Shift investment from health to social care, says ADASS
The sticking plaster approach taken by government to funding adult social care must end if the sector is to recover and thrive.
That was the message from the Association of Directors of Adult Social Services (ADASS) annual spring survey, which calls for longer term investment.
The survey - sent to every director of adult social services across 153 English councils - found the size and complexity of care packages for people being discharged from hospital had increased in three quarters (76 per cent) of council areas in the past year.
Council-funded homecare requiring more than one carer has risen by 7.4 per cent.
People are increasingly having to fund support themselves or seek it from already cash-strapped local councils, the survey found.
Directors said higher costs due to "an increased complexity of need" was their number one concern.
But 65 per cent also said providers in their area had closed, affecting an estimated 5,000 people in need of homecare.
Meanwhile, homecare hours continue to rise – the number of hours delivered in the first quarter of 2024 was 30 per cent higher than in 2021.
Adult social care budgets were overspent by £586 million, the highest level for a decade, and 90 per cent of directors say they will not be able to meet statutory duties in 2024/5.
The majority (92 per cent) said care package costs had exceeded projected spends.
The overspend sits in sharp contrast to the £903 million in savings needed for the current year, and £905 million next year for councils to balance their books.
Half of the directors surveyed (51 per cent) say they may not be able to meet legal duties regarding prevention and wellbeing in the coming year.
More than a third (37 per cent) of directors say they will need to dip into one-off funding, including council reserves, to fund social care - more than double the 15 per cent reporting this in 2022/3.
Nearly all (99 per cent) of directors say increased NHS pressures will result in additional pressures for adult social care, and 80 per cent say frontline adult social care staff are shouldering the burden previously picked up by NHS staff.
To balance the books, 94 per cent of councils had increased council tax by around three per cent in the past year.
The government announced the Social Care Grant would be increased by £1.192 billion to £5.044 billion for 2024/5, of which 60 per cent goes to adult social care.
The ADASS survey calls for greater investment in the workforce, support for unpaid carers, and early intervention to stem the flow of people in and out of an already overburdened NHS and care system.
Melanie Williams, ADASS president, said: “The one-year funding settlements from government that have been the norm for several years have failed to create the conditions for adult social care to thrive. In fact, quite the opposite.
“Directors are in a place where, collectively, they overspent more on adult social care budgets than in recent history; where complexity of need is increasing and where over 400,000 people are waiting for an assessment, care to begin or an assessment of their needs.
“The impact of long waiting lists… means that in many cases, people are requiring more complex support in the longer run as they wait longer with unmet needs whilst their health, wellbeing and independence deteriorates.”
In a direct plea to the new Labour government to shift the focus to adult social care, Williams added: “Instead of focusing on investment in hospitals and freeing up beds, the new government… must have the courage to commit to a long-term, fully funded solution for social care and shift from short-term crisis management, especially during winter, to more care at home in the long term.”
Kathryn Smith, chief executive of the Social Care Institute for Excellence (SCIE), said: “This report throws down the gauntlet for the new government by setting out the scale of the task at hand. The message is clear, the social care system is severely overstretched.
“Councils are unable to meet their statutory duties. The result is unmet or under-met social care needs.
“Expanding the social care offer through sustained investment in community rehabilitation, reablement and intermediate care will prevent the need for long-term care as well as unplanned hospital admissions.”