The Association of Directors of Adult Social Services (ADASS) has revealed that failure to properly fund adult social care is negatively affecting people who rely on services. The ADASS Budget Survey 2019 also shows that there is a negative impact on families and those who work in social care.
The report states that thousands of older and disabled people and their families face being severely impacted by service closures and further budget cuts for councils.
Since the beginning of the decade, adult social care directors in councils across England have had to make £7bn of savings, and need to find a further £700m for 2019/20, despite both the level of demand and complexity of needs increasing.
More than 7,000 people have been affected by care home and homecare services closing or ceasing to trade in the last six months, more than double the number affected last year.
Lack of certainty from Government about continued funding for adult social care from April 2020 onwards, including the Better Care Fund and Improved Better Care Fund which provide more than £5bn, will force directors of adult social services and their councils to make incredibly difficult decisions, says ADASS. These could include giving notice to providers unless urgent clarity is received on future funding by September this year.
This is also likely to have a significant impact on the NHS, says the report, including more admissions and greater demand on hospitals due to a lack of support at home, despite the stated aims in the NHS Long Term Plan. Reductions from Continuing Health Care (CHC) will add even further pressures on the health service.
The ADASS Budget Survey 2019 has also found a high proportion of councils (87%) have continued to experience pressure from increased hospital admissions, while 60% of directors surveyed say demand for social care as a result of premature or inappropriate discharge is a cause for concern.
In the survey, an overwhelming majority of adult social care directors said they felt fairly or very pessimistic about the financial state of the wider health and social care economy in their area over the next 12 months. Only 10% said they felt optimistic, a reflection of directors’ disappointment at a continued failure by Government to publish a long-delayed and desperately-needed green paper on the future of social care.
Emergency, one-off funding injections have not been enough to give directors confidence in their ability to meet future requirements, with an estimated 1.4 million people aged 65 and over with unmet needs, according to Age UK. Continuing financial uncertainty is also making it difficult for councils to commit to longer-term solutions needed to prevent people from requiring care in the future.
ADASS is calling on the Government to provide:
- A long-term, sustainable funding solution for adult social care.
- Funding from the Spending Review to be for at least two years and to continue until whatever is in the promised green paper can be produced and implemented.
- Adequate funding to meet an increasing number of people’s needs in the ways they want.
- A proper debate with the public about the priority of social care.
- A continued focus on recruitment and retention.
- A vibrant care market which gives people choice and control.
- Investment in new, asset-based approaches and prevention.
President of ADASS, Julie Ogley said, 'Older and disabled people need dignified, high-quality care and support. We know that when this is properly resourced, it works.
'Every minute of every day, heroic care staff are making an essential difference to the lives of the people they look after. Many receive great care and support throughout and to the end of their lives.
'Sadly however, as this budget survey shows, we are still desperately lacking the sustainable, long-term funding needed to provide vital services that will support people to live as independently and healthily as possible.
'Too many older and disabled people and their families still struggle without getting the help they need. Social workers, managers and councillors are having to make incredibly difficult decisions based on dwindling resources, which should not be allowed to happen in a modern, compassionate society.
'We cannot be expected to keep relying on emergency, one-off funding just to keep services going while not knowing about how much might be available for the rest of this year, let alone next...
'Our message from this survey to the new Prime Minister, whoever this may be, is very clear: Make social care an immediate priority. A thriving economy and a caring nation requires it.'
Commenting in response to the ADASS Budget Survey 2019, Nick Ville, Director of Membership and Policy at the NHS Confederation said, 'This report is another damning indictment of the failure of successive governments to deliver the basic care and support that thousands of the most vulnerable people in our society need and deserve.
'Patience is wearing thin among people needing support, their carers and families who are stretched to breaking point. As this report shows, while the government fails to act, the problems facing councils have got worse and the crisis for people needing care is escalating. Low salaries and poor morale continue to be major barriers to recruiting and retaining care workers and this must be tackled.
'Local councils cannot continue to rely on emergency funding – we need to see a sustainable social care system delivered on the back of a long-term funding settlement. This must be at the top of the in-tray for the next Prime Minister.
'The pessimism felt by directors of adult social services is mirrored in the views of health leaders – there is little hope among either that this challenge will be met any time soon. The consequences for people needing care and support will continue to be profound. And we expect this to put the brakes on the ambitions set out in the NHS Long Term Plan. Nine in 10 health leaders say they are not confident the NHS will be able to deliver the reforms set out in the plan without a long-term financial settlement for social care.'
Kate Terroni, Chief Inspector of Adult Social Care at the Care Quality Commission said, 'The ADASS budget survey...once again highlights the mounting pressure on adult social care budgets and provides a stark reminder of the fragility of our social care services. The findings firmly reinforce concerns we have previously expressed through our State of Care reports about the consequences of under-funding for councils impacting on the cost they can afford to pay for care and therefore the sustainability of care providers.
'This report helps to show the human consequences of such under-resourcing and highlights the urgent need for a long term sustainable funding solution for adult social care. If we are to meet our collective ambition of providing the high-quality, personalised care that we all want, then the forthcoming green paper must address this.
'Councils and providers continue to do all they can to help ensure high quality services, but unless action is taken to tackle the ever more overstretched council budgets then people’s care could suffer.'