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Systemic failings will spread until there is a proper commitment to the value of care

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LGC’s essential daily briefing.

The fact that there has not already been widespread failure in the adult social care system after years of relentless cuts to council funding is testament to the expertise and determination of staff and management to protect the vulnerable, despite the government’s careless attitude towards services that provide support, dignity and hope.

However, when pressure continues to mount processes can be weakened, judgement can be compromised and mistakes made.

It is no surprise that a review by the local government and social care ombudsman Michael King this week sounded the alarm on not just the levels of complaints being upheld, but also the nature of mistakes being made. Namely, in a significant move, he said trends showed a shift away from “one-off mistakes” to problems with systems, policies and procedures.

Among the most significant findings was the fact that the number of completed investigations resulting in the ombudsman recommending staff training or changes to policies and procedures rose to 274, a 19% increase on 2016-17.

Also, 40% of complaints in 2017-18 resulted in the ombudsman suggesting changes to address systemic problems and improve services.

Notably, Mr King said the review had shown the “stark reality” of pressures on the adult social care system were “now playing out in the complaints we see”.

He added assessment and care planning, and how care is paid for, were the focus of a large volume of complaints.

But the fact that complaints are often not “mistakes occurring in one-off circumstances”, which has been the case in the past, the biggest concern is that complaints now concern “systemic issues where a policy or procedure is being regularly incorrectly applied”.

The review included some worrying examples of this.

After one unnamed council concluded that an elderly lady had gifted sums of money to avoid paying care costs, her contract with her care home, where she had been staying for nine years fully self-funded, was terminated. The ombudsman found the council had failed to carry out a full financial assessment and provided no evidence to show how the council had reached its conclusion.

In another case, a woman spent 10 months in a dementia care home 15 miles from her home after a hip operation despite not having the condition because the contracted providers did not have the capacity to care for her in her home. Tellingly, the ombudsman identified that the contracts had been put in place with preferred care providers to provide all homecare in their “zones” in a bid to stabilise the local market, but this meant there was no suitable alternative available when the provider did not have the capacity to meet the woman’s needs.

As the ombudsman made clear in his report, cases like these were not isolated incidents but a reflection of disturbing systematic trends.

One can only imagine the trauma these avoidable mistakes caused to individuals and their families. The public deserves much better.

But without the commitment of central government to act decisively to address weaknesses in an underfunded system struggling under increasing pressure the public is, despite the best efforts on the ground, unlikely to get it.

Jon Bunn, senior reporter

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