Before coming to Ekklesia, I worked for many years in social care. I loved the work (mainly in services for adults with learning disabilities), though it was not without challenges. The biggest of which, was the constant scrabble to make money stretch as far as it could. Though this was less evident in the times of plenty than it is in today’s Austerity Britain, I’ve never known a year when we weren’t asked to do a little bit more for the same amount of money. A trend which in the last few years has shifted towards being asked to do a whole lot more for a whole lot less.
Before coming to Ekklesia, I worked for many years in social care. I loved the work (mainly in services for adults with learning disabilities), though it was not without challenges. The biggest of which, was the constant scrabble to make money stretch as far as it could. Though this was less evident in the times of plenty than it is in today’s Austerity Britain, I’ve never known a year when we weren’t asked to do a little bit more for the same amount of money. A trend which in the last few years has shifted towards being asked to do a whole lot more for a whole lot less.
Which is why knowing my way round a spreadsheet was always as important a part of my job as ensuring services were person-centred and provided good quality. Over many years, I’ve worked with colleagues, providers, service users, carers to find ways to do things more efficiently, without compromising quality or personal autonomy.
Sometimes this meant preventative funding. If we provided extra respite and day care services, we could support a family to continue looking after their relative. This was often cheaper than providing supported living.On some occasions, this meant working with service users, their providers, and families to identify ways their support could be delivered more cheaply. This could mean changing shift patterns so staff weren’t around during the day when all the tenants were at day services. Or taking out a waking night post, originally required for someone who had left the service.
Another approach was to look at assistive technology, such as an on-call system, that reduced the need for some people to have staff twenty-four hours a day. We looked at the size of properties and built extra rooms to increase the numbers of people supported, which reduced the overall service cost. And we constantly challenged service providers to find ways to reduce their overheads, and thus the rates they could charge us. Particularly those (and there were several) who padded out their prices with unspecified miscellaneous costs which were often proved to be superfluous when investigated further.
Such projects were time consuming and complicated to achieve. Sometimes people really welcomed the changes (for instance when too many staff reduced their independence) and we made more of a saving then we’d anticipated. On other occasions, we found an initial idea floundered, when we hadn’t considered the complexity of providing support in a particular setting, or the service users and families felt what the proposed changes would compromise quality. Nonetheless, I believe these approaches helped us manage the budgets we had in the fairest most efficient way to meet the growing need we experienced every year.
This all changed in 2008, when the banker’s crisis led to a squeeze on public sector funding. Suddenly, we weren’t being asked to be “efficient”, we were having to make real cuts. Since then local government spending has reduced by 25 per cent – by the end of next year, by 33 per cent.The impact on social care has been far reaching with the cuts falling hardest on the poorest and those most in need of support.
What I’ve seen with my own eyes is social care services teetering on the brink of collapse. The drive to push provider prices down has resulted in restructures which is stretching management to the limit. It is recognised good practice that a manager to staff supervision ratio should be between five and eight. Ten years ago, that was the norm. These days, it is common for first line managers to have 10-12 staff to supervise. A regional manager used to have two, maybe three counties to manage. Now, I know of people whose patch covers Bristol, Somerset, Gloucestershire, Warwickshire, Oxfordshire, Cornwall and Devon. We know good leadership is critical to ensure good quality provision and yet most social care managers these day are finding themselves doing the task of two. Whilst I hugely admire the many individuals I know who are struggling to make this work, in the long run I don’t think this is sustainable.
The cuts have also led to a loss of other sources of income that might have helped us manage these problems better. In the past, one of the ways we were able to make money stretch further was to share service costs with other funders. But budgets like Supporting People (for housing related support) are dwindling into non-existence, the Independent Living Fund (which enables physically disabled and learning disabled people to live independently) has been abolished, and education grants that have helped young people have meaningful activities during the day have been cut to ribbons.
So when the IFS concluded that George Osborne’s Autumn Statement would result in a further 40 per cent cuts, my jaw literally dropped to the ground. Because the public sector is already cut to the bone. Another 40 per cent will see public services collapse entirely. Social work teams will be cut, social care services will be reduced to the bare minimum. And it won’t just be social care either. Forty per cent cuts to the police, child protection, the fire service, rubbish collections, the highways, leisure centres, libraries, will impact on every local community in the country. Been burgled? Forget any help from the police, they’ll only have the resources to deal with the worst crimes. Seen a pot hole? Don’t expect it to be fixed unless it’s on a major road. As for leisure centres and libraries – they’ll soon be a thing of the past.
One of the most frustrating things about the last few years,has been seeing the press pile adulation on George Osborne for his tough approach to the economy. Perhaps, because the cuts have been targeted on the poorest people in society, it has been easier for the well off to ignore them. But last week’s statement may just have changed that. Maybe it’s the self interest of recognisng that a reduced fire service or police force affects us all. Maybe it’s the sobering realisation that if he continues in this vein, he will return us to the spending levels of the 1930’s. Maybe it’s the recognition that all these cuts have only halved the deficit and increased public borrowing. Whatever the reason, the callousness of his plans has been exposed, and subjected to a level of critique we’ve not seen in four years.
Which is all to the good. Because if the press has finally woken up to it, maybe the rest of us will too. The Chancellor has given us his vision of the country. It is time to tell him ours.
* More on the Autumn Statement from Ekklesia: http://www.ekklesia.co.uk/autumnstatement
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© Virginia Moffatt is chief operating officer of Ekklesia. Before working for Ekklesia, she spent 30 years working in services for people with learning disabilities, most recently for Oxfordshire County Council.