social care Archives - The Stray Ferret

Adult social care finances “precarious” due to hospital discharge costsAngel on a tractor delivers meals on wheels in Harrogate

A local charity that provides meals and care to older people has rebranded its core service, with a dose of heavenly inspiration.

Harrogate Neighbours provides older people with a daily hot meal, preventing social isolation and enabling them to stay in their own homes where possible.

To mark National Meals on Wheels Week (October 30 to November 3), the service is now known as ‘Harrogate Neighbours Meals on Wheels Delivered by Angels‘. It is run by 50 volunteers known as ‘angels’, who deliver over 150 meals every day.

Sue Cawthray, chief executive of Harrogate Neighbours, said:

“Last year, we delivered meals by horse and carriage and the service-users loved it.

“We wanted to do something a little bit different this year, so we decided to deliver the meals on a vintage 1950s tractor by an angel, which evoked lovely memories for our clients.”

Demand for the service is growing, and the charity is calling for more volunteers to deliver even more meals.

New ‘angel’ Zac Evans said:

“It’s not about finding time – it’s making time to support the local community. Dressing up as an angel and delivering the meals by tractor was an amazing experience and something I certainly won’t forget!

“Being a volunteer and making the time makes a real difference to the service-users we get the chance to meet and have a chat with.”

Photo of Zac Evans, a volunteer for charity Harrogate Neighbours, delivering meals on wheels from a vintage 1950s tractor.

‘Angel’ Zac Evans making a delivery.

Now in its 11th year, Harrogate Neighbours relies on support from local authorities, businesses and the wider community, and Sue said more government funding was needed to support older and vulnerable people, who without the volunteers who run the service would not receive a nutritionally balanced, hot daily meal. She said:

“The future of meals on wheels looks bleak unless the government can do more to support this much-needed service.

“We are supporting an ageing population, and the service is a lifeline for older and vulnerable people living in our community. We are calling for the government to ensure funding is available to local councils to safeguard the service now and in the future.”

In addition to the domiciliary care and hot meal service it provides, the charity also operates two sites: Heath Lodge Community Haven, a residential care home, and The Cuttings, an extra care housing scheme.

Government ‘refuses to consider’ compensating North Yorkshire for scrapped care pilot

The government has “refused to consider” funding the costs of additional work on a now scrapped care reform scheme in North Yorkshire.

North Yorkshire County Council was one of six pilot authorities chosen by the Department of Health and Social Care for the project, which would have seen a cap of £86,000 placed on each individual’s spending on their care in their lifetime.

The reforms would also have allowed people to retain up to £100,000 of their own assets and still qualify for funding for their care. The current limit is £23,250.

However, the government has since informed councils the scheme is being abandoned after initially delaying it until October 2025.

The council carried out an overhaul of its IT system as part of the move and looks set to absorb any additional costs associated with staffing into its own budget.

It was awarded £1,159,684 in funding from government as part of the pilot.

But despite this initial funding, the Department of Health and Social Care has refused to contribute to the ongoing costs.

Anton Hodge, assistant director for strategic resources at the council, said in a report due before councillors on Friday:

“Although funding already received to cover costs in 2022/23 will not be required to be repaid, we and other trailblazers have pointed out the ongoing costs of staff already appointed in support of the project and we continue to pursue that aspect.

“However at this stage the Department of Health and Social Care has refused to consider any contribution towards these and therefore any continuing costs will have to be consumed within existing budgets.”

Senior councillors had previously warned that the pilot could “bankrupt councils” if more funding was not made available.

Cllr Michael Harrison, the Conservative executive member for adult services at the council, said much of the work for the trailblazer was taken on by staff taking on additional responsibilities.

He added:

“The county council was asked by the Department of Health and Social Care to be one of six national sites for testing adult social care charging reforms. Early funding was identified nationally to support this work.

“Given that the bulk of this work involved frontline social care and customer services staff undertaking additional responsibilities, the national funding has been used to enhance existing staffing levels rather than to create separate new posts.”

A Department for Health and Social Care spokesperson said:

“The department is grateful to all the trailblazers for their work on charging reform and has been working closely with them to understand any costs incurred as a result of their work to date.”

County council bosses raise concern over social care reform

Officials at North Yorkshire County Council have raised major concerns about social care funding reforms, including that it could leave the local authority needing to find tens of millions of pounds every year.

A report to a meeting of North Yorkshire County Council’s care scrutiny committee on Tuesday states the new system, in which an £86,000 cap could be introduced on resident’s care costs, would mean recruiting more staff in a sector already facing a recruitment crisis.

While the government has delayed the scheme to help make expected reductions of over £30bn a year in spending, Whitehall officials this week told county council bosses charging reform was still government policy and had only been delayed until October 2025.

The scrutiny meeting also comes just days after Healthwatch North Yorkshire called for immediate and significant action to deal with the growing social care crisis and underlined concerns for the future of services in the county.

Its chief officer, Ashley Green, said:

“Despite the hard work and commitment from those delivering care and who commission services, the significant lack of qualified and available staff is having a devastating impact on the provision of care for those people who most need it most.”

The council report states the significant increase in the number of social care and financial assessments required with the new system would mean an increase in staffing, which it says would have been difficult to recruit.

North Yorkshire had been due to be part of a “trailblazer” project from January, along with four other authorities around the country, to implement the policies and test the system before it was rolled out further.

The report adds its calculations, echoed by other councils, showed a significant potential gap between funding from the government and costs, running into tens of millions of pounds on an annual basis.

It said:

“We made it clear that any final decision on our participation in the Trailblazer project was dependent on central government recognising and filling the funding gap, or at least underwriting any excess costs.”

Outlining the an array of measures the council had launched to ease pressure on the NHS and social care services, the authority’s executive member for adult social care, Cllr Michael Harrison, said:

”We are reliant on the government to champion reform of the sector.”

He said challenges the council faced included increases in hospital discharges, high occupancy in residential care settings resulting in low availability, continuing low availability in the home care sector and an increase in requests to the authority for financial support from social care providers.

He said:

“We are operating waiting lists for social care in a way that we probably wouldn’t have done pre-pandemic.”

Cllr Harrison said positive interventions by the authority had led to some reductions in waiting times, and over the past few months included 41 “hardship” payments, costing £1.8 million, to care providers, compared to just four a year ago.

He said the authority had prevented numerous struggling care homes from closing by dispatching its quality improvement team and through improvements in recruitment, including attracting care workers from overseas and promoting apprenticeships and increasing pay for frontline staff.

Delaying cap on costs would be a ‘slap in the face’, say Harrogate care leaders

Social care leaders have warned that another delay in the government’s long-promised cap on care costs would be a “slap in the face” for the struggling sector.

Chancellor Jeremy Hunt is reportedly preparing to put back the £86,000 cap on the amount people pay for care across their lifetime by a year or more.

And now there are further uncertainties over the planned reforms after the resignation of prime minister Liz Truss on Thursday.

Mike Padgham, chair of the Independent Care Group which provides services in North Yorkshire and York, said not introducing the cap as planned in October 2023 would be a “betrayal” of people who are facing the “nightmare of paying their care costs and having to sell their homes to do so”.

He said:

“It is seven years since the introduction of a cap on care costs was first hit by delays and we cannot keep seeing this reform get kicked further and further down the road.”

Sue Cawthray, chief executive of care charity Harrogate Neighbours, also said there had been no let up for the sector which is struggling with rising costs and staffing shortages, and that another delay by the government would be a “slap in the face”.

She said:

“We seem to be stuck on a merry-go-round and just can’t get off because of all the challenges that are being thrown at us.

“When is the government going to recognise the terrible situation that health and social care finds itself in?”

Although the reforms are planned for next October, the cap and other measures which mean people with assets under £20,000 won’t have to contribute to their care costs are due to be trialled several months earlier in North Yorkshire.

North Yorkshire County Council was chosen as one of six local authorities to introduce the changes in January as part of a “trailblazer” scheme.

The authority declined to comment on the national reports of delays.

The long-awaited reforms to fix the broken social care system come as the average weekly cost of residential care in the Harrogate district has risen to £1,029.

That figure remains the highest in North Yorkshire and is equivalent to almost £54,000 a year.

Harrogate care costs climb to £54,000 a year as ‘colossal’ price rises bite

Harrogate’s high care costs are being compounded by the cost of living crisis as bosses warn that they have no choice but to pass on some of the “colossal” price rises to residents.

With care homes being hit by huge increases in energy and food prices, the average weekly cost of a residential care home in the district is now £1,029.

That figure remains the highest in North Yorkshire and is equivalent to almost £54,000 a year.

The climbing costs come at a time of significant workforce pressures as care homes continue to rely upon agency staff and constantly recruit to try to fill vacancies.

Sue Cawthray, chief executive of care charity Harrogate Neighbours, described the price rises as “colossal” and said further increases in insurance costs and workers’ wages were adding to the pressures of keeping care services running.

Sue Cawthray, chief executive of Harrogate Neighbours

She added that the only way for care homes to be able to keep their costs down was for the government to provide more funding and support for services.

Ms Cawthray said:

“There is a serious shortage of funding in health and social care.

“This has been going on year after year and the situation is only getting worse as more people get older and need to go into care.”

After years of funding cuts and promises to fix the broken care system, the government earlier this year announced a new £86,000 cap on the amount anyone will have to spend on care over their lifetime.

This was due to be funded by a 1.25% rise in National Insurance, however, the tax rise was reversed by prime minister Liz Truss and funding will now come from general taxation.

The price cap and other measures are to be tested out as part of a “trailblazer” scheme which has seen North Yorkshire County Council chosen as one of six local authorities to introduce the reforms several months ahead of elsewhere.

There are, however, questions over when this will begin next year and if it will entail a huge bill for the county council.

Aside from the trial, Cllr Michael Harrison, executive member for health and adult services at the authority, said it was doing “everything possible” to support the care sector, although he added these efforts were being made “within the constraints of the funding allocated by central government”.

He said:

“We continue to make the case to the government for comprehensive reform and funding of social care.

“The council is implementing a three-year deal to address the actual cost of care provided by care homes, ahead of many other local authorities.

“We are now working with the sector on a similar long-term plan for home care.”

Meanwhile, the county council has further plans to build an extra care facility after purchasing a £1.8 million plot of land at Harrogate’s Cardale Park, and there are also proposals to introduce “micro-providers” in more rural areas.

Cllr Harrison added:

“In the Harrogate area, we are pursuing several projects to try to improve market conditions, including identifying potential new opportunities to provide care directly.

“We are also hoping to see the introduction of micro-providers in rural areas and are working with care providers to pilot new workforce models, attracting people to the sector with the prospect of the rewarding careers which can result from caring for others.”

Social care pilot scheme in Harrogate district ‘could bankrupt council’ without more funding

A national overhaul of the adult social care system will be trialled across North Yorkshire next year – but could leave authorities with a budget deficit stretching into the millions.

North Yorkshire County Council is one of five authorities signed up to be part of the pilot scheme from January, before it is rolled out across the country in October 2023.

It will see a cap of £86,000 placed on each individual’s spending on their care in their lifetime, after which the local authority will fund it for as long as needed.

The reforms will also allow people to retain up to £100,000 of their own assets and still qualify for funding for their care. The current limit is £23,250.

While the result will be a benefit to individuals who get to keep more of their own money and pass it on to their relatives, there is an obvious challenge facing local authorities.

NYCC believes the new system could cost it £45m per year more than it currently pays for adult social care, and it has yet to be told how much money it will be given for the pilot scheme, known as ‘trailblazers’.

Cllr Michael Harrison, executive member for health and adult care, told the Stray Ferret:

“It will benefit residents because no-one is going to pay more [for their care during their lifetime]. Most people are going to pay less, depending on how long they’re in the care system.

“It’s entirely positive for residents from a financial perspective. The rub is, who’s going to fund it?”

At the same time as the changes to funding are introduced, reforms in care fees are being planned.

They will do away with the current two-tier system, which sees local authorities pay a lower rate than a private individual has to pay for the same care.

Cllr Harrison said it is not yet clear what the new fees would be, but it was inevitable that local authorities would end up paying more so care homes did not see a drop in funding.

“If you reduce their income, the viability of the market is threatened.

“Whatever we’re paying, when it comes down to what the individuals working in social care earn, most of them are either on minimum wage or not far off.”

Cllr Michael Harrison

While those two reforms to funding and charging are being planned, a third financial implication for local authorities will come in the form of overseeing an inevitable rise in the number of people accessing local authority funding towards their care.

“The sheer workload of assessment and brokerage and IT – there’s a huge weight of bureaucracy surrounding that because there’s just going to be more people in the system.

“We don’t know how many people are out there self-funding who will come to us – why would we?

“It’s new costs in a market that’s already under stress. How much, we don’t know.

“A piece of work has been done by the County Council Network and we think this could all cost NYCC up to £45m a year – additional [to what it already spends on care].”

Implementation of the new equal care fees system has recently been delayed by the government. The new funding structure being introduced next year will also only apply to people entering the care system, not those already in it.

While this takes the immediate pressure off NYCC’s budget by phasing in some of the changes, Cllr Harrison and his department’s officers know the full impact will be felt in the future.

The changes are set to be funded by the new health and social care levy, brought into effect in April, which has seen a 1.25% increase in National Insurance. The money raised is to be shared between the NHS – which will take most of it – and adult social care.

However, the current Conservative leadership race has seen almost all of the contenders to be Prime Minister declare they would scrap the levy – yet none has said what they would do about funding the scheme without it.

Meanwhile, Cllr Harrison said it has not yet been confirmed what NYCC’s share of the money will be to fund the new system coming into force in less than six months.

“If we apply the normal ratios, we can usually be pretty confident what our share of funding would be. If we’re right, we’ve got up to a £23m hole in our budget in a council already producing a structural deficit of £50m. It would bankrupt us.”

So why did NYCC agree to be part of the trailblazers project, bringing the problems of the new system forward by nine months?

Cllr Harrison said he believes North Yorkshire County Council has a reputation for being competent and working constructively with central government.

At the same time, North Yorkshire has certain characteristics that can be tested through the pilot scheme: an older than average population, a large, rural landscape, with 500 care providers spread across it, and a relatively high proportion of self-funders accessing services.

The rural nature of the county, along with a higher than average elderly population, make it a useful case study for the government to test how its new system will work.

He also hopes it will be an opportunity to make careers in care better funded and more respected, in line with the council’s Make Care Matter campaign.

“Part of being involved in the trailblazers is to try and shape government policy to understand the challenges and find solutions to those challenges and pilot the changes up front.

“The risk to us is if it’s going to hurt us financially before the rest of the country.”

However, he said, there are clauses in the agreement which will allow NYCC to pull out if the scheme is not working and to revert to the current arrangements until all councils move to the new system after the pilot concludes.

The aim, however, is to go through the trailblazers project with the ear of the government, proving that more money is needed before it can be rolled out further. But will the funding come through?

“I’m hopeful. If it doesn’t, it will bankrupt a number of councils round the country and potentially impact the viability of the whole care sector.”

Reassurances issued over ‘onerous’ social care revamp across Harrogate district

A council has denied claims its scheme to ensure high social care standards has been designed to “weed out” some care providers.

Hundreds of residential and home care providers and day services have been asked to reapply to be on North Yorkshire County Council’s approved care providers lists.

It is the first stage of a huge transformation of the social care market in North Yorkshire.

A meeting of the authority’s care scrutiny committee heard while some £160m of taxpayers’ money was spent annually buying social care services in the county, the current system allowed providers to set their own rates and give few details about their coverage.

Although many local authorities have been able to set rates for providing care as they dominate their area’s care market, about half of care services in North Yorkshire are paid for privately, so the county council has regularly been forced to watch some providers’ rates soar.

North Yorkshire County Council’s offices in Northallerton.

Councillors were told contracts with care providers would in future be based on a set of service specifications.

Jill Quinn, chief executive of Dementia Forward.

Committee member Jill Quinn, chief executive of Burton Leonard-based charity Dementia Forward, told the meeting completing the new process to be an approved provider was “onerous”.

She added the process appeared to aim to prevent certain providers from being placed on the lists.

She said:

“We understand why it needed revamping and the need for quality markers. Can we reassure people that are applying that it’s not meant to catch them out and that there will be sympathy and support, otherwise I feel we will lose some good people.

“I’m quite seasoned at this and I’m half-way through doing mine and it really is like quite a job.”

The meeting heard trying to maintain quality standards across 155 care home providers and 225 residential and nursing homes was a huge undertaking for the council.

Cllr Michael Harrison, who represents Killinghall, Hampsthwaite and Saltergate and is North Yorkshire County Council’s executive member for adult services and public health, said the process aimed to identify providers who are able to give the level of service that both the 90,000 residents receiving care and the council could afford.

He said:

“We are wanting to make sure the residents who are receiving social care receive a quality that they and we are happy with. We are absolutely not wanting to weed any providers out. ”

Cllr Harrison said setting clear standards for care was vital, adding the council had moved people out of a residential care home earlier this month after becoming concerned for their safety.

He said:

“That’s a last resort, but it’s also a good example that we’re not prepared just to take any service just because it’s available.

“It’s got to be a service that is safe and appropriate for the individuals receiving it, which include some of the most vulnerable people in society.”

Cllr Harrison (pictured above) said the changes would ensure a transparent process for people to bid for contracts from the county council and confirm providers were getting the funding they need from the authority to be viable and sustainable, including paying their staff a decent wage.

He added:

“We need to make sure what we pay for the service is delivering what we need. Whilst we need to go through the process, we need to make sure that we don’t put providers off from coming on to our approved provider list because the process is too onerous.”

He said in response to the concerns, the council would offer support to any providers that found the process difficult.

Council completes £1.8 million purchase of Cardale Park land

North Yorkshire County Council has completed the £1.8 million purchase of land earmarked for a care home near Cardale Park.

The three-acre site on Beckwith Head Road in Harrogate was previously owned by Tees, Esk and Wear Valleys NHS Foundation Trust, which runs mental health services in the district.

However, the county council has now bought the land in order to progress a “scheme to assist with social care market development in the Harrogate area”.

Following the purchase, council officials are now expected to outline plans for the facility to senior county councillors in May.

A spokesperson for the county council said:

“We have completed purchase of the land and we are planning to go back to executive in May 2022 for a final decision on the use of the land and in the meantime and we are completing viability studies on best use of the site.”

The land was previously given approval to build a 36-bed mental health facility on the site, following the closure of Harrogate District Hospital’s Briary Unit, which helped adults with mental illness.

However, those plans were dropped in 2019 and inpatients on the unit were sent to Foss Park Hospital in York instead.

Council social care staff in Harrogate district to get £320 thank-you bonus

North Yorkshire County Council is set to distribute up to £9.2m between care firms and their staff in a bid to ease the staffing crisis.

The local authority has had to ask staff in non-critical services such as highways to help keep vulnerable people safe due to a severe shortage of care workers.

So the council’s executive will tomorrow consider match funding a £3m NHS grant to give the county’s 16,000 care sector worker a “thank-you bonus” of about £320 to recognise their efforts this winter.

The payment will effectively bring forward the national living wage increase by four months.

A meeting of the authority’s leading members will also examine a proposal to offer care firms grants of up to £40,000 to support initiatives to increase or retaining their workforces.

1,000 jobs available

The proposed moves come at a time of continuing fierce competition for the care sector in the labour market. On any given day there are at least 1,000 care sector jobs available across the county.

In the autumn, the council launched its biggest ever recruitment drive in response to declining numbers applying for social care jobs, while care providers in the county have been offering extra financial incentives to staff to take on the roles, from £1,500 golden handshakes to carers being offered £2,000 for referring three friends.

An officers’ report to the executive states:

“During 2021 it has become clear that workforce issues, specifically difficulty in recruiting and retaining front line care workers are becoming a significant issue not only for social care but also having a knock-on effect for the NHS, both in terms of the continuing health care services which it funds and in relation to availability of care to enable safe and timely hospital discharge.”

‘Won’t fix long-term problems’

Councillor Michael Harrison, a Conservative who represents Lower Nidderdale and Bishop Monkton who is also the authority’s adult services and health executive member, said there were a host of good career opportunities in the care sector but earning the minimum wage in the care sector required a relatively high commitment from workers compared to other minimum wage jobs.

He said:

“This is effectively a bonus, a small recognition of the effort that those workers are making, but it’s not going to fix the long-term structural issues in the sector.

“It does reflect a wider realisation from central government that more needs to be done to improve the pay for the sector and particularly the people at the bottom of the pay scale. It’s a welcome start to the year, but more needs to be done to reflect the value of what those people do in their pay packet.

“We hope central government will realise they need to divert money from their new National Insurance tax that they will be raising so that it doesn’t just focus on the NHS. People are recognising that social care is an integral part of that health system.”

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1,000 jobs available

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‘Won’t fix long-term problems’