Social care must be priority for incoming prime minister
Author: Caroline White
Home care and care home closures, fears over the future of the care market, and the need for councils to slash millions more off their budgets in 2019-20 are taking a huge toll on those who rely on these services and their families, social care leaders have warned.
The publication this week of the Association of Directors of Adult Social Services (ADASS) annual Budget Survey reveals that since the beginning of the decade, adult social care directors in councils across England have had to make £7bn of savings, with the need to cut a further £700 million from their budgets for 2019-20, despite rising demand.
Only a third of directors of adult social services are fully confident that these savings will be fully met in the year. Only 35% are fully confident that budgets will be sufficient to meet all of their statutory duties in 2019-20.
More than 7,000 people have been affected by care home closures and home care providers closing or ceasing to trade in the past six months, more than double the number affected last year.
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 councils to make incredibly difficult decisions, says ADASS.
These could include giving notice to providers, such as care homes and home care services whom older and disabled people depend on, unless 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 heap further pressures on the health service, says ADASS.
Most councils (87%) have continued to experience pressure from rising hospital admissions, while 60% of directors surveyed say demand for social care as a result of premature or inappropriate discharge is a cause for concern.
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 one in 10 said they felt optimistic.
Emergency, one-off funding injections have not been enough to give directors confidence in their ability to meet future demand, 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 a long-term, sustainable funding solution for adult social care. It wants 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.
It is also calling for a proper debate with the public about the priority of social care.
President of ADASS, Julie Ogley, said: “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.”
She continued: “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.
“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.”
Responding to the findings, director of policy and strategy at NHS Providers, Miriam Deakin said: “This report makes it clear that the social care sector is in a perilous state. For too long action to address this critical issue has been put off, and this is leaving vulnerable people without the care they need. This can’t go on.
“Directors of adult social care are sending a clear message – they do not believe that this situation is going to improve in the short-term. The ongoing uncertainty around funding for social care is forcing them to make incredibly difficult decisions over the future of local care services. Each decision has a real impact on the quality of care somebody receives.”
She added: “The NHS and social care are two sides of the same coin. So this will also have a significant impact on the NHS, as more people seek urgent and emergency care or end up staying in hospitals longer than they need to."
Nick Ville, director of membership and policy at the NHS Confederation, said the report was “another damning indictment of the failure of successive governments to deliver the basic care and support that thousands of the most vulnerable people in our society need and deserve.”
He continued: “As this report shows, while the government fails to act, the problems facing councils have got worse and the crisis for people needing care is escalating. Low salaries and poor morale continue to be major barriers to recruiting and retaining care workers and this must be tackled.
“Local councils cannot continue to rely on emergency funding – we need to see a sustainable social care system delivered on the back of a long-term funding settlement. This must be at the top of the in-tray for the next prime minister.”
He added: “The consequences for people needing care and support will continue to be profound. And we expect this to put the brakes on the ambitions set out in the NHS Long Term Plan. Nine in 10 health leaders say they are not confident the NHS will be able to deliver the reforms set out in the plan without a long-term financial settlement for social care.”