1. Funding doesn’t match increased needs for, and costs of, care for older and disabled people
There are ever greater numbers of older and disabled people needing essential care and support, their needs are increasingly complex and the costs of care have increased. To maintain care at the same level as last year would require more than an extra £1.1bn. This year budgets for social care have increased slightly although there is very wide variation between individual councils (70 councils, in fact, reported a fall in budget). This is because:
- The new social care precept flexibility (used by 93% of councils) raised a total of £380m. This does, however, raise much more in some areas than others and raises least in areas with the greatest need for social care.
- Local Government continues to try to protect adult social care despite competing pressures on other services and cuts in central grants. This year adult social care accounts for 35% of total council spending, the same as the last two years. Many councils had to cover overspends on adult social care last year by drawing on reserves (62 councils) and by cutting other services (52).
But the social care precept this year raises less than two-thirds of the calculated costs of the National Living Wage. So this year Directors of Adult Social Services (Directors) have to find more savings of £941m (7% of the total net budget).
2. More people’s lives are affected by reductions in social care funding
Directors report that:
- In spite of the population of older people increasing by 3%, we saw no increase in the numbers of older people actually receiving services in 2015/16
- At least 24% of this year’s savings will come from cutting services or reducing the personal budgets of people who receive care and support
- The quality of care is compromised: 82% of Directors report that more providers already face quality challenges as a result of the savings being made. As of June 2016, CQC inspections under the new regime show that 27% of adult social care services “require improvement” and 2% are “inadequate”.
3. Directors are increasingly unclear where the funding needed will come from
Financial risks are rapidly increasing for local authorities. In 2015/16 the majority of social care departments overspent on their budgets, and as a result, Directors’ confidence in the ability to both make continued savings and at the same time meet increased duties is diminishing.
Last year 45% of Directors were fully confident planned savings would be met. This year it is just 31%. Confidence falls to only 6% when thinking about making savings in 2017/18. These savings are required at a time when the number of applications for Deprivation of Liberty Safeguards has risen more than tenfold in the last two years and 2015/16 saw the first full year of the implementation of the Care Act 2014. Faced with this pressure, only 36% of Directors could say that they are fully confident of being able to deliver all of their statutory duties this year, falling rapidly to just 8% who are sure they can do so next year.
4. The continuity of the care market is under threat
We expected to see significant increases in fees to providers due to the impact of the National Living Wage. The survey findings suggest that the total cost, including compliance with the existing National Minimum Wage, will total over £600m. 82% of councils increased fees to providers: nearly a quarter by more than 5%. Though the National Living Wage is welcome, in many areas providers will continue to struggle to recruit staff, especially in home care and where employment is high. Maintaining a caring, compassionate and trained workforce in a sustainable provider market is an urgent concern.
80% of Directors reported that providers in their area are facing financial difficulties now. Providers are increasingly selling up, closing homes or handing back the contract for the care they deliver to older or disabled people. This affected thousands of people across the country last year.
5. Investment in prevention is being further squeezed
Directors see increased prevention and the integration of health and social care as the two most important ways in which savings could be made over the next three years. But, as budgets reduce further in real terms, it is becoming harder and harder for councils to manage the tension between prioritising statutory duties towards those with the greatest needs and investing in services that will prevent and reduce future needs. As a result of this tension, this year councils will be spending 4% less on prevention than last year.
6. Reduction in funding for social care has wider impact
Directors feel that negative consequences due to budget cuts have already been felt right across health and social care and agreed particularly strongly with statements regarding issue faced by the wider sector:
- 85% thought that the NHS is under increased pressure
- 84% thought providers are facing financial difficulty
- 85% thought providers face quality challenges
Social care is essential but the investment simply isn’t there
The whole sector, including senior leaders from the NHS, local government and the independent sector, are united in recognising the importance of an adequately funded social care system in promoting the country’s wellbeing and ensuring the right care is available. We are at the tipping point where social care is in real jeopardy and this impacts on the millions of people needing care and support. More people work in adult social care than in the NHS and they make a positive difference every minute of every day.
We welcomed the additional funding for future years that the Chancellor announced in last year’s Spending Review but the results of this year’s survey confirm our view that these measures are too little and come too late. We urge the government to address this.