Delivering the Vision
Dame Denise Platt Chair, Commission for Social Care Inspection
Presentation to Socialist health Association Conference 2005
What is the state of adult social care now?
What do people want from their social care services? A few practical challenges in delivering the vision for the future.
What do we do?
- Inspect services which provide care
- Assess performance of local councils (star ratings)
- Register and inspect regulated services
- Report to Parliament on the state of social care
- Publish special studies
- Report on the views of people who use the service
Improvement at the centre of everything we do
Social care
- 1.4 million people work in it
- 25,000 employers of social care staff
- 150 local councils
- Private and voluntary sectors provide the majority of social care services
- 80% of the regulated sector is comprised of small businesses
- 4,000 domiciliary care agencies registered with the Commission
- Councils spend £14.5b on their social services.
Services – the people
- 1.6 million people use social care
- 30% of people using social care find and fund their own care
- 8 million unpaid carers
- 21,833 people receive Direct Payments (2005)
- 278,000 residents funded by councils in residential/nursing home care (2004) 78% are over 65
- 390,000 people receive council supported care in their own home
Services – Good News!
- More services promoting independence
- Timely help
- Admissions to residential and nursing home care falling (slightly)
- Numbers receiving intensive home care rising
- More care services meet the national minimum standards
- Wider range of services, new investment in intermediate care.
- Councils better led, managed and more staff better trained.
Services – but…….
- Services for adults with disabilities, or with mental health problems are making much slower progress.
- Small improvements come from a very low base of provision and fall far short of the expectations and choices which many people want to see in their service.
- Lack of information for the self funders
- Services for ethnic minority groups lag behind.
- Still some stark differences in performance across the country.
- No increase in the average number of people helped to live at home since 2001
Getting in the system
Once in the system people say the services can be satisfactory BUT!
- Difficulties in getting proper information about what their rights are, what services are available or what the choices might be
- People (20%) still complain about long waiting times for all services they need to be available
- Very low expectations of what services will actually provide to help them to live the life they choose
What have we heard?
- ‘I share a house with another man and we have staff that come to help us. It’s really good because I can chose what food I have and I can do my own shopping. I can look after my own money now and that’s good as well’ [John used to live in a residential service for people with epilepsy].
- ‘[The staff] are bossy – you can’t decide where to sit. You pay a lot of money and need a bit more courtesy’
- ‘It’s like receiving my care on the M26 so many people traffic through my house each day. When the doorbell rings I start to take my clothes off’
- ‘It’s not our home – it’s their institution’
What people want
- Independence and choice
- Empowered to make choices
- Dignity and respect
- Services to be consistent
- Competent courteous staff
- To feel safe
A few practical challenges
- Choice and control – what does it really mean?
- Individual budgets – who decides?
- Commissioning – individual services – managing the market
- Expand the range of services – safely
- Listening to people, creative solutions in partnership
- Innovation – people who use the service and the providers
- What are we preventing? Or are we sustaining?
- Risk and ‘the vulnerable’
- People with profound and complex needs
- Health – universally available – free at the point of need
- Social care – universally available – but only some will receive publicly funded care
Delivering the Vision: Building Services around people
All CSCI speeches can be found by visiting
www.csci.org.uk