Social care services for vulnerable adults are on the verge of collapse in some areas of England, despite the provision of extra government funding, senior council officials have warned.
The fragile state of many council social care budgets – coupled with growing demand for services, increasing NHS pressure, and spiralling staff costs – is highlighted in research by the Association of Directors of Adult Social Services (Adass).
It says councils “cannot go on” without a sustainable long-term funding strategy to underpin social care and warns that continuing cuts to budgets risk leaving thousands of people who need care being left without services.
“The overall picture is of a sector struggling to meet need and maintain quality in the context of rising costs, increasingly complex care needs, a fragile provider market and pressures from an NHS which itself is in critical need of more funding,” the annual “state of the nation” survey says.
It reveals English councils plan to push through social care cuts of £700m in 2018-19, equivalent to nearly 5% of the total £14.5bn budget. Since 2010, social care spending in England has shrunk by £7bn.
A government green paper on adult social care funding is expected in the next few weeks, and while councils are hopeful this could put budgets on a firmer footing over time, they warn that extra funding is needed to shore up services in the short term.
“Social care is essentially about making sure we not only look after people with profound and increasingly complex needs, but also help many transform their lives. Sadly, however, this budget survey reveals, once again this essential care and support is just not being given the resources it needs,” said the president of Adass, Glen Garrod.
He added: “We cannot go on like this. How we help people live the life they want, how we care and support people in our families and communities, and how we ensure carers get the support they need is at stake – it’s time for us to deliver the secure future that so very many people in need of social care urgently need.”
A government spokesperson said: “We know the social care system is under pressure — that’s why we’ve provided an extra £9.4bn over three years. We will shortly set out our plans to reform the system, which will include the workforce and a sustainable funding model supported by a diverse, vibrant and stable market.”
The Adass survey says the social care market is “increasingly fragile and failing” in some parts of the country, with almost a third of councils reporting that residential and nursing home care providers have closed down or handed back contracts.
Although councils are spending an increasing proportion of their total budget on adult social care – almost 38p in every pound in 2018-19, compared with 34p in 2010 – social care directors admit they will have to continue to reduce the number of people in receipt of care packages.
The survey reveals councils are increasingly reliant on so-called “self help” or “asset-based” approaches to care – in effect using networks of family and neighbourhood groups to provide volunteer support for some social care recipients.
Half of local authorities overspent on adult social care budgets in 2017-18, the survey finds, with half of these drawing on council reserves to meet the overspend.
The National Audit Office has warned that about 10% of councils will exhaust reserves in three years at current rates of deployment, putting them at risk of insolvency.
Ministers acknowledged the financial crisis facing council adult social care services last year, when they provided £2.6bn over three years through a combination of grants and by enabling councils to raise extra social care funds locally through a council tax precept.
Adass says this injection of cash helped stave off financial collapse in some council areas. But it warns that the additional funding has “temporarily relieved, rather than resolved” the long-term funding needs of the sector and there is a danger council services could collapse before any new arrangements are in place.
Although councils have a legal duty to ensure there is a functioning care market in their area, nearly four in five say they are concerned that they are unable to guarantee this because of the fragility of many care firm balance sheets and rising care staff wage bills.
Councillor Izzi Seccombe, the chair of the Local Government Association’s community wellbeing board, said: “Councils and providers are doing all they can to help ensure older and disabled people receive high quality care, but unless immediate action is taken to tackle increasingly overstretched council budgets, the adult social care tipping point, which we have long warned about, will be breached and councils risk not being able to fulfil their statutory duty under the Care Act.”
Richard Murray, the director of policy at The King’s Fund, said: “This latest evidence, from every council in England, lays bare once again the need for, as the prime minister put it herself, a proper plan to pay for and provide social care.
“Older and disabled people and their families and carers continue to be let down by a system that is on its knees.
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