Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission.
I have never witnessed political turmoil like the last few days in my lifetime — the momentous referendum decision to leave the European Union has thrown the leadership of our two main political parties into disarray with the Prime Minister resigning and the Leader of the Opposition under threat.
Since Friday claims and counter-claims from both sides of the argument have been disputed, dismissed and derided.
But while this has all been going on, hundreds of thousands of people have still been cared for and supported by adult social care services. What might all of this mean for them, the staff delivering that care and the adult social care sector as a whole?
I cannot answer that question reliably as without a crystal ball, my ability to see into the future is no more credible than anyone else’s. Community Care did a good round up of initial issues for social care on Friday, but let me comment on four key issues — staff; discrimination; money; and quality.
This interesting analysis from Independent Age and the International Longevity Centre UK shows that a substantial proportion of social care staff are from EU countries as well as from further afield. Some of these staff may well feel anxious about their position and worried about their future. The Citizens Advice Bureau has clarified the position and said:
“The UK public has voted to leave the EU. This means it’s likely that some laws will change in the future — but not immediately.
Everything will stay the same until new laws are made.
If you’re an EU citizen living in the UK, your rights to live, work or get benefits won’t change unless the government passes new laws.”
However, reassurance for vital staff must go further than this. Anxiety about employment may be allayed by the current legal position but these staff may also be feeling alienated by some of the rhetoric and blatant racism also on show in the last few days. Employers need to provide personal assurance to staff from the EU and beyond that their contribution continues to be recognised and valued. NHS England’s Chief Nurse Jane Cumming’s message on Friday to all EU nurses, midwives and care assistants working in England’s health and care system expressed this so well:
“You are hugely valued and appreciated. You are an integral and vital part of the health and care family…your vital contribution to our work together will continue; you are appreciated by me and most of all, by those we care for.”
I agree and would extend that message to all EU citizens working in adult social care whatever their role — with a big thank you too.
A sad feature of the post-referendum world has been the increasingly intolerant tone of the debate on all sides. I have mentioned the racism that some staff may have faced already but another danger is the outrage of the young against older people as the statistics show that the younger the voter, the more likely a vote for Remain. Some of the comments I have seen on social media have been truly awful. I understand why people may be angry but pitting young against old will not help as Beth Britton has so eloquently explained in her blog Care and Support in the Post-Brexit Landscape along with this piece — It is wrong and unfair to denigrate older people because of the EU Referendum result — by Caroline Abrahams from Age UK. We absolutely have to guard against this becoming an ageist agenda and being used to justify detrimental impacts on vital services.
Money for the NHS was a significant issue in the referendum but, as ever, sustaining or increasing resources for social care didn’t really feature in the political debate — though it is worth mentioning this key extract from the speech NHS England Chief Executive Simon Stevens made to the NHS Confederation conference recently:
“I do not believe that it would be prudent for us to assume any additional NHS funding over the next several years, not least because I think there is a strong argument that were extra funding to be available, frankly we should be arguing that it should be going to social care. That is one of the arguments that I have been making publicly, and I think social care has a very strong case for that”.
I am no economist but it feels unlikely to me that the current volatility will lead to an increase in public finances and a reduction on the pressure of social care budgets. Finances will continue to be tight and the pressures facing local authorities and providers will undoubtedly remain.
Which brings me to quality: we continue to see variation in the quality of services across the country. It is a joy to read Outstanding reports like this one from Teesdale but awful to see how poor services can affect people so badly as the recent prosecution against St Anne’s Community Services demonstrated.
We have to ensure that in the midst of all this we retain our focus on ensuring people receive care that is high-quality, effective, compassionate and responsive to their needs. I was heartened by the response of sector leaders on Friday including the UK Home Care Association and the National Care Forum who highlighted the needs of people using social care services as being paramount in future discussions.
This will remain CQC’s focus in the weeks, months and years ahead and you have my personal commitment that it will be mine too.
Originally published at www.cqc.org.uk.