Spotlight on Care: Turmoil in the Sector

The level of uncertainty and disruption in the UK care sector has reached unprecedented levels in recent years. Inconsistencies in government funding for business owners and support workers within the sector is often quoted as the main driver of a reality where resources are stretched to their limits and operators within the sector are struggling to meet the standards of care needed by an increasing number of patients.

Some challenges are new, others stay the same

Many of the challenges within the sector have existed for many years, but others have surfaced more recently and have had a devastating effect. Traditional challenges are seen as including:

An ageing population that places greater pressure on existing care resources, with more people in need of services as they get older
Changes to the levels and structure of government funding have led to NHS facilities receiving less support, impacting the resources available to care for patients
Pay and conditions for support workers is a huge issue for attracting and retaining staff, with many able to earn equivalent or improved salaries in other industries that also offer better working environments and support structures
The care home sector is very fragmented, with operators ranging from small independent care companies to large corporate groups
Media reports often highlight the facilities within existing care home stock are below levels they should be, meaning their capacity for providing specialist care is diminished
Increased competition within the sector has led to fewer, larger care homes and put pressure on the availability of suitable sites, with residential developments across the UK often reducing the volume of sites available, particularly in the public sector

In addition to the long-term challenges facing the care sector, more recent events have had an instant and devastating impact:

Brexit introduced significant political and economic uncertainty to an already ailing sector. Withdrawing EU policies related to freedom of movement and the recognition of professional qualifications forced many healthcare workers to leave the UK, shrinking the labour pool further and intensifying a growing skills shortage.
COVID-19 has brought the shortcomings of the sector into sharp focus and exposed the lack of infrastructure and facilities within the sector as inadequate. Care teams on-hand to look after patients have been regularly decimated, with infections, illness, and isolations reducing available staff numbers and impacting patient care and safety. The turmoil created has been highly publicised, with the shortages in staff and equipment contributing to tragic outcomes that could have perhaps been avoided.

These issues have had a profound impact on patients and their families, with the uncertainty surrounding immediate and continuing care the cause of great anxiety and distress. Continuity of care has been a challenge with COVID constantly interrupting staff availability, leading to patients often being unsure who will be available to provide the care they need from day-to-day.

Jo Wilkins, Head of Care Support Services at Bush & Co, highlights a further issue when stating:

“There is a genuine concern that safeguarding has been an overlooked issue of the pandemic, with under-staffed care homes sometimes unable to follow normal training and compliance protocols and the management of incidents marginalised as a result of not always having enough support workers to oversee correct procedures”.

Is the future brighter?

Changes to isolation periods will have a positive effect on staff availability, but the government mandate that care workers must be vaccinated continues to cost the sector highly experienced and qualified people.

It is hoped legislative changes to the Health & Care Worker Visa this year will alleviate some of the chronic staff shortages in the sector, but more is needed as the sector is incapable of functioning without support from an international workforce and immigration policies must again make the UK an attractive destination for health and care workers to live and work.

Advances in technology will continue to facilitate the introduction of new tools and platforms that will make healthcare more accessible and affordable and transform how it’s delivered. Investment will be needed and assurances over security and regulatory support in place to allow this to happen with the pace necessary to make the benefits felt as quickly as possible.

A desperate shortage of staff in social care remains the fundamental issue and the cause of much of the turmoil in the sector. The future will be much brighter if this can be addressed successfully.

Costs of care

The diversification within the sector has seen a number of independent care home owners struggling financially and selling to larger operators with more resources. Costs often increase as a result, as higher fees are needed to meet greater operating costs and shareholder expectations.

The inability of government funding to keep pace with the changes in an individual patient’s needs can also create a deficit in funding, leaving families and care providers vulnerable to being without sufficient funding to maintain levels of care at short notice.

The fees local authorities pay for patients receiving domiciliary care or care home services show significant variances across the UK, but regardless of what level this is, it’s deemed insufficient. Patients that don’t qualify for care under the NHS pay more, meaning they are effectively meeting the shortfall in funding within the care system.

Changes to qualification criteria can also result in a patient’s condition remaining unchanged, but NHS Continuing Health Care (CHC) funding being withdrawn because they are no longer entitled to receive it.

Increases in care costs place greater emphasis on ensuring awards remain aligned, so appropriate levels of care continue and don’t become too expensive. Knowing they are in the right place receiving the right care from the right people has an enormous positive impact on people’s mental health and wellbeing.

Concerns can be mitigated further by the way that care is provided. Support workers can operate through care agencies, but they can be engaged on a direct employment basis, which can prove a better option emotionally and financially.

The benefits of direct employment

As the name suggests, direct employment uses available funding to recruit dedicated support workers to deliver social care, as opposed to using a care agency to source staff. Both approaches have benefits, with direct employment offering consistent and monitored care while the care agency route perhaps offers greater agility to react to the unexpected.

Whether funded using a settlement from a court action or a local authority personal health budget, direct employment places greater control with the patient, making them the recognised employer of their support worker and allowing them to select and develop relationships with the people providing their care.

Bush Care Solutions provides comprehensive, cost-effective patient care management using the direct employment model, with dedicated Case Managers operating under delegated responsibility to oversee a patient’s care plan and perform a supervisory role over support workers.

Bespoke packages of care can be developed and implemented, providing patients with all the benefits of being an employer and the peace of mind that the administration is all taken care of.