Funding for adult social care is being cut. What funding exists is inadequate. But the sector does not simply need more money now. It needs capital investment for the longer term.
Implausible as it may sound in these austere times, councils can develop cohesive adult social care investment plans. The borrowing terms town halls are able to access can help them do so.
These plans must of course be focused on achieving financial benefit and be affordable, sustainable and prudent. While they are unlikely to relieve pressure within two years, they can address the three-to-ten year outlook. Social care economists agree that the pressure will continue to increase year by year.
There are three big investment opportunities that stand out:
Councils have always used capital to pay for social care business systems. But the digital world now offers far more potential (and diversity) than can be captured in an electronic filing system. The sector needs technology business cases that encompass much more of the consumer’s digital experience, including peer resilience, assistive tech, self-service and more. Despite how rapidly the world is digitally changing, the care sector seems to still be hamstrung in adapting products to improve care and wellbeing.
Historically, councils have shied away from investment in the care estate. But if they can invest in shopping centres to create income, then investing in social care property to reduce costs and improve outcomes seems closer to the core purpose. In some cases, councils can create income streams via self-funders, but the big benefit is to reduce the weekly costs of care by using cheaper capital to pay for the land, buildings and facilities components. In most cases it would make sense for the independent sector to operate these assets.
Notwithstanding the Care Act and Market Position Statements, the lack of cash in the system is making things worse for providers, not better. While councils cannot afford blanket price changes, it is possible to jointly invest in modernising the local care estate, help providers reduce their overheads, and delegate more minor commissioning to trusted providers.
There is a direct line of evidence in Care Quality Commission (CQC) inspections between under-investment and inadequacy, yet we have created a situation where there is a lack of creative dialogue between care providers and commissioners. It is in no one’s interest for local markets to collapse and we should think about how to invest before it becomes too costly, too confrontational, and too late.
Care, despite the cuts, is a growth industry because of an ageing population., and councils should consider local economic vibrancy alongside the financial and outcomes case. So despite the cuts, councils must prioritise investment into adult social care when discussing budgets.
These are the big areas for action. Social impact bonds and other preventive experimentation should of course be a part of the plan, but councils need to draw clear lines of sight between investment and return.
Social care transformation is spoken about often without real engagement with the meaning of the term. Councils can be seen trying to achieve change with ever-narrower horizons. No wonder savings plans are failing.
The scale of change envisaged by adult social care investment plans gives the sector a chance to gather some of the resources needed for real reform. It won’t solve the problems of today but will give the sector a fighting chance of addressing the challenges of tomorrow.
As previously seen published in The Municipal Journal.