Social Care Insights

From Simon Bottery

As many people feared, summer and autumn turned out to offer no more than a brief lull in the impact of COVID-19 on social care. With the onset of winter, death tolls in care homes started to climb again. The high rates of transmission in the wider community and the newer, faster-spreading variant mean it has proved impossible – despite valiant attempts by managers and staff to keep the virus out of all care settings.

Facing this second wave, it is clear there is far more support for social care, particularly care homes, than in the first wave. The social care taskforce has brought much-needed expertise and knowledge of the sector, working relations between the NHS and local authorities have improved and there has been a huge effort by representative bodies like the Association of Directors of Adult Social Service, Care England, the National Care Association, National Care Forum and the UK Homecare Association to give voice to the sector. January’s additional funding for workforce recruitment in response to worrying numbers of vacancies was a sign of their impact.

However, the sector’s voice has not always been heard. This was evident before Christmas during an increasingly angry dispute about resident visiting, with families understandably desperate to see loved ones but Government apparently uncertain about how to permit this safely. The failure to address the issue properly over the summer led to the rushing out of a plan, that providers felt was undeliverable with the resources and time available. The argument has now been dampened down somewhat by the reality of the wider national lockdown, the increasing number of deaths and – more positively – the vaccination programme.

There was a similar problem in relation to care home insurance. It was clear into the autumn that many providers were struggling to find cover because insurance companies had pulled out of the market or were quoting far higher premiums. Yet, the Government was reluctant to act and the eventual response – a workaround that was both belated and applied only to those homes designated to take COVID-19 patients from hospital – had to come from the NHS.

These episodes illustrate some key themes in adult social care policy – the extent to which national Government involves itself in the working of the social care market, the degree to which the sector has influence and the relationship between the NHS and adult social care. COVID-19 has undoubtedly brought about changes in all these areas. There is greater awareness of social care from national Government, more support from the NHS for providers and the sector has a louder voice.

This is not without its own challenges. Greater involvement leads to calls for more oversight and regulation; more NHS support leads some to believe it should run social care; a louder voice brings even greater attention to what is being said.

Nonetheless, we must accept the scrutiny that more support and engagement brings. Greater understanding of social care will be key to achieving long-term reform of social care when COVID-19 is – hopefully – far less of a threat.

Reflecting on how the social care sector has gained more support since the first wave of the pandemic.

Simon Bottery is a Senior Fellow in Social Care at The King's Fund. Email: S.Bottery@kingsfund.org.uk Twitter: @blimeysimon

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