By Bethany Hemsley
The COVID-19 pandemic has exacerbated existing problems in social care, including inequalities for people with protected characteristics, and highlighted the urgent need for long-term reform, investment and workforce planning. This is what has been revealed in the Care Quality Commission (CQC) State of health care and adult social care in England 2019/20 report.
The report looks at the quality of care over the past year, both before and during the pandemic.
Pre-COVID-19 care was generally good but had not much improved since the previous report. Social care continued to be fragile and some of the poorest services did not make any progress, with 3% of care homes having never been rated better than requires improvement.
Interdependence of health and social care systems:
The pandemic intensified existing problems in social care and exposed the lack of support social care received compared to the NHS in regards to PPE, testing and staffing.
Kathy Roberts, chair of the Care Provider Alliance said: “Care providers are to be congratulated for their remarkable achievements: 85 per cent have achieved a good or outstanding CQC rating despite the huge pressures they have faced, but they cannot be taken for granted.
“COVID-19 has revealed, more starkly than ever, the lack of parity in the support given to the NHS and that given to social care. Paradoxically it has also highlighted the absolute inter-dependence of the two systems. CQC’s report provides clear evidence and recommendations for improvement.”
Professor Martin Green, chief executive of Care England adds support: “The Covid-19 pandemic has demonstrated the interdependence of the health and social care system and the organisations that operate across the system”.
COVID-19 further revealed the inequalities within social care. The report found that the disproportionate effect of COVID-19 on people with protected characteristics, such as Black and minority ethnic backgrounds, older people, and people with some long-term health conditions and other disabilities, affected staff as well as people in need of care.
Adult social care staff were particularly vulnerable, demonstrated by data from Skills for Care showing that a quarter of staff were aged 55 or over, and 1.4 percent were aged 70 or over.
Dr Rhidian Hughes, chief executive of The Voluntary Organisations Disability Group (VODG) said: “The pandemic has highlighted the government’s lack of recognition for working age adult social care services and the inequities that exist for many people with protected characteristics – as CQC rightly reports, the pandemic has exacerbated the challenges already faced by the UK’s 14.1 million disabled people and the social care sector that supports them.”
The report also touches on the loneliness and stress that resulted from many care homes stopping visits during the pandemic.
Fiona Carragher, director of research and influencing at Alzheimer’s Society comments: “People with dementia have been hardest hit by the virus and we’ve been hearing daily via our support line from families desperate to visit loved ones locked away in care homes, and unpaid carers exhausted from lack of help.
Lack of coordination:
The reports reveals that sectors did not feel “consistently engaged in the coordination of responses to the crisis” with some collaboration between sectors being based on pre-existing relationships, particularly between care homes and GP practices.
Looking to the future:
Going forward, it is essential to acknowledge that the pre-COVID-19 problems still exist. There needs to be new practices to reduce health inequalities and a deal for the adult social care workforce that develops clear career progression, secures the right skills for the sector, better recognises and values staff, invests in their training and supports appropriate professionalisation.
Ian Trenholm, chief executive of CQC, said: “Pre-Covid, the health and care system was often characterised as resistant to change. Covid has demonstrated that this is not the case. The challenge now is to maintain the momentum of transformation, but to do so in a sustainable way that delivers for everyone – driven by local leadership with a shared vision and supported by integrated funding for health and care.
“There is an opportunity now for Government, Parliament and health and care leaders to agree and lay out a vision for the future at both a national and local level. Key to this will be tackling longstanding issues in adult social care around funding and operational support, underpinned by a new deal for the care workforce. This needs to happen now – not at some point in the future.
Read the full report here.