To ask Her Majesty’s Government what assessment they have made of the survey by the Association of Directors of Adult Social Services, published on 13 May, which found that more than 500,000 people in England were waiting (1) for a social care assessment, (2) for their care package to begin, or (3) for a review of their care.
Local authorities are responsible for meeting the needs of those who require care and support under the Care Act. The ADASS survey highlights that their waiting lists are increasing, which is why we are investing to support improved outcomes and experiences of care for people and their families, including through an additional £5.4 billion over three years to begin a comprehensive programme of reform.
My Lords, both the ADASS survey on social care waiting lists of 500,000 and Age UK’s estimate of 1.6 million people with unmet care needs are a stark wake-up call for the Government’s mantra of having fixed social care. The Minister knows that the official figures that he always quotes and quotes today are nowhere near enough to meet current and future demands, as key stakeholders and the expert think tanks routinely remind him. What are the Government doing to prioritise care and support in people’s homes and local communities? Does the Minister not recognise that the situation is getting worse, not better?
Many noble Lords recognise the challenges faced by not just this sector but all sectors, during Covid. One issue we have been looking at for many years, over subsequent Governments—we discussed this during the Health and Care Bill—is that social care was seen as a Cinderella service for many years. For the first time, thanks to noble Lords’ support, we managed to get the Health and Care Bill through to have a properly integrated health and care system. We are also looking at how we can make sure that we properly understand the health and care landscape, with the register and the hub, and that it is a vocation that more people find attractive.
My Lords, I urge my noble friend, in light of the extraordinary number of vacancies in the social care sector—more and more staff are leaving to join other sectors—to urge the Government to revisit the Immigration Rules that do not allow overseas care workers, who could fill those gaps, to come in. We have a special system for agricultural workers; surely my noble friend agrees that we must not put picking fruit and vegetables above the needs of the most vulnerable in our society.
I thank my noble friend for the question, but make the point that it is important that we look not only to our domestic workforce but to recruit people from far and wide to fill those gaps. We have always done that. As I often say from this place, we must remember that public services in this country were saved by people from the Commonwealth after the war. They played a very important role in making sure that this country and its public services recovered after the war. On recruitment from overseas, on 15 February, we added care workers to the health and care visa and shortage occupation list, allowing these roles to be recruited from overseas. We hope that will enable us to fill thousands of eligible vacancies.
My Lords, I go back to the previous question: this ADASS survey shows that almost 170,000 hours of homecare a week could not be delivered for the first three months of this year, because of a shortage of care workers. This is a sevenfold increase on the previous year. The changes proposed to the social care system will not increase the rates of pay for social care workers, at the moment, to make it attractive to others, who can work in hospitality. But there is a dire need for people now. What will the Government do right now to help solve this crisis?
As the noble Baroness will acknowledge, some of the problems have been in evidence for a long time. Sometimes, we are tackling the legacy of this neglect of the social care system. At the same time, we have to remember that many social care providers are not run by the state; they are private providers. Following the People at the Heart of Care White Paper, we want to make sure that, first, we encourage better conditions for workers. We also want to make sure that local authorities determine a fair rate of pay based on local market conditions. We have seen an increase in the national living wage, which means care workers will get an increase. But we are looking at all this as part of the overview of the social care landscape.
My Lords, could the Minister comment on the March 2022 progress report on the Out of Sight – Who Cares? report, which came out in October 2020? It found that of the 17 recommendations, none had been fully achieved and only four had been partially achieved. Can the Minister say when Government will address these recommendations and end the excessive use of the dehumanising isolation, segregation and seclusion within adult social care?
My Lords, 500,000 is a staggering number, but the number experiencing the deepest emotional and physical impact on families may be in the millions. Is the noble Lord and his department aware of the costs associated with neglecting these people and how many may have lost their lives while waiting for these services?
When we look at the 500,000 number, we are talking about an assessment of any kind. These are not people who are outside the system; sometimes they may be in the system but waiting for another assessment within the system. For example, they could be waiting for Care Act deprivation of liberty safeguards, occupational therapy assessments, the beginning of direct payments or a review of their care. It means they are in the system but just waiting for another part of the system to work. The other thing about the report was that there was a 61% response rate, and it was extrapolated from that. Anyone who has read behavioural economists Daniel Ariely or Daniel Kahneman will know that people are more likely to focus on losses rather than gains and, similarly, in surveys people are more likely to report bad things than things that are going well.
My Lords, does my noble friend accept that what these figures show is that local authorities with insufficient resources are introducing rationing of services to some of the most vulnerable people in the country? Why did we pay more in national insurance if the money was not to be made available to social care until three years down the line and the crisis is now?
I wonder if I could correct my noble friend. The Government implemented a comprehensive review of the programme on adult social care with a £5.4 billion investment over three years from April 2022, of which £1.7 billion will be used to begin major improvements across adult social care in England, including but not limited to £500 million investment in the workforce and £150 million to improve technology. As many noble Lords recognise, for too long this sector has been neglected. In some cases, there is a lack of understanding about the breadth of the sector. We are trying to understand it and get people to register, and then we can improve it.
My Lords, I declare my interests as set out in the register. Some hospital NHS trusts have a third to a quarter of their beds bed-blocked by people who are clinically ready for discharge but cannot leave because of no social package being available. What are the Government doing now to deal with this problem? It undermines the NHS waiting list backlog as well.