Care workers' low pay jeopardising quality of care with abuse complaints on the rise

The quality of care in both care homes and domiciliary care is being put at risk by the low pay and working conditions of care workers, with abuse and neglect complaints on the rise, according to MPs.

The Public Accounts Committee has published its report into adult social care in England and has found ‘there are continuing risks to quality of care and continuity of services both because of pressures on providers and changing oversight arrangements’.

Adult social care spending saw an eight per cent cut between 2010/11 and 2012/13, despite the growth in the number of elderly and disabled people - the groups most likely to be reliant on care.

Consequently care and support has been cut, as with less money to spend local authorities have had to focus on those with the most severe needs. The Rt Hon Margaret Hodge MP, chair of the Committee of Public Accounts, said: “We are particularly concerned that local authorities have cut costs, partly by paying lower fees to providers of care, which has led to very low pay for care workers, low skill levels within the workforce, and inevitably poorer levels of service for users.

“Safeguarding referrals recorded by local authorities have risen 13 per cent in the two years from 2011.”

She added: “It is appalling that up to 220,000 people working in the care system earn less than the minimum wage. In some areas, whilst local authorities might pay private providers £13 an hour, the worker only earns the minimum wage of around £6 per hour. It is also unacceptable that around one third of the workforce are on zero-hours contracts.”

MPs are unsure whether the rise in safeguarding referrals to local authorities is due to an increased awareness of abuse or because of overstretched resources and pressure within the system. However, 43 per cent of the safeguarding referrals have been substantiated, MPs revealed.

There has also been a tenfold increase in calls to the Care Quality Commission’s whistleblowing helpline.

In the report, MPs called on the Department of Health, in conjunction with local authorities, to endeavour to understand why safeguarding referrals are rising, in particular whether this indicates rising levels of abuse, and target its interventions and support to local authorities accordingly.

Funding is falling while demands for care are growing

The Public Accounts Committee warned that the Government does not fully understand the scale of the social care challenge facing local authorities or the costs associated with implementing the Care Act. Lady Hodge said: “We are facing a great adult social care squeeze, with need for care growing while public funding is falling.

“The Government’s agenda to change and improve adult social care, most notably through the Care Act, is rightly ambitious. However, it simply does not know whether the care system has the capacity to become more efficient and spend less while continuing to absorb this increasing need for care.”

The Care Act will require unprecedented levels of coordinated working between central and local government and across local authorities and health bodies and put new burdens on the local authorities.

The aim of the Care Act is to put people and their carers in control of their care and support and to put a cap on care costs of £72,000. It will also mean there will be a minimum eligibility threshold across the country – a set of criteria that makes it clear when local authorities will have to provide support to people.

Lady Hodge called for the Government to “quantify the new burdens the Care Act will introduce for local authorities, establish a realistic timetable for implementation given the financial constraints, and acknowledge the limits on the sector’s capacity to absorb the growing need for care with falling public funding”.

Social care funding needs to be sustainable

Cllr Katie Hall, chair of the Local Government Association’s Community Wellbeing Board, called the report “yet another stark warning to Government that adult social care funding needs to be put on a sustainable footing or social care services will remain substantially underfunded and will suffer as a result”.

She added: “Council finances are on a knife-edge and next year will be make or break for local services provided by councils and for the NHS. Although councils have managed to limit the impact on the essential care services that people rely on, it is inevitable that services will eventually start to suffer unless there is a long-term commitment to reforming our broken fundingsystem. It will be the most vulnerable families and older people in our communities who will bear the brunt.”

A spokesman for the Department of Health said: “The Care Act will make the social care system fairer. We know we need a skilled, valued and fairly paid workforce and are working with councils to clamp down on rushed visits.”