It is now well established that there is a crisis in social care and that we urgently need more money in the system. But we must also reform the way care services are organised and delivered: a priority that has been absent from recent debate, says IPPR researcher Laura Bradley.

Next week’s Dilnot commission will set out how more money can be brought into social care, most likely through a combination of individual contributions up to £35,000 with the government covering any additional costs. This is wholly welcome and perfectly achievable but it will require the government to have the strength to make some potentially unpopular decisions, something which is critical if they are to resuscitate a system that is breaking under pressure. But additional funding should also be accompanied by comprehensive reforms to the way social care services are provided.  

An area that is desperate for both investment and reform is the care workforce, which has been the focus of a report published today by IPPR and the City of London Corporation’s City Bridge Trust. The report highlights that in order to meet growing demand for care in a way that maintains the dignity of older people some urgent changes are needed. Projections show that the sector will need to attract up to 1.5 million recruits by 2025 if it is to meet demand. It is also dependent on a migrant workforce, particularly in London where 75% of domestic employees are born outside of the UK and migration policy could serve to further tighten the supply of workers.

But social care is struggling to attract recruits and those that do go into the sector are held back from giving quality care. An employee in social care can expect low pay, limited career progression and a highly stressful working environment which restricts the time they can spend older people and their ability to provide personal care. This is evident in the EHRC report which found 15 minute home care visits were common place and that people often have to endure a variety of workers coming into their home and performing very personal care.   

Lessons from the past have shown us that money alone will not save a system that has deeply rooted problems. We know from education and health that only when investment is coupled with necessary service reform can we reap the benefits. In both cases, raising the status of frontline staff has been central to achieving positive change as well as ensuring the right system is in place to facilitate quality delivery.  

We currently have a huge opportunity to overhaul the way care is delivered.  A number of potential reforms offer a way forward for the social care profession. One way to raise the status of carers would be to pool health and care budgets to fund ‘super carers’ who are trained to provide elements of both service and given opportunities for development. A single professional body to represent social care workers could also be used to galvanise and give voice to its members.

Regulation of the market itself is also needed to ensure safety nets are in place for those relying on private providers. The urgency for such measures is evident in the Southern Cross debacle and other controversies that have plagued the care industry of late. They serve to highlight the level of risk we will be taking if we fail to tackle the deep rooted problems in social care system through both increased investment and public service reform