People with a learning disability are being denied care close to home
Efforts to move people with learning disabilities out of long-stay units, miles from their family, into the community nearer to home will fail, warns a new coalition of care providers, Learning Disability Voices, which launches the Care Crisis Manifesto on Wednesday.
It states that the Transforming Care programme, set up by the government in response to abuse at Winterbourne View, will not succeed because providers don’t have the resources to transfer institutionalised individuals into the community in a safe and effective way.
The fact that 17 charities, not-for-profits and companies, which make up 20% of the learning-disability care sector – including Mencap, United Response and Voyage Care – have come together to launch the Learning Disability Voices campaign, demonstrates the gravity of the position that we are now in. For five years, we have had to cut fees for local authorities, which have had to make spending cuts of about 40%. Now some smaller organisations are closing services they can no longer afford to deliver. Larger providers are being asked to step in to take over affected individuals’ care packages. But for how long will they be able to do this? The impact of the national living wage on learning disability organisations is acute. Staffing accounts for around 70% of our fees.
The government has introduced both the social-care precept, which allows councils to add 2% to council tax bills to pay for social care, and the £5.3bn Better Care Fund . Yet the BCF has not reached any of the organisations represented by Learning Disability Voices, with evidence suggesting it is largely being used to ease pressures on the NHS caused by elderly people with social-care needs. While the social-care precept is being levied by almost every council in England, the revenue is not being passed on to providers. Many councils have offered no increase in fees for our services. Unlike care homes for older people, there are virtually no self-funders among our clients, so we can’t cross-subsidise with private fees.
Learning-disability providers are caught in a pincer effect of wage rises and cuts. Today, support for people with learning disabilities
comprises 30% of social-care funding. We calculate that the additional funding needed in 2020 will be £1.2bn. At the moment we are heading towards a £926m shortfall. Without action soon, we could see more market failure. Care providers might not go under entirely – many operate in sectors beyond learning disability, where they can continue to function – but they may be forced to withdraw from this vital sector.
Our manifesto asks the government to give councils the freedom to raise the social-care precept above 2%, to spend BCF funding on care packages for people with learning disabilities and to ensure that supported housing schemes are viable by exempting them from the proposed cap on housing benefit.
Winterbourne View and other abuses have exposed institutional settings as unsuitable for the long-term care of people with a learning disability, autism or challenging behaviour. The government has recognised that community provision is best, but without adequate funding it is undermining its own policy objectives and denying people the opportunity to receive good-quality care in their own home, or in supported housing in their own community.