Prof. Vic Rayner (OBE), CEO of the National Care Forum asks why social care is never mentioned in the same sentence as growth and economic value.
Amongst the current talk of the importance of ‘economic growth’ and the previous emphasis on ‘levelling up’, no-one ever mentions the social care sector’s best kept secret; the fact that it makes a massive contribution to the English economy, to the tune of nearly £56bn according to the latest Skills for Care data.
This makes it twice as big as agriculture and bigger than the ‘Accommodation and food service activities’ industry according to data collected by the ONS (£41.8 billion in 2021).
This may seem surprising, given that adult social care is always portrayed as a problem to be solved.
Far from being a drain on public resources, adult social care is key to the economies of local communities because social care is often a very local business, generating a wide range of value in local communities.
Care and support providers are big employers, both nationally and often locally. This may seem surprising, given that adult social care is always portrayed as a problem to be solved, a ‘drain’ on our public finances.
Far from being a drain on resources, adult social care is key to the economies of local communities because social care is often a very local business, generating a wide range of value in local communities.
Care and support providers are big employers, both nationally and often locally.
The social care workforce is bigger than the NHS workforce, with 1.52m working in the sector, compared to 1.43m in the NHS and we know that social care workers are often very likely to live locally to where they work and therefore spend in their local economies.
Care and support providers also generate spending within local supply chains which often remains within the same community in which they exist, and they have physical assets as part of the built environment locally if running accommodation-based services.
Benefits
Beyond the numbers, there are the much broader aspects of the enabling benefits of adult social care for our society.
For those able to access care and support, I suspect we are all only ever one or two connections away from a person whose life is positively benefiting from the work of care and support services, be that a parent, siblings, children or other family or friends.
Carers UK tell us that one in seven people in the workplace in the UK are juggling work and care and that on average, 600 people a day quit their job to care for a loved one who is older, disabled or seriously ill. This emphasises the importance of being able to access professional care and support, so those 600 people a day do not have to give up work and can continue to operate in the labour market.
It also highlights the enabling role that care and support provides to unpaid carers (often women) to join or return to the workforce, and indeed those people in receipt of care and support who are keen to work. Furthermore, social care is a powerful tool in addressing social and economic inequalities.
As well as being local employers and local purchasers, not-for profit providers often have a distinctive set of characteristics due to their heritage, mission and not-for-profit culture.
This culture manifests itself as being very connected to the communities in which they operate, often for years and decades, responding to existing, emerging and evolving need.
In so doing, they have created a much wider ecosystem of care and support services, including community-based services, supported by volunteers as well as paid staff, using all their resources to focus on delivering great care and support in ways that their communities want.
Services
This ecosystem often includes a wide portfolio of services which is more common in the not-for-profit sector.
Some of the bigger charitable providers such as Belong Villages and Brandon Trust, offer a range of services for all ages and all levels of support need, from learning disability, employment to the journey through older age and frailty.
Belong Villages operates eight vibrant community villages for older people across the North West, offering a range of services, accommodation and amenities to support people as their needs change and enable active lifestyles for people with dementia.
This, together with Belong’s philosophy of enablement and its specialist exercise and rehabilitation service, means its customers have far less reliance on external health services than would be the case in more traditional models; resulting in significant economic benefits as well as enhanced outcomes for individuals.
Villages include small-scale households providing 24-hour nursing and dementia care, independent living apartments, day care and home care services.
There is also a vibrant hub of public facilities including bistro, hair salon, entertainment venue and a specialist gym, which are key to integrating the wider community.
It is Belong’s not-for-profit status which enabled it to pioneer the household model, and which continues to drive Belong’s investment in new initiatives and technologies to enhance its services.
Brandon Trust is a charity supporting around 1,600 children, young people and adults with a learning disability, autism or both.
Their individualised, high-quality support, that positively impacts their wider communities, ranges from light-touch enabling services to employment opportunities and long-term residential care for people with complex needs.
They work across the south of England and south Midlands and employ over 2,000 colleagues. Support is provided in people’s own homes, in registered accommodation, short breaks, day services and leisure and learning opportunities, helping people gain skills, build relationships, and support their wellbeing.
Their social enterprises offer people with learning disabilities and autism creative and interesting opportunities to gain work skills, vocational training, and, very importantly, independence through paid employment.
These social enterprises include a farm, a ceramics studio and pottery, two cafes, five charity shops and Enterprise Packaging, a service which fills orders for transplant retrieval kits for use across the NHS.
Government
The next government must seize the opportunity to create an economic growth strategy for adult social care.
Our members tell us that this needs to include a capital investment fund to enable not-for-profit providers to develop and create new services and new models of care; a ‘Greener Social Care’ strategy with resources and incentives to help the sector meet net zero and environmental sustainability targets; a Zero-rated VAT for not-for-profit adult social care providers to enable VAT on operating expenses to be reclaimed; and some new duties for the CQC to promote innovation, improvement and economic development of social care services that is enabled by LA and ICS commissioning.
We also need a funded national framework for the price of registered and unregistered care which ensures good quality, sustainable care wherever you live and removes the catastrophic costs providers, individuals and families are expected to pay to subsidise the state.
Of course, the taxpayer is going to be very interested in the value for the public pound here.
A great example of how we might do this is from one of our members Guild Care who work with the Social Value Lab to assess their social return on investment.
Their SROI evaluation shows that the Guild Care services are creating a considerable social value of £5.84 for every pound of investment.
A strategic focus on investing in care for people, not profit, must underpin the economic growth strategy.
Over the next 10 years we need the next government to help grow the volume of not-for-profit care provision by putting people before profit through a strategic, mindful and deliberate focus on commissioning and funding not-for-profit care; to develop a pathway to enable more care organisations to adopt a not-for-profit care model and ensure that regulation has a focus on financial transparency to ensure confidence and accountability.
