Page 8 - Community Living Magazine 35-3

legal: care duties
Councils admit they ration care

Many councils are limiting amounts of care and are likely to be on the wrong side of the law.
Belinda Schwehr reports on recent findings, and discusses how the apathetic response provides
an object lesson as to how legal rights are lost

ore than half of councils have support for facilitated social contact, need and that, where unpaid carers are
admitted to “rationing” care over leaving people with dementia, learning helping their loved ones, they are being
Mwinter because of staff shortages, disabilities or mental health problems forced to do more for longer, unaided and
according to a survey by the Association of isolated or alone for longer periods with no chance of a break.
Directors of Adult Social Services (Adass). than normal. Edel Harris, chief executive of Mencap,
Adass carried out a national survey People with unsourced care may have said that its support workers went above
about adopting policies for limiting care been going without but were more likely and beyond the call of duty every day for
provided because of Covid pressures to be receiving care in a less appropriate those they supported and the skilled work
over Christmas. NInety-four of the 152 setting, such as in hospitals or care they provided was being taken for
English local authorities responsible for homes, or being looked after, unpaid, by granted by the government.
social services answered and the results family members, who would likely have She added that those who stayed in
were published in January. no idea that it need not be that way. the care sector were being stretched
In the same week, The Observer to breaking point, and were having to
newspaper made freedom of information prioritise meeting basic needs over
enquiries to local authorities about Councils were accepting encouraging independence and
unfilled hours of need on people’s care providers’ views of risk, relying supporting social interaction that
plans – that is, unmet needs that are empowered people with a learning
eligible for a service or funding response. on people, carers or providers disability to live fulfilling lives.
Within the 96 local authorities in to flag issues up, and carrying Anne Pridmore, who runs a support
England that responded, 8,808 people in group for people using personal assistants
their areas had “unallocated” or out reviews only on request (PAs) through direct payments, said that
“unsourced” hours of home care. The what was blatantly missing in this survey
overall number of unsourced and unmet was any mention of direct payment
hours had risen from 15,905 in April 2021 There is a right to be paid for care, even employers and the burden of
to 60,664 by December. if this is provided by a close relative in the responsibility placed upon them.
same family, if a council has judged that “Recruitment and retention over the last
Rationing care is necessary. two years has been horrendous,” she said.
The ADASS survey showed that the The local authority cannot just say “People are able to earn more working at
responding councils were taking steps that “that’s a conflict of interest” – it has to Amazon or Aldi than work in care. I have
they themselves regarded as “rationing” address the evidence as to necessity, been recruiting on and off now for 12
care because workforce shortages meant because the regulations for direct months and I still do not have a full team
providers simply could not find the staff to payments specifically require it to of PAs.”
fill the hours in care plans. consider necessity as a reason for
Half of all councils who responded to departing from the normal arrangements.
the survey were taking at least one
exceptional measure to prioritise care and Going without
assess risk for at least some of their area There were shocked reactions to the
and for some of the time. This included survey findings.
prioritising life-sustaining care over Caroline Abrahams, Age UK’s charity
helping someone else to get out of bed or director, said: “It comes to something
completing other activities. when so many paid-for hours of care are
Beyond the 13% that had carried out not being used, all because there aren’t
this most extreme form of rationing, 43% enough staff to put them into effect.
of councils were reprioritising support to “This inevitably means that growing
those most at risk with essential activities numbers of older and disabled people are
only, and 42% were reviewing risk itself on going without the care and support they
a reduced basis.
This included accepting providers’ view Association of Directors of Adult
of risk, relying on people receiving Social Services president Stephen
services, carers or providers to flag issues Chandler: “Opportunities were
up, and responding only to requests for repeatedly missed to ensure that
reviews, rather than carrying them out as adult social care would be robust
a matter of course. enough to withstand the challenges
Of the respondents, 11% had paused posed by Omicron”

8 Vol 35 No 3 | Spring 2022 Community Living www.cl-initiatives.co.uk