Adult Social Care Statistics in England: An Overview 2020
This new report brings together data collected by NHS Digital across different aspects of adult social care funded by local authorities. It aims to produce an insightful and coherent narrative about the trends in adult social care in England.
National Care, Support and Independent Living Service
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We the undersigned, pledge our commitment to campaigning to end the crisis with Social Care by supporting the call for a National Care, Support, and Independent Living Service. We will raise the seven NACSILS demands internally within our trade unions, political organisations and campaign groups as well as externally, with members of the public, local and national policy makers, and the mass media because we believe a new Service has to be:
- Publicly funded, free at the point of use
- Publicly provided, not for profit
- Nationally mandated but designed and delivered locally
- Co-produced with service users and democratically accountable
- Underpinned by staff whose pay and conditions reflects true value and skills
- Designed to meet the needs of informal carers
- Informed by a task force on independent living led by user controlled groups from diverse backgrounds
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Parliamentary debate 18th March 2021
Social Care Reform and the Social Care Workforce
Thank you to David Scully from Ealing Reclaim Social Care Action Group for providing this link and summary speeches:
Thousands of people could live more independently if councils continue to deliver social care - new report
10 February 2021
A new blueprint for delivering social care in England could help tens of thousands of adults each year who need care and support to live more independent lives - if councils are given the ability to reshape services through the government's long-awaited reforms.
A major new report published in February by the County Councils Network, Newton and the Association of County Chief Executives (ACCE) argues strongly that social care should remain being delivered by local authorities rather than giving increased control to the NHS or central government.
The report argues that social care should continue to be delivered by local authorities, rather than via the NHS, and the CCN has launched a #KeepCareLocal campaign.
Following engagement with over 150 individuals across the social care sector, and built on an extensive new evidence base, Newton concludes that only councils, working with their partners - including the NHS and providers - can deliver their new wide-ranging blueprint for services that supports individuals to live as independently as possible.
- Download the full report here, and a summary here.
- Alongside the report, you can also visit a new interactive microsite for the project www.futureASC.com.
The report outlines new ways of working and improved practices for local authorities, care providers and the NHS in what Newton terms an 'optimised local delivery model' to help transform services for many of the 1.4m people who approach councils each year for local authority arranged-care in England.
This can be achieved through a mix of interrelated improvements, including better long-term commissioning of residential and home care; greater collaboration between councils, the NHS and care providers; investment in reablement services; maximising the use of the voluntary and community sector; and embracing digital transformation.
However, the report warns that this model can only be delivered if councils are given the clarity of a long-term funding model for care, due to be outlined in the government's long-awaited green paper, and remain under local democratic control. The Local Government Association estimate that by 2025 there will be a funding gap in adult social care of £3.6bn just to maintain services.
The blueprint shows that, as part of a wider transformation that would improve services for many of those who need care and support, tens of thousands of individuals could live more independent lives every year. This would help deliver £1.6bn nationally in financial benefits per year from reducing care costs if councils are put in the driving seat to reform local services. This includes:
- At least 90,000 additional older adults each year could benefit from greater access to short-term services, such as reablement, to reduce or prevent their need for long-term-care. This, coupled with services being more effective, could reduce long-term care costs by £867m a year.
- Around one fifth - 10,800 - of older adults who go into long-term residential care each year could be supported to live in a more independent setting, such as their own home. This could reduce long-term care costs by £178m a year.
- Working age adults with learning disabilities outside of residential care receiving formal support could be enabled to develop the skills they need to live more independently. In turn, they could have their level of required home care support hours reduced by 8% on average - delivering £261m in savings per year.
- Around 11,600 working age adults with learning disabilities who currently live in residential care could be living in a more independent setting, such as in supported living or with a Shared Lives carer. This could deliver £74m a year of reduced costs.
- Greater collaboration between care providers and councils to tailor home care support around the individual, which maximises their potential for independence, could save £75m per year. At the same time, more use of voluntary and community sector services when adults approach social care could deliver a £95 million financial benefit per year.
But for service improvements to be realised, Newton outline several 'foundations' that must be in place through the government's long-awaited social care reforms. These include setting out plans for a long-term funding solution for adult social care. Parity of esteem with the NHS is also called for, with social care getting a more prominent voice in local decision-making, and more campaigning to raise the positive profile of the sector with the public.
The report suggests reforms could also be underpinned by a new, outcomes-based performance framework. In exchange for more funding, the framework would make clear the impact of funding decisions, highlighting areas of good and poor practice, and give central government a new mechanism to monitor and support improvement.
- Co-production, social care and participatory democracy - Discussion article by Richard Hatcher
- Association of Directors of Adult Social Services (Adass) Budget Survey 2019 - revealing the scale of the growing crisis
- A House of Commons Library briefing paper looks at the forthcoming Green Paper on social care for adults. Its publication has been further delayed - it will now be published "at the earliest opportunity". A link to the full report in pdf format can be found here.
- Short article on changing Labour Policy
Labour reveals plan to "offer dignity" with adult social care boost
- Austerity: There is an alternative and the UK can afford to deliver it - IPPR blog
- How to Fully Fund Social Care
Draft discussion document by Simon Duffy and Gordon Peters, Reclaim Social Care
- NHS - love is not enough
By Peter Beresford and Mark Harrison, published in Labour Briefing
- Social Care and Support (model Labour Party Resolution) (Drawn up in collaboration by various Reclaim Social Care supporting organisations)
- A taxing question: how to pay for free personal care, Independent Age
- New article by Peter Beresford in CLASS (Centre for Labour and Social Studies) Root And Branch Reform Of Social Care Needed
- Fixing the state of social care, Gordon Peters
- Reforming Social Care, and the case against Integrated Care, Dr Simon Duffy
- Notes of Health Campaigns Together Reclaim Social Care Meeting Birmingham 28.2.19
- A Draft Summary of the Reclaim Social Care Group's discussion and recommendations, Brian Fisher
- Case study: The (Birmingham) Council Budget - time to open the books and change policy: the case of Adult Social Care, Birmingham Against The Cuts
- Sustainable Funding for Social Care and Intergenerational Fairness, National Pensioners' Convention
- The crisis of local authority funding and its implications for independent living for disabled people in the United Kingdom, by Steve Graby & Roxanne Homayoun (From Disability and Society, January 2019)
- What is wrong with the 'cap and floor' system for funding of adult social care, Ann Bannister
- Health Foundation and KF on funding options
- Bob Hudson on a more general discussion, more optimistic than usual
- The financial shenanigans of the corporates in residential care
- Select Committee's thinking on funding
- Barker's KF thinking on the affordability of SC free at the POU
- NEF on alternative providers
- Women's Budget Group on how paying for social care is an investment, not a cost.
- The Dilnott Report
Links to other articles and analysis on social care:
- Where are we at with social care for adults with learning disabilities? - Very well informed blog, which concludes:
"I think it shows that councils are trying to protect social care funding for adults with learning disabilities relative to the huge cuts in income they have experienced.
"However, this isn’t nearly keeping pace with the number of people needing social care support, and there are worrying signs that there are likely to be large numbers of adults with learning disabilities either getting no support at all, or getting support that isn’t right for them, with immediate and longer-term consequences for them and their families."
- MPs Briefing: Opposition Day Debate Adult Social Care Funding - ADASS warns that "The ongoing financial challenges facing adult social care could have significant consequences on the delivery of statutory duties. Respondents to the recent ADASS Autumn Survey either had no confidence or partial confidence that their social care budget will be sufficient to meet statutory duties relating to Market Sustainability (88.66%) by the end of 2019/20."
- Private firms are making big money out of children's social services - Guardian article lifting the lid on another area of privatisation, shows that:
"Almost three-quarters of children’s homes in England are privately owned and managed, and almost half of all local authorities do not provide and manage any children’s homes.
"Almost a third of all children in foster care in England live with foster carers provided through private agencies.
"In 2015, Corporate Watch reported that eight private foster care agencies (there are many more) made profits of more than £40m while also making big payments to senior managers."
- How cuts changed council spending, in seven charts - BBC data from December 2018 that gives more details useful for campaigners
- Changes in councils’ adult social care and overall service spending in England, 2009–
10 to 2017–18
- IFS report with damning statistics on the rapid rundown and underfunding of social care
- Home care in England: Views from commissioners and providers - A new report from The King’s Fund and the University of York drawing on the views from commissioners and providers finds that the market for home care providers is extremely fragile, with squeezed margins and low fees forcing providers to leave.
In 2017 providers handed back home care contracts in more than one in three local authorities, and some of the largest providers have withdrawn from the publicly funded home care market altogether. 40% of home care workers leave their jobs each year, and more than half of them are on zero hours contracts.
Staff shortages are a ‘relentless challenge’ for home care providers in many places. It finds concerns that fees paid by some local authorities are too low to maintain quality services, leading to high turnover of providers and staff.
- Changes in councils’ adult social care and overall service spending in England, 2009–10 to 2017–18 - Useful statistics on social care spending from the IFS
- Complaints over social care in England nearly trebled since 2010 - The Guardian reports:
"Complaints and inquiries about adult social care have nearly trebled since 2010, a damning report reveals, prompting warnings that the industry is struggling to cope with funding pressures."
- Social Care - forthcoming Green paper - HoC Library briefing - A very useful collection of data and historical policy debate.
- Hundreds of care home patients have died dehydrated or malnourished - Guardian report based on official figures:
"More than 1,000 care home patients have died suffering from malnutrition, dehydration or bedsores, new figures reveal.
"At least one of the conditions was noted on the death certificates of as many as 1,463 vulnerable residents in NHS, local authority and privately-run care homes in England and Wales over the past five years..
"The figures have been obtained by the Guardian from the Office for National Statistics (ONS), which completed an analysis of death certificates at the newspaper’s request.
"It follows a separate Guardian investigation that revealed some of the country’s worst care homes were owned by companies that made a total profit of £113m despite poor levels of care."
- Fair care: A workforce strategy for social care - New IPPR report on the social care system argues that says nearly half of the 1.3million people working in the care sector are earning less that the real living wage of £9 an hour, with one in four (325,000 people) on a zero-hours contracts.
It warns that unless pay and conditions are improved there could be a shortage of 400,000 care workers by 2028.
Nearly two-thirds of home care workers are only paid for contact time and not for travel between the homes of people they care for.
One in three carers said they often don’t have enough time to prepare a meal or help with washing and bathing, while a staggering 89 per cent said that they don’t get enough time even to have a chat with clients.
- Financial sustainability of local authorities 2018 visualisation - NAO figures showing the massive scale of cuts in local government funding from Westminster since 2010.
- Stop telling people who need social care they aren’t eligible – be honest, there isn’t enough money - Interesting article from The Conversation: "Being told by an official that you don’t need the help you believe you do, just so as not to create an inconvenience for them, is not semantics, it’s deception. There is not sufficient money in the system."
- The NHS and Social Care are one family, we need to love them both – Keep Our NHS Public - Updated discussion article from Keep Our NHS Public
- Forecasting the care needs of the older population in England over the next 20 years - The Lancet Public Health article highlighted by the Guardian on August 30
- While Brexit dominates, the crisis in social care is deepening - Polly Toynbee joins some dots in a hard hitting Guardian update on the growing crisis in social care
- Beyond barriers How older people move between health and social care in England - Another reminder of how far the current health and care system is from any real "integration". Following comprehensive reviews of 20 local authority areas, the CQC has called for a new approach to the way the country runs health and care services.
The ‘Breaking Barriers’ report followed people’s journeys through the health and social care system and identified gaps where people experienced poor or fragmented care, with findings showing “the urgent necessity for real change.”
- Delay to green paper caps dismal 48 hours for social care - Still no sign of ministers recognising any urgency for action on social care crisis
- £1bn needed to stave off crisis, say social care bosses - Social care directors send another warning on under-funding
- The revision of the Relative Needs Formulae for adult social care funding and new allocation formulae for funding Care Act reforms - Complex researched report with lots of maths, but basically arguing far an adjustment of the formula for allocating financial support for social care, from PSSRU.
- Adult social care services on brink of collapse, survey shows - Guardian report says that research published in June 2018 by the Association of Directors of Adult Social Services (Adass) shows councils “cannot go on” without a sustainable long-term funding strategy to underpin social care.
Adass warns that continuing cuts to budgets risk leaving thousands of people who need care being left without services.
It reveals English councils plan to push through social care cuts of £700m in 2018-19, equivalent to nearly 5% of the total £14.5bn budget. Since 2010, social care spending in England has shrunk by £7bn.
- ADASS BUDGET SURVEY 2018 - A report from the Association of Directors of Adult Social Services (ADASS) warns that:
“Insufficient social care, together with reductions in primary and community health services mean that for more people hospital may be the only option.
“Alongside the £7bn reduction in adult social care funding since 2010, resulting in less spending on prevention, there has been little meaningful investment in primary and community health care and prevention of ill health, with fewer GPs, a 45% reduction in district nurses since 20103 and a 10% reduction in the Government grant for public health since 2015/16.
“Significant increases in hospital attendances and admissions over the last winter, leading to increased demand for social care on discharge have been experienced by 95% of councils as a pressure.”
- A fork in the road: Next steps for social care funding reform - A joint report between the Health Foundation and the Kings Fund, which highlights low public awareness of social care and a lack of agreement on priorities for reform as major barriers to progress, despite apparent political consensus on the need for urgent action.
It argues that reforming the current system will be expensive, but states that if reform is chosen, England is now at a clear ‘fork in the road’ with a choice between "a better means-tested system" and one that is "more like the NHS" -- free at the point of use for those who need it.
- Plight of care home residents laid bare in damning report - Independent online report covering appeal by 80m charities for change of government line of squeezing social care as quality declines in care homes.
- Adult Social Care: An Intractable privatisation? - Professor Bob Hudson
- Financial sustainability of local authorities 2018 - National Audit Office