By Rebekah Cresswell | August 7, 2025
Last Updated on August 7, 2025
Rebekah Cresswell, Chief Executive of Priory and a member of the Care England working-age adult care policy board takes a look at why we need to shift public opinion on social care.
When people hear the term ‘adult social care’, they often picture care homes for older people. But this perception, while common, is incomplete. As we know, adult social care is for anyone over the age of 18 who needs support to live a fulfilling, safe and independent life.
At Priory, we are committed to challenging this misperception and this is reflected in our purpose of ‘Live your Life’, which is about supporting people to meet their potential, to enjoy their lives and to live them to the fullest.
As an organisation that supports many working-age adults, we see first-hand how a narrow understanding of social care can lead to underfunding, poor policy decisions and, most importantly, the marginalisation of vulnerable people who don’t fit the presumed criteria.
We must reframe the conversation, because when adult social care is seen in these narrow terms, it can delay reform and prevent very necessary investment. The cost, however, is borne by younger adults – people in their 20s, 30s, and 40s and their families – who face a postcode lottery of care, with their needs often overlooked or misunderstood.
Public perception
If you ask the average person who adult social care is for, they will likely say ‘the elderly’ and it is not hard to see why when much of the media coverage around care focuses on ageing populations, dementia and the crisis in residential care for older people. While these are critical issues, they only tell half the story – and that is literal, given more thanhalf of the adult social care budget in England is spent on working-age adults, many of whom require lifelong, specialist support.
This includes people with profound and multiple learning disabilities, autism spectrum condition, complex mental health needs and those recovering from traumatic brain injuries. Yet, sadly, these people can often be invisible in public and political discourse. As a result, adult social care is seen by the public as a service they might need eventually and not something that hundreds of thousands of people need well before their retirements.
Why this matters politically
This perception problem has major implications for funding and policy. If adult social care is viewed as only related to older people, investment becomes a future problem, not a present one.
In our evidence to the Health and Social Care Committee’s adult social care inquiry last year, we highlighted that public misunderstanding of adult social care and raised serious concerns about the mismatch between council fees for working-age adult placements and the actual cost of delivering care.
This mismatch needs to be viewed as a structural threat to safeguarding vulnerable people, who are being removed from homes where they are thriving with their supporting teams due to closures or providers serving notice as they cannot deliver the complex package of care the person needs based on the fees received.
This is against a backdrop of increasing costs for providers, including the investment required in pay strategies and development for a skilled workforce that quietly cares for and supports millions of people annually. Our evidence made clear that when councils fund placements at below the cost of delivery, providers are forced to absorb the loss or turn down referrals, with neither option safe or sustainable.
I have consistently warned of the human consequences behind this funding gap. We are at risk of the disparity developing further and resulting in irreversible consequences for people accessing social care and their families. It is a national concern that requires immediate attention.
Changing the narrative
In order to shift public and political attention to the full scope of adult social care, we must see a change in the type of language used. ‘Care homes for 30-year-olds’ may sound jarring but it is exactly the stark reference needed to make the point. It disrupts outdated assumptions and invites people to reconsider what social care really is. It’s not about age but about need.
That’s why we use and prefer the term ‘support’ over ‘care’ as it better reflects the goal we set out in our purpose, ‘Live your Life’ of independence, autonomy, and inclusion – not just meeting basic needs.
We must shift the narrative and the media plays a crucial role here. Instead of focusing only on funding or crisis, we need more stories that centre on younger adults, including their lives, ambitions and the support that helps them thrive.
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We must also see change in the systems that are holding back progress. This will include the need for longer-term funding settlements, fairer commissioning models and better integration with the NHS. These aren’t just administrative issues; they directly impact the stability, quality and availability of services for working-age adults across the country.
Long-term impact and benefits
A more accurate perception of who care is for would generate greater political will to fund and reform it, with more strategic commissioning, greater investment in specialised services and better outcomes for the people using them.
Care homes for this group of younger adults need to be reflective of their generation and not a ‘one size fits all’ model. As part of this, there must a be a new way of looking at commissioning for working-age adults which incorporates technology and digital support as well as an understanding that must cater for the interests of the individuals being cared for.
Ultimately, we need to shift how society sees those who receive care and, as outlined previously, see it as vital support. They are not a burden or a cost to be managed, but individuals with potential, rights and aspirations to achieve. When we fund care properly, we are not just supporting services, we are investing in inclusion, equality and a more humane society.