‘Many adult social care services failing to help people live healthier lives’

Fewer than two thirds of adult social care services in England are deemed to be doing a good job of supporting people to live healthier lives, according to data said to reveal the need for a “radical rethink” of how the sector works.

The Royal Society for Public Health (RSPH) said the current adult social care system is “a long way ” from being one that supports people to live the best quality of life for as long as possible.

The charity submitted a Freedom of Information request to the watchdog on its inspections of care homes and homecare settings, and found that in the 1,097 recent inspections, as of May this year, where this element was reported on, shortfalls were found in 462 cases.

This meant that 58% of services inspected by  the Care Quality Commission (CQC) met a “good” standard when it came to supporting people to live healthier lives.

Relevant measures included how well social care service users were encouraged to make healthier choices in their diet, lifestyle and physical activity, and the extent to which health risks were identified through GP referrals or other health checks to prevent someone’s condition deteriorating.

The charity also spoke with carers and found that while they might often identify warning signs of health problems in a person they are caring for, they are not supported to intervene or make referrals into health services “until a crisis point is reached”.

The RSPH recommended care staff and carers should be connected to formal health services, “ensuring they can make referrals at the right moment”.

They also said Government should include social care as part of its overall planning for preventative health services.

One care worker said the “most urgent change” they would call for is longer care visits, arguing 15 or 30-minute slots are often “rushed” and are not adequate to support people with complex needs.

The RSPH recommended short 15-minute visits by carers should be phased out in favour of care plans tailored to individual needs.

The charity said: “This will require changes to commissioning practice and sufficient funding from central Government to ensure that longer visits
are financially sustainable for providers.”

William Roberts, chief executive, Royal Society for Public Health, said: “We need to radically rethink how we see and do adult social care in this country.

“Caring for others is a hugely valuable service that not only benefits the care receiver but our society as a whole.

“Our ambition as a nation should be having an adult social care system that supports people to live the best quality of life for as long as possible.

“As our analysis shows, we are long way from achieving that. However, we have the skills and knowledge to turn things around.

“We can’t afford to kick the can down the road any longer, that’s why it’s vital that we see social care as a core part of the Government’s plans for a preventative national health service.”

Homecare Association chief executive, Jane Townson, said: “We welcome RSPH’s call for greater collaboration between homecare and public health services.

“The problems they’ve identified – from 15-minute visits to high staff turnover – stem directly from how services are commissioned and purchased by councils and the NHS.

“You can’t deliver quality, relationship-based care when contracts are insecure, there are insufficient hours per provider, and fee rates don’t cover the true costs of proper training and support. Fix the funding, commissioning and contracts, and you’ll fix the care.”

A Government spokesperson said they are “supporting care workers to deliver health interventions at home, funding 15,000 additional home adaptations, and shifting from sickness to prevention”.

They added: “We’re also bringing care closer to home with neighbourhood health services – so all people can receive the best possible care in the most appropriate place.”

Meanwhile, Age UK has warned that the health and care system is “under unprecedented pressure – in some places, at times virtually under siege”.

In a new report, the charity called on he Government to make serious efforts to reduce the number of emergency hospital admissions for acute and chronic conditions that could be managed in the community to under 100,000 a year; guarantee that all older people diagnosed with severe frailty in the community receive at least a structured medication review and falls risk assessment; and cut the numbers of people delayed in hospital when fit for discharge back to pre-pandemic levels – to around 4,500 on a typical day compared to 12,000 now.

Age UK urged the commission into adult social care, headed up by Baroness Louise Casey, to publish its final report earlier than the current 2028 timeline.

Charity director, Caroline Abrahams, said: “The decade that has passed since we first started producing these reports has been largely wasted as regards the need to adapt Health and Care for a growing older population, even though the trend in population ageing has been so obvious it should have been visible from outer space.

“With the 10 Year Health Plan we’re now finally trying to do the right things but much later than we should be and at a time when there’s less public money available to invest compared to ten years ago.

“That’s why we have to go as fast as we possibly can now in achieving transformational change in community-based health and care services, as the NHS will never run optimally until this task is complete.

“From this point of view we think that the Government needs to accelerate its timetable for social care reform and in our report, we call on them to do so.”

Responding to Age UK’s report, a Department of Health and Social Care spokesperson said: “We know that elderly people have been failed by the health and care system in the past, and we’re determined to fix this.

“That’s why we have commissioned Baroness Casey to provide an independent roadmap to building a National Care Service – with the first steps due next year.

“We have taken immediate action to support the social care sector, including a funding boost of more than £4 billion, money for an extra 15,000 home adaptations for disabled people, the biggest uplift to the Carer’s Allowance threshold since the 1970s, and the first ever Fair Pay Agreement to boost recruitment and retention in the workforce.”