Health & Lifestyle

Social care in meltdown as shock report warns crippled system is busier than ever

Social care is under ‘intense pressure’ and must be reformed after a record 2million adults asked for support last year, a report warns.

Local authorities have seen a surge in applications for publicly-funded care over the past decade but the number receiving it has actually fallen.

The Social Care 360 report, published by the King’s Fund think-tank, reveals thousands of people are being left to struggle without the support they need.

It could mean they are missing out on a place in a care home or help with washing, cooking and dressing in their own home.

The report calls on the next government to make social care a priority after years of reform being ‘consistently dodged or delayed’.

Social care is under ¿intense pressure¿ and must be reformed after a record 2million adults asked for support last year, a report has warned (stock image)

Social care is under ‘intense pressure’ and must be reformed after a record 2million adults asked for support last year, a report has warned (stock image)

The figures come amid a tightening in financial eligibility criteria and against a backdrop of an ageing population, the report adds.

Local authorities received 11 per cent more requests for care in 2022/23 than in 2015/16, with the number rising by almost 200,000 from 1.81million to 2million.

However, the number of people receiving publicly-funded long-term care has fallen by 2 per cent per cent over the same period.

Just 835,000 people were in receipt of such care in 2022/23 compared to 873,000 in 2015/16.

The report highlights that financial eligibility for care has continued to tighten, with the threshold for help remaining unchanged since 2010/11.

Local authorities are also facing rising costs, with the bill for purchasing care from providers continuing to rise faster than inflation.

According to the King’s Fund, the average fee for working-age adults has increased to £1,540 from £1,400 since 2015/16, while the weekly fee for older people increased from £670 to £840.

The think-tank also claims the vacancy rate in the social care workforce is at its second-highest on record, while about 19,000 fewer unpaid carers are receiving direct support.

Simon Bottery, senior fellow at The King’s Fund and lead author of the Social Care 360 report, said: ‘For decades social care reform has been promised by governments but consistently dodged or delayed.

‘The latest figures make clear that the sector is showing little sign of improvement, leaving thousands of people without the support they need.

‘There are severe financial pressures on local authorities who fund adult social care, and no sign that national government will step in to help. Nor is there a credible longer-term plan to recruit and retain the staff needed.

‘At a time when adult social care has never faced more profound problems, with record numbers of people requesting support, this is surely the time for the next government, whatever colour it may be, to make social care a priority.’

The King’s Fund is calling on the next government to increase funding to stabilise the social care sector and make it more attractive to current staff and potential new recruits.

It also said there must be funding and eligibility reforms to make the system fairer, as well as reforms to improve quality.

Kaya Comer-Schwartz, social care spokesman for the Local Government Association (LGA), said: ‘This important annual report highlight the perilous state of adult social care.

‘It is disappointing and concerning that the Budget provided no new money for these under pressure services, despite an increased demand for them.’

The Department of Health and Social Care said it is ‘fully committed’ to improving the social care system, adding that it had made up to £8.6billion in additional funding available this financial year and next.

Thinktanks warn the crisis could see people missing out on a place in a care home or help with washing, cooking and dressing in their own home (stock image)

Thinktanks warn the crisis could see people missing out on a place in a care home or help with washing, cooking and dressing in their own home (stock image)

Separate research today shows one in 30 private care homes have been forced to close since 2011 amid concerns over safety.

Nearly all homes closed by the Care Quality Commission were found to be privately ran, according to analysis by Oxford University.

The failings meant up to 20,000 residents have had to urgently relocate during that period as a result of closures, they estimate.

Experts said the findings suggest care homes operating on a for-profit basis tend to deliver poorer care than third and public sector providers.

The study assessed the number of care homes required to close following assessments carried out by the CQC, the independent regulator of health and social care in England.

An involuntary closure is typically a last resort for care homes that have put their residents at risk, or whose care services have continuously failed to meet industry standards.

They found 804 out of 816 closures involved for-profit care organisations, totalling around one in 30 of all privately run facilities, according to the findings published in The Lancet Healthy Longevity.

Alarmingly, 52 of the homes which had been forced to close had been rated as ‘good’ during their last CQC inspection, suggesting these homes posed urgent safety concerns with residents at acute risk of harm.

Lead author Dr Anders Bach-Mortensen, said: ‘Although these are rare events, enforced closures typically involve serious regulation and safety breaches that can inflict substantial costs to both the local authority and residents in need of relocation.

‘But most importantly, the neglect leading up to an enforced and acute closure can be traumatic and harmful for residents.

‘To protect care users going forward, it should be a priority to investigate if there are systematic reasons for why these enforcements occur almost exclusively in private for-profit provision.’

The analysis, commissioned by the Nuffield Trust health think-tank, was based on data on enforced closures requested from the CQC.

Registered charities, council and NHS Trust care homes were considered as ‘not-for-profit’ or public, whilst all private companies, partnerships, and individual providers without a charity number were ‘for profit’.

Researchers warned there is a growing reliance on private providers, which accounted for more than 85 per cent of all care homes in England in September 2023 compared to 78 per cent in 2011.

Co-author Dr Benjamin Goodair said: ‘What is needed is a comprehensive assessment of the impact of for-profit provision on the quality and sustainability of adult social care in England.’

A Department of Health and Social Care spokesman said: ‘We expect all care homes to adhere to high standards of quality and safety, regardless of whether they are run on a for-profit basis. When a setting or provider puts patient safety at risk, the Care Quality Commission will take action accordingly.

‘We are fully committed to improving our social care system, having already made up to an additional £8.6billion available over this financial year and next to support adult social care and discharge.

‘Additionally, we are investing up to £700million on a major transformation of the adult social care system, which includes improving care workers’ skills and supporting career progression, investing in technology and digitisation, and adapting people’s homes to allow them to live independently.’


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