REPORTS discussed at recent meetings of two key council committees have laid bare the extent of Pembrokeshire’s crisis in adult social care.On Thursday, September 9, the Social Care Committee heard detailed evidence from senior officers dealing with social care.


£4M OVERSPEND IN ADULT SOCIAL CARE

On Thursday, September 16, the Corporate Services Committee were told how much the continuing crisis was costing the Council.


The latter meeting discussed the Council’s running budget and how separate departments within it performed against budget.

The inability to recruit home care workers has hit the budget for residential care provision.

The residential care budget is overspent by almost £3m, while supported accommodation has a £950,000 overspend.

In year grants made to cover the increased costs have not been enough to paper over the cracks in the system.And although some areas underspent, for example, day centres closed during lockdown saved the authority £340,000, those savings are not enough. They are unlikely to be repeated in the future.

The position appears even grimmer as the budget report revealed all additional Covid-19 related costs were covered by the Covid-19 Hardship Fund.


A LONG-TERM PROBLEM WITH NO EASY ANSWER


The problem Pembrokeshire faces is chronic, and the picture will not improve any time soon.


Pembrokeshire’s population is living longer and living longer in poor health.

While social care budgets might get a boost from one-off inputs due to extra funding for services in England, it will not be enough to tackle fundamental flaws in the social care system.

Those flaws are well-known: the system is fragmented, inconsistently funded, health boards squabble with councils over which should fund different elements of care, the sector is short-staffed, and its workers underpaid. As the cherry on the top of that cake, residential care workers are consistently undervalued by the public and politicians.

A few kind words and a clap on the doorstep will not replace recognition of care workers’ status as key workers within the communities they serve.

And the artificial separation between what constitutes nursing care and residential care is an ongoing scandal for which those responsible should be ashamed.

It is hard to believe that an entire tranche of NHS staff’s job is to decide not to fund care that straddles the ill-defined boundary between nursing care and residential care. But they are.

And while the NHS resists paying for care needing medical support, hospital beds remain blocked by the lack of community staff who can care for discharged patients’ needs.In the circumstances, it’s easy to see why joint working between health boards (which seldom run balanced budgets) are treated with suspicion by local authorities (whose budgets must balance by law). Uniting social and health care into a consolidated service without integrating social care funding means councils face pouring their money into the black hole of NHS finances.


772 ADULTS WAIT FOR CARE ASSESSMENTS


The budget figures considered by the Corporate Services Committee were grim.


The human end of those figures reported to the Social Care Committee was grimmer.

The demand for social care continues to rise.

Meanwhile,  vacancies in Social Worker and Carer posts cause longer waiting times for service delivery.

In Pembrokeshire, 772 individuals remain on the waiting list for an adult social care assessment.

To tackle the backlog, social services staff are working extra hours on Saturdays in a desperate effort to clear more cases and reduce them.

However, as more and more referrals pour in, the chances of reducing the backlog to a more manageable level remain slim.

The Head of Adult Social Care, Jason Bennett, told the Committee the Council has a vigorous recruitment policy for new social care staff and several micro-businesses to deal with the crisis recently started in Pembrokeshire.

However, the scale of the recruitment problem became clearer when Mr Bennett addressed filling current gaps in staffing with agency workers.The Council approached fifteen agencies to find temporary social care staff.

Every approach was unsuccessful.

Members reflected on the shortage’s origins in the decisions made between 1996 and 2017 to keep Pembrokeshire’s social services and social care workers among Wales’ worst paid.

In response, Mr Bennett offered the faint hope that recently-announced extra funding for England would enable councils – particularly Pembrokeshire – to recruit staff and reduce the backlog.In answer to a direct question, Jason Bennett declined the offer to say he was ‘optimistic that would be the case.

He added that Councils must appreciate that the balance of power had shifted back to the employee in the market for domiciliary care.