Adult Social Care and The Proposed Green Paper: Sue Roberts Head of Quality and Compliance at Future Care Group

Adult Social Care

The political landscape in the UK remains in turmoil, which means the publishing of the long-awaited Green Paper on adult social care has been pushed further back from its original due date of early 2019, with no current date for release on the horizon.

There have been concerns about the funding of social care in England for more than 20 years and if these concerns continue without being properly addressed, the UK will continue to fail some of the most vulnerable people in our society.

We know there is an increasing ageing population (approximately 12 million at present) which is due to double in the next 30 years. Many of these people are living with multiple and sometimes complex co-morbidities and cuts in funding have placed Adult Social Care in a very unstable position, so the government needs to find a solution to this problem sooner rather than later.

The State of Care in England 2017 – 2018 CQC report showed that in general the quality of care delivered in care homes has remained largely stable, despite the significant challenges around funding, recruitment and retention of staff and demand for placements.

The current CQC ratings for care homes in England is approximately:

  • 3% Outstanding
  • 69% Good
  • 25% Requires Improvement
  • 3% Inadequate

But is this good enough?

In order for care homes to comply with their legal responsibilities we need;

  • Sustainable long-term funding – not just injecting enough cash to keep services going.
  • A conduit of skilled workforce – however, Brexit may also affect this pipeline.
  • Joined up working with NHS colleagues – how will services work together to support person-centred care. Currently there is ineffective collaboration between health and social care which has led to many breakdowns in care delivery.
  • Introduction of technology – many homes are still using paper driven care records that do not capture the care delivered in ‘real time’ which is not just costly in time, but also in failure to accurately evidence the planning, delivery and evaluation of care, which could lead to enforcement from CQC and concerns from the local clinical commissioners.

Sadly, some providers have ceased trading due to CQC enforcement or financial collapse or have been forced to reassess their social care contracts due to financial constraints. This could lead to unmet needs, reduction in choice and reduction in access to good or outstanding services.

Unless the Green Paper resolves the issue of long-term sustainable funding, for some Providers, there will be:

  • Lack of finances to improve the environment.
  • Lack of investment in the recruitment, retention and development of the workforce.
  • Increase in reliance of agency staff which is costly and affects the continuity of person-centred care.
  • Burn-out and frustration of workforce.
  • Lack of finance to introduce technology.
  • Constraints in the provision of appropriate equipment.

For these Providers this could lead to:

  • Increase in home acquired pressure ulcers.
  • Increase in accidents and incidents.
  • Increase in safeguarding incidents.
  • Increase in dehydration and weight loss.
  • Increase in avoidable hospital admissions.
  • Delay in transfer of care.
  • Lack of person-centred activities leading to a reduction in wellbeing.
  • Lack of compliance and breaches in legislation which could result in costly enforcement by CQC which will potentially push the smaller providers out of business.
  • Increase in Duty of Candour incidents leading to potential claims being made against the provider.

Reduction of social care placements in homes that are inadequate or requires improvement placing further financial restraint on providers.


Unless the government, through the Green Paper (or any other means) addresses the problems in our underfunded and volatile social care system we will continue to let down our frail older citizens and those people who live with a disability.

To quote Jeremey Hunt (March 2018) when he was the Health Minister:

‘How we treat the most vulnerable people will determine whether or not we are a civilised society’

I will leave it up to you to decide whether or not the government should be proud of the way they currently treat those in greatest need.

Whilst we appreciate that placing a loved one in care in time of political uncertainty can be a difficult decision, we strongly believe that our staff live our Groups Mission, Vision and Values to make our Homes an inspiring place for our residents to have a great life. We are a stable company committed to changing the way care is being provided within a challenging industry.

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