ADASS Spring Survey: Rising adult social care needs leave councils £715 million over budget

If Andy Burnham becomes the new Prime Minister, councils across the country will hope his public commitment to reforming adult social care comes to fruition, helping them to deal with the highest levels of social care need and cost they have faced. 

The number of people approaching their council for adult social care support has increased again and council care costs have gone up for the fourth consecutive year, leading to an overspend of £715million, according to the latest annual survey from the Association of Directors of Adult Social Services (ADASS). 

Published today, the survey shows councils are supporting an increasing number of adults who have complex care needs. This includes people with health-related needs whose care has previously been the responsibility of NHS Continuing Healthcare. There has been a significant increase in safeguarding concerns. There are also growing pressures supporting young people entering adulthood with mental health needs. 

Owing to this growing complexity, the overall council overspend on adult social care budgets last year was three-quarters of a billion pounds. 

Phil Holmes, President of ADASS, said: “ADASS’ latest survey highlights the disconnect between government ambitions for adult social care and the funding provided to deliver them. Councils continue to be placed under huge financial pressure, with no signs of this abating. Behind every number there is person needing support, a family struggling or an unpaid carer taking on huge responsibility. 

“There are areas that need particularly urgent attention. The ongoing reduction in the number of people receiving NHS Continuing Healthcare flies in the face of our ageing population. Increasingly frequent funding disputes are leaving people and families facing uncertainty about whether they will get the care they need, or whether their existing care will continue to be possible. This year’s ADASS survey provides even more evidence that NHS Continuing Healthcare urgently needs national reform. 

“This must be just the start. A new Prime Minister is about to take the helm and Baroness Casey is saying that adult social care needs fundamental reform and sustainable investment with no more ‘sticking plasters’. We must make sure that our government uses this momentum so that next year’s ADASS national survey signals positive change rather than more of the same”. 

Other key findings from the report include: 

Continuing Healthcare: Directors are concerned that increasing numbers of people, often with the most complex needs, whose care and support was previously covered by the NHS Continuing Healthcare (CHC), are now having to seek support from their local council or pay for it themselves. Three-quarters of Directors report an increase in the number people presenting to adult social care who were or would have previously been eligible for CHC. The focus on which organisation is responsible for paying distracts from focusing on the person and care they need. 

Integrated Care Boards (ICBs): Despite growing needs, councils are reporting that ICBs are failing to invest in services vital for supporting people in the community, including CHC, section 117 funding for mental health (S117) and joint funding packages. 

Mental health needs increasing: Some 86% of Directors reported an increase in mental health needs in their local areas from 2025 to 2026. Despite growing need, shortfalls in NHS funding are impacting councils’ ability to meet that need, whereas mental health services and supporting should be planned and funded in a joined-up way. And 77% of Directors reported either an increase or a significant increase in younger people presenting with mental health needs from the community. 

Young people costs: The number of young people (18-24) that adult social care supports is increasing. Their needs are more complex – such as complex mental health issues like acute trauma, and profound physical or learning disabilities – meaning their care packages can be high cost. Many of these young people have SEND (Special Educational Needs and Disabilities) as children or are previously cared for, which represents a challenge whereby children’s services and adult’s services need thorough, integrated planning to ensure a smooth transition when those young people turn 18.  

Waiting times: More than 400,000 people are waiting for an assessment, care and support, a direct payment, or a review. Each person waiting could have an unmet, under met or wrongly met need, potentially impacting their independence and wellbeing. 

Safeguarding impact: Over half of Directors have only partial or no confidence in meeting their legal duties for safeguarding. Safeguarding is multi-agency, and while we welcome the National Safeguarding Board being established, we are concerned that most key partners (councils, ICBs, police forces) are undergoing re-organisation, which may disrupt relationships and systems leading to people falling between the gaps. 

Carers: For the second year running, the proportion of councils positively investing a rising proportion of their budget in unpaid carers has fallen. Some 39% of councils had a positive investment strategy in 2025/26, while only 35% are looking to spend more in this area in 2026/27. This is even though 73% of Directors report an increase in the number of unpaid carers needing support, and the number of people waiting for a carers assessment (including young carers and parent carers) has increased significantly. 

Contact: Emma Pollock, Communications Lead: Emma.pollock@adass.org.uk / 07496018530