Thousands of older and disabled people and their families face being severely impacted by home care and care home closures, fears over the future of the care market and the need for councils to make even more difficult budget savings, social care leaders say.
Many people who use adult social care services receive great care and support to live good lives and die with dignity. Yet too many are struggling without enough, or no help, with care workers, managers and councillors to make increasingly tough and challenging decisions.
The Association of Directors of Adult Social Services (ADASS) reveals today in its annual budget survey of members how the failure of successive governments to address long-term funding for adult social care is negatively affecting the people who rely on these essential services, their families and those who work in the arranging and delivery of care.
Since the beginning of the decade, adult social care directors in councils across England have had to make a staggering £7 billion of savings, and need to find a further £700 million for 2019/20, just as demand and needs are rising.
In an illustration of the scale of the crisis, a fragile and failing care market has seen more than 7,000 people affected by care home closures and home care providers closing or ceasing to trade in the last six months, more than double the number affected last year. Behind each and every one of these closures there is an individual whose care has been directly affected, with consequences for both themselves and their families.
Lack of certainty from government about continued funding for adult social care from April 2020 onwards, including the Better Care Fund and Improved Better Care Fund which provides more than £5 billion, will force Directors of Adult Social Services and their councils to make incredibly difficult decisions. These could include giving notice to providers, such as care homes and home care services whom older and disabled people depend on, unless we urgent clarity is received on future funding by September this year.
This will also have a significant impact on the NHS, including more admissions and greater demand on hospitals due to a lack of support at home, despite the stated aims in the NHS Long Term Plan. Reductions from Continuing Health Care (CHC) will add even further pressures on the health service.
A high proportion of councils (87 per cent) have continued to experience pressure from increased hospital admissions, while 60 per cent of directors surveyed say demand for social care as a result of premature or inappropriate discharge is a cause for concern.
In the survey, an overwhelming majority of adult social care directors said they felt “fairly or very pessimistic” about the financial state of the wider health and social care economy in their area over the next 12 months, an increase on the previous year’s survey. Only 10 per cent said they felt optimistic, a reflection of directors’ disappointment at a continued failure by government to publish a long-delayed and desperately needed green paper on the future of social care.
Emergency, one-off funding injections have not been enough to give directors confidence in their ability to meet future requirements, with an estimated 1.4 million people aged 65 and over with unmet needs according to Age UK. Continuing financial uncertainty is also making it difficult for councils to commit to longer-term solutions needed to prevent people from requiring care in the future.
ADASS is calling on the Government to provide the following:
A long-term, sustainable funding solution for adult social care
Funding from the Spending Review to be for at least two years and to continue until whatever is in the promised Green Paper can be produced and implemented
Adequate funding to meet an increasing number of people’s needs in the ways they want
A proper debate with the public about the priority of social care
A continued focus on recruitment and retaining of a caring, skilled and valued workforce
A vibrant care market which gives people choice and control
Investment in new, asset-based approaches and prevention
President of ADASS, Julie Ogley, said: “Older and disabled people need dignified, high quality care and support. We know that when this is properly resourced, it works.
“Every minute of every day, heroic care staff are making an essential difference to the lives of the people they look after. Many receive great care and support throughout and to the end of their lives.
“Sadly however, as this budget survey shows, we are still desperately lacking the sustainable, long-term funding needed to provide vital services that will support people to live as independently and healthily as possible
“Too many older and disabled people and their families still struggle without getting the help they need. Social workers, managers and councillors are having to make incredibly difficult decisions based on dwindling resources, which should not be allowed to happen in a modern, compassionate society.
“We cannot be expected to keep relying on emergency, one-off funding just to keep services going while not knowing about how much might be available for the rest of this year, let alone next. Despite these immense challenges, the 150 adult social care directors across the country who provided these results have shown what they have been able to do in order to make savings, while continuing to keep the interests of the most vulnerable and elderly in our communities at the very heart of every decision they take.
“Good care and support transforms lives, helping people to live good lives, or the best they can, in a variety of circumstances. It enhances health and wellbeing, increasing independence, choice and control. It is distinctive, valued, and personal.
“Our message from this survey to the new Prime Minister, whoever this may be, is very clear: Make social care an immediate priority. A thriving economy and a caring nation requires it.”
Commenting on the ADASS 2019 Budget Survey, Helen Walker, Chief Executive at Carers UK, said:
“The latest survey of Adult Social Care Directors points to bleak prospects for older and disabled people and the families that support them. The care funding gap has now become a chasm as cumulative cuts of £7 billion this decade mean further rationing of vital care as well as cuts to information and preventative services that can delay future needs developing. 600 people a day are leaving paid jobs in order to care for family or friends as care and support needs go unmet (1).
The ADASS budget survey paints a picture of councils having to make impossible decisions affecting some of the most vulnerable in society in a context of growing demand and uncertainty about future funding.
Local authority surveys of carers themselves have shown the stark impact on the health and wellbeing of unpaid carers that the care funding crisis is causing. The numbers of unpaid carers experiencing stress, depression and sleep deprivation is growing (2). Worryingly, today’s survey reveals a quarter of Directors of Adult Social Care expect the quality of life of unpaid carers to get even worse in the next two years.
The future Prime Minister must take responsibility for ending the mounting care crisis; putting in place immediate funding and a clear path to a sustainable funding solution. Carers and their families have already waited too long for consistently high quality and affordable care and access to the breaks and support carers need for their own health and financial security.”