The content of this website is intended for healthcare professionals only

We’ll struggle to provide statutory services this winter, warn social care leaders

Insufficient capacity and possibility of major provider collapsing fuelling fears of directors of adult social care

Caroline White

Friday, 29 November 2019

Social care leaders fear they won’t be able to provide statutory services this winter, amid insufficient capacity and the possibility that a major provider could fail, the results of a survey* from the Association of Directors of Adult Social Care (ADASS) indicate.

The survey aimed to gather views from directors of adult social care services at councils across England on budgets, the ability to meet statutory duties, local capacity and the impacts of the national focus on reducing rates of delayed discharges. Some 98 out of a total of 151 directors responded (65%).

The responses show that almost all directors are concerned about their ability to meet their statutory duties to provide care for older people and those with disabilities.

Nearly all have concerns that they have insufficient capacity to deal with winter pressures over the coming months (90%) and/or or manage the failure of a major care provider (93%).

Directors said that there had been unintended consequences of the strong focus on reducing rates of delayed transfers of care from hospitals in their areas: more than eight in 10 (85.5%) said there has been a moderate, significant, or very significant increase in rapid discharges to short-term care home placements that became long-term. This compares with 82.3% in 2018. 

Nearly all directors (94%) said that have little or no confidence that they will be able to fulfil their statutory responsibilities for care market sustainability by the end of 2020-21.

More than eight out of 10 (82%) have no or only partial confidence in their ability to deliver their statutory responsibilities for Deprivation of Liberty Safeguards (DoLS)/Liberty Protection Safeguards (LPS), with three out of four feeling this (76%) about prevention and wellbeing.

More than three quarters (76.6%) report there has been a significant increase in readmission to hospital (up 13% from 63.6% in 2018).

ADASS president Julie Ogley said: “Back in July, our budget survey showed that we are desperately lacking the sustainable long-term funding needed to provide vital services that will allow us all to live the dignified lives we want to lead.

“We are relentlessly positive about what social care can achieve. But it’s clear from [the] findings that the situation is worse than in July.” 

She added: “We cannot keep relying on emergency, one-off short-term funding and we cannot afford more vague promises or partial solutions. Those of us who are not getting care and support, those who are not getting enough care, those who are giving up work to care for family members and those who are getting ill and ending up in hospital for want of care at home deserve the social care we know is possible and essential.”

She continued: "This is why, whoever forms the next government must make a choice and prioritise adult social care. They must give certainty about funding, longer-term reform and a long-term plan that puts fairness at the heart of everything.”

Niall Dickson, chief executive of the NHS Confederation, commented: This is a cry of anguish and politicians need to wake up and act now.

“Winter is coming and social care leaders are not just saying things are bad, they are warning services could collapse and that they may not be able to meet their legal obligations.

“Our members echo every word of this: 97% of NHS leaders in our survey [**] claimed the social care crisis was damaging patient care.

“How often must we say this? Social care in England desperately needs a long-term plan and significant investment. Without this, the promises and plans for the NHS will fail. We now have a raft of promises from the political parties, but the truth is decisive action on social care has been ducked for far too long.”

Chairman of the Local Government Association’s Community Wellbeing Board, councillor Ian Hudspeth, said that rising costs and demand pressures had meant that “incredibly difficult decisions are having to be made.”

He added: “This is one of the major issues facing society…The next government needs to bring forward substantive proposals for the future of adult social care as soon as possible, to reassure all those who use and work in this vital service.

“We need an honest debate about what the future of care and support should be and how it should be funded in the long-term.”

*Autumn Survey of Directors of Adult Social Services 2019. Association of Directors of Adult Social Care, November 2019.

**Fit for the future: how should the incoming Government help the NHS? NHS Confederation, November 2019.

Registered in England and Wales. Reg No. 2530185. c/o Wilmington plc, 5th Floor, 10 Whitechapel High Street, London E1 8QS. Reg No. 30158470