap up…
The former Chancellor Nigel Lawson once said that the NHS is the closest thing we have to a national religion.
Now like many of you in this room, sometimes I get frustrated that social care doesn’t get thought of in the same way.
For the skill and dedication of everyone working in the care sector. For the compassion and humanity in almost every interaction. And for the way care quite literally helps people to carry on living.
But actually the truth is that we don’t need another national religion.
We need a modern care system, with the flexibility to respond to changing needs.
We need a diverse care system, where people can choose the care that works best for them.
And we need a care system that’s rooted in our communities, drawing on the strengths and skills of local organisations, professionals and people’s loved ones.
That is what we are building; and I am proud to work with each and every one of the organisations helping us do it.
Local authorities, sector representatives, providers, charities, innovators, regulators and individuals like Shared-Lives carer Sarah.
All of us working together are helping more people live the life they want to live.
Now I’m very sorry I’m not going to be able to take questions today because we’re in the Purdah period in the run up to the local elections.
I’m particularly sorry actually, because the questions part of this kind of event is the bit that I find most interesting I guess because then I get to hear from you and a sense of your views and you also get to put me on the spot and ask me what you really want me to talk about.
But I’ve been given very strict, I guess, requirements that I can only come today and speak today if I specifically didn’t take questions, so I can’t do that.
But I do have one more thing to ask of everyone in the room. This is that the next time someone says to you that social care is broken – that its problems are being ignored – that it’s in crisis or it’s not being reformed – or that care workers need a career structure – these sorts of things. I know all of you in this room have heard what I’ve said today.
In fact, I know that many of you in the room are involved in these reforms.
I know that some of you share my frustration at the talking down of social care.
So my final ask of you is to tell it as it is. We know social care has big challenges, we know there’s a lot for us to do, we know that there are big challenges ahead, but we are working on them.
Together we are doing this, we are making a difference, so I say let’s be proud of it.
Thank you.
