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Care England, the largest and most diverse representative body for independent providers of adult social care has appealed to the Government to involve providers in the Build Back Better plans for health and social care reform.

Professor Martin Green OBE, Chief Executive of Care England, says:
“The plan must adequately underpin the sector’s potential to support some of society’s most vulnerable. We are keen to work with Government to find a long-term sustainable solution for the sector, but are concerned that the £5.4 billion announced in September for adult social care over the next three years though the Health and Social Care Levy, as well as the £4.8 billion of new grant funding over the SR21 period for social care and other services, will not be enough to achieve the ambitions set out by Government”.
Care England has boiled down the plans to a set of ten key asks which relate to establishing a fair rate for care, ensuring a sustainable workforce and the National Insurance (NI) contributions. These key asks are aimed at putting central government on notice of the very real concerns the sector has in relation to Build Back Better: Our Plan for Health and Social Care, as well as presenting some pragmatic solutions to reprimanding these concerns.

Martin Green continues:
“We hope that our key asks will represent an opportunity for meaningful co-production, all of which must be underpinned by adequate funding for the proposals, wider support for the workforce and parity with the NHS on National Insurance that only national government can address”.
1. A fair cost of care needs to be paid that promotes continued inward investment
to ensure a sustainable system fit for the 21st century. LaingBuisson estimate that
residential care homes for older people in England currently need to charge fees
of £696 to £849 per week to generate a sustainable return, whilst residential nursing
care costs between £969 and £1,075 per week. Average council fees were £596
for residential and £764 nursing for 2020/21. For specialist care services, including for younger adults with a learning disability and autistic people, this rate will be higher.
Establishing this fair cost of care will give taxpayers value for money and empower
those in need of care, and their families, to make meaningful choices so they
receive the right care across a variety of services including care homes, home care
and supported living services.

2. As part of a fair cost of care, it must be recognised that funding needs to increase
for adult social care providers to ensure the system promotes fairness for the
individual, the taxpayer, the local authority and the NHS. Crucially, local authority
funded and self-funded resident rates must both meet the costs of care and allow
providers to continue to improve and develop quality services. The system should
not be levelled down. Any service user should be allowed to pay more if they want
additional or enhanced services. The mechanism used to establish fair rates,
including the role of topping-up for both local authorities and the NHS, must be part
of an open and transparent engagement process with the provider sector.

3. We hold that £5.4 billion announced in September for adult social care over the next three years through the Health and Social Care Levy, as well as the £4.8 billion of new grant funding over the SR21 period for social care and other services, will not be enough to achieve the ambitions set out by the Government. This does not equate
to the recommendations in the various parliamentary Select Committees and sector

4. We are concerned that by focusing of the planned Levy over the next 3 years for
the NHS directly, the health service will not see the benefits of a strong social care
sector and will continue to feel these unnecessary pressures, fuelling an expensive
NHS-centric cycle of acute care. We want to be able to help the NHS not contribute
to its burdens.

5. Adult social care providers, as well as employees, will need to pay significant sums in increased National Insurance (NI) contributions, without providing the ability for
providers to offset the increase, putting financial sustainability under further strain.
The approximated impact upon the sector, for both employers and employees, is
circa £600m per annum. This is at odds with the NHS where employer contributions
are being recompensed by government; adult social care and the NHS are two
sides of the same coin and they need parity.

6. The £86,000 cap does not come into force for another two years and so is of little
benefit to the majority of current care home residents, nor does it cover hotel or
accommodation costs. Further detail about the cap is required, including: How is
the cost of a weekly fee going to be split; What does it really mean; Who will benefit;
What lexibility will independent providers have to set fees? and is there a fixed
‘go-live’ date? The cap will also need to be subject to a high-profile public
information campaign.

7. Although £500m for the adult social care workforce is welcome, it is part of, not extra to, the £5.4bn allocation. Workforce development is going to cost far beyond a
single £500m allocation; broad estimates suggest the allocation translates into £100
per care worker over three years. If uplifts in fees are not provided, how can staff be
recruited, compensated and rewarded? This is particularly pertinent within the
context of attracting and retaining nurses in adult social care. Any change to pay
and reward must be centrally funded for publicly funded services.

8. An adult social care workforce strategy must extend beyond three years. This needs to the first of many steps in order to better align social care with the NHS Workforce
Plan. The plan must be characterised by a basic pay framework for social care staff
and a national policy on how this should be funded.

9. It is vital that the Adult Social Care Reform White Paper and the Comprehensive
Spending Review (CSR) include plans and funds to improve pay and conditions, as
well as training opportunities, for people working across the care sector in order to
address the recruitment and retention issues in the long-term and provide the
sustainable service we need. Care England wants to be part of these reviews to add
its unique insight.

10. The White Paper must also look to tackle the issues which the plan has seemingly
overlooked including innovation and investment, unmet need and digital
transformation within the sector. Ensuring the future sustainability of the social care
sector market through appropriate investment is of fundamental importance for the
sector itself, but also for England’s society and economy in broad terms. A mixed
economy is, and will continue to be, the best means of ensuring that quality care is
both maintained and increased.