Every year ADASS produces a Budget Survey. This is the seventeenth time we have done so.
Over recent years, the ADASS budget survey has become an important barometer of the state and ‘health and wellbeing’ of adult social care in England. The unique ADASS membership enables us, on an annual basis, to reach into local authorities and to take a snapshot of the financial temperature.
This year has been unique in so many ways and this is reflected very clearly in this year’s survey.
The timing has enabled us to also gather data relating to the impact of and the response to the Covid-19 pandemic. As a result, there are two reports this year. This is the first and it focuses specifically on the response to the Covid-19 pandemic. The second report will be published shortly and will set out and explore the wider financial impact of Covid-19 for adult social care in England.
This particular report underlines the all-consuming nature of the Covid-19 pandemic and its impact for those of us with care and support needs, our families, carers and for those who commission and provide advice, care and support in our own homes, care homes and within our communities.
I have to articulate grief at the numbers of people who have died, not just of Covid 19, but of all of the other causes that more people have died of during this pandemic. It has hit disproportionately those of us who are in the most vulnerable circumstances: older people at the end of our lives, particularly in care homes, people with learning disabilities, black and minority ethnic and poorer communities. And it has hit hard at the incredibly courageous, largely female, low paid but highly skilled and committed care staff, who have died at higher rates than the rest of the population, but who, nonetheless have continued to provide care at huge risk to their own lives and to their families.
More than ever the numbers contained in this report mask the experiences of millions of lives; those of us who have advice, care and support needs ourselves, care for a family member who does, or provide care as care professionals. Around 4.5 million people are new to caring. That population is different – younger and much more likely to be working age. Many more are juggling work and care. If you reach the tipping point where there is a crisis and insufficient care, you start pulling unpaid carers from the working population which will impact on the economy. This impacts more on women.
These are real lives, experiences and real pressures. People whose lives have been profoundly affected and changed by Covid-19. The millions who have been locked down and shielded, who have been impacted by increased domestic abuse and mental ill health, the thousands who have lost their lives prematurely, those left grieving by their passing and those of us temporarily unable to access the care and support we need to live our lives.
It is clear that adult social care was rendered ill-equipped and under-resourced to deal with the Covid-19 pandemic by the failure of successive governments of all political colours to recognise and understand how essential social care is and to put the people who need and work in it at the forefront, to put social care on a sustainable and enduring footing.
Our NHS and the people who work in it have been magnificent. Those who work in and who contribute in other ways, as family carers, as leaders of organisations who speak for older and disabled people, care providers, regulators and councils have been too.
But there was under-recognition of the vital and essential care, supports and safeguards that social care provides for us and our families. We must learn for future waves of the pandemic that a response that focussed on emptying acute hospital beds without considering the impact on social care; on PPE and testing for hospitals with social care as an afterthought; a focus on rapid discharge when there were shortages of PPE, testing and the ability to isolate people in social care, and that meant that many people ended up in the wrong place to meet their needs and with insufficient reablement to help them get home is a response we must change. We have to think of hospitals, community health services, social care, family carers, housing and communities as one wide set of supports that help us to live the lives we want to lead as well as keep us alive.
The survey illustrates the increased numbers of people with unmet or unknown social care needs; the lengths councils are going to support both people with care and support needs; the measures taken to shore up our fragile care markets; the innovative ways that services are being adapted to serve their communities; and the challenges still faced by many parts of the country to ensure that those of us who have care and support needs are safe and protected.
There are also many very positive aspects to the pandemic. The unbelievable commitment of staff everywhere, the fact that rough sleepers were rapidly given roofs over their heads, the local working together, neighbours and families looking out for each other.
The report also indicates what is needed in the short to medium term to ensure that we are all safe and to restore care and support to all of us who need it to live our lives. In the immediate term the Government must prioritise social care and protect those of us at risk from the current and subsequent waves of Covid-19. It must also ensure that as the rest of society emerges from the lockdown, that we reconnect families who have been shielded and separated, restore the lives of those who have been unable to access their usual levels of care and support, maintain support for homeless people, support those who have been discharged from hospital without an appropriate assessment and those who have experienced domestic violence, mental health crises, addiction or exploitation during the lockdown.
Longer term, the Government must fulfil the promise of delivering sustainable funding and reform. Things must be different simply because things can never be the same again.