Last Updated on July 15, 2025

The Association of Directors of Adult Social Services (ADASS) has published the findings of its Spring Survey 2025. According to the survey findings, which voice the contributions of 139 directors of adult social services, councils are being forced to cut back on early care and support to prevent people's health and wellbeing deteriorating, as they struggle to meet the rising cost of more complex and expensive social care.

The annual survey of social care leaders in local authorities across the country shows that despite a Government focus on neighbourhood health and prevention, overstretched budgets mean care leaders have reduced spending on the latter by more than 10% this year as they are forced to prioritise immediate needs and people in crisis. According to ADASS, this could throw the Government's ambition into jeopardy.

The ADASS annual survey estimates that collectively, directors were left with little choice but to overspend on their budgets by £774m last year to meet their legal duty to provide care and support, the highest the overspends have been in a decade. This is likely to result in councils further tightening the eligibility criteria for social care, so they can deliver their legal obligations leaving very little left for preventative measures that would likely save the state money in the longer-term and most importantly, improve outcomes for people.

Spending pressures include an increase in the size of people's care packages, indicating the growing cost of providing complex care as people live longer but often with multiple illnesses, conditions and disabilities. For example, this could mean people are requiring multiple visits per day, sometimes with more than one carer or adaptations to their home.

Three quarters of directors continue to see increasing numbers of people with some of the most complex care needs approaching their councils for support, who would have previously had their care funded free of charge through an NHS Continuing Healthcare (CHC). Data shows a postcode lottery for CHC funding, with people less likely to be successful in obtaining CHC support according to where they live in the country. The trend of care workers increasingly being asked to carry out health tasks that would normally have been covered by NHS staff continues despite this often being unfunded, and 100% of those directors surveyed believe increased pressure on the NHS will in turn increase pressures for adult social care into next year.

Commenting on the survey findings, Jess McGregor, ADASS President and Director of Adult Social Care in Camden, said, 'The maths simply doesn't add up – more people are coming to councils for help and their care is complex and costly, which means we don't have funds left to provide the early support and prevention that would stop people’s health from deteriorating and help them avoid spiralling into crisis, where they frequently end up in hospital.'

According to ADASS, the increase in costs has not been accounted for by the Government in the latest Spending Review. It saw social care receiving up to £4bn additional funding by 2028/29 (compared to 2025/26). But uncertainty remains around what this amount covers, including the potential for it to need to be used to pay for measures like a much needed but costly Fair Pay Agreement for care workers. It comes after costly increases in employers' National Insurance contributions and the National Living Wage, plus inflation, which have pushed the cost of care up. It also assumes that every council will increase council tax by 5% to fund that additional spending.

Ms McGregor added, 'We shouldn't have to choose between helping people with complex needs now and preventing others from getting unwell – we need to support people at both ends of the social care spectrum. But without more investment to keep people well and independent at home, we risk undermining the shift towards prevention and neighbourhood health that Wes Streeting, the NHS and this Government are rightly championing.

'It's vital that adult social care leaders who are well versed in delivering support at the community level are meaningfully involved in decisions about where and how resources for neighbourhood health and care are spent. After all, acute hospitals are not best placed to deliver social care at the neighbourhood level – but councils are.'

Cllr David Fothergill, Chairman of the Local Government Association (LGA) Community Wellbeing Board, said, 'This survey starkly shows councils are caught in the impossible position of having to choose between meeting people's complex care needs and supporting other people's wellbeing to prevent their needs from escalating. In this situation, councils cannot deliver the Government's ambition to shift care from hospital to community without sustainable funding for adult social care.

'Councils want to focus on prevention and help people stay independent at home, but rising costs and more people needing access to care is forcing them to prioritise crisis care instead. A promise to reform adult social care must be matched by long-term investment so councils can plan, recruit and deliver services that support people to live the life they want to lead and reduce pressure on the NHS. Local government is best placed to lead this shift and deliver neighbourhood-level care, but it cannot do so with one hand tied behind its back by underfunding.'

Dr Rhidian Hughes, Chief Executive at the Voluntary Organisations Disability Group (VODG), said, 'Across the country there is a wealth of good practice, partnership and innovation delivered by councils, disabled people and third sector organisations, showing care and support at its very best. Yet the latest survey of directors of adult social services once again highlights that the ability of councils to invest in early intervention, foster new ways of working and encourage innovation in social care is severely limited when up against successive years of central Government underfunding and unsustainable overspends. As the report states, the numbers just do not add up.

'The Government’s shifts for the NHS and recently published 10-Year Health Plan are welcome but will only become a reality in the lives of disabled people and their families when councils fully fund the care and support people rely on. Social care offers huge potential for economic growth, community cohesion and social impact, but this will only be fully realised once social care is recognised as an essential public service we all, at some point, rely on, rather than a burden more easily kicked into the long grass.'

Kathryn Marsden OBE, Chief Executive at the Social Care Institute for Excellence (SCIE), said, 'The ADASS Spring Survey offers further evidence of a system under profound strain. When local authorities are forced to divert limited resources into crisis management, the opportunity to invest in preventative, early intervention is lost. This not only undermines outcomes for people who draw on care and support but also the Government's own ambitions for both social care and the NHS.

'A sustainable health and care system relies on a rebalanced model – one that moves resources into community settings to enable support to be delivered earlier, closer to home, and in ways that promote independence. The Government's 10-Year [Health] Plan rightly looks to address this – but largely overlooks the essential role of social care.

'Social care plays a vital role in facilitating safe hospital discharge, supporting individuals to maintain their wellbeing at home and enabling them to lead independent and fulfilling lives. Although the sector is in desperate need of reform to unlock its full potential, it has already done the work to identify what the problems are through reports such as this one. It has also been developing solutions that can be deployed now to improve the efficiency, integration and quality of care through projects like the ones funded by the Department of Health and Social Care's SCIE-supported Accelerating Reform Fund.

'It is now up to the Government, working in partnership with social care leaders, to ensure the preventative role of social care is not sidelined but prioritised in our health and care system reforms.'

To read the ADASS Spring Survey 2025 in full, visit the ADASS website.

In other news, the Universal Credit Bill has passed through the House of Commons, with 336 votes for to 242 votes against, giving an overall majority of 94.