Social workers will have to cut the cost of service users’ care packages as councils reduce social care budgets by £1.1bn this year, according to research by the Association of Directors of Adult Social Services.
The sixth annual Adass budget survey revealed that £1.1bn will be taken out of social care budgets in 2015-16. The figures factor in additional funding provided from government for Care Act implementation and via the better care fund – a pooled budget between councils and NHS commissioners.
The reduction brings the total spending cuts, including inflation and demographic pressures, to £4.6bn since 2011. The total cut is equivalent to almost a third (31%) of the £14.6bn spent on adult social care by councils in 2010-11.
This year’s funding gap will lead to cuts to care packages, reductions in service provision and a greater proportion of resources being taken from prevention services to shore-up teams fulfilling statutory duties, directors said. The cuts have also intensified fears over both the fragility of local care markets and a growing recruitment crisis in the sector that is being driven by low pay and conditions for care workers.
The government has committed to giving the NHS an additional £8bn in funding by 2020 but has offered no guarantees on social care investment. This week a survey of NHS leaders revealed that 99% believed that social care cuts were adding to the pressure on the health service.
Campaigners fear parts of the social care system could “collapse” without urgent action and Adass called on the government to use the forthcoming budget and spending review to address the funding shortage.
The government downplayed the Adass findings and said councils and NHS providers can improve services and save money by working together.
How councils plan to find £1.1bn
The £1.1bn funding gap identified by directors is made up of a £500m reduction in the cash being put into social care departments and a further £600m of savings that bosses say must be found to cover increased costs from demographic pressures and inflation.
Councils aim to make most of the reduction through efficiency savings (75% or £807m). Some £228m (28%) of these efficiencies will come through cuts to the volume of care packages. Another £463m (57%) will be gained through productivity gains, described as “doing more or the same for less”.
A further £192m of savings (18%) will come through reducing services, with home care earmarked for the greatest reductions. Adass estimates that funding cuts implemented last year led to around 16,000 fewer people receiving home care, nursing or residential care.
Fears over ‘fragile’ care markets
Yet the survey suggests that the squeeze on care provider fees that has been a major cost saving target in recent years may have bottomed out. This year, provider fees are earmarked to deliver £32m of efficiencies, that’s 3% of overall savings. Just 2% of councils said they did not increase fees to care providers to cover inflation, compared with 45% two years ago.
The change of tack partly reflects councils’ growing fears over the fragility of care markets and the impact the squeeze on fees is having on staffing. More than half of directors (56%) report that providers are facing financial difficulties now.
Ray James, president of Adass, said:”The ongoing clamp-down on fees to providers is beginning tohave an inevitable clamp-down on staff skills, staff training, staff remuneration and staff satisfaction. Yet a well-paid, properly valued workforce is the rock on which the safety, care and security of so many of our vulnerable population is based. Maintaining a sustainable workforce in a sustainable provider market is now a key concern.”
He added: “Short-changing social care is short-sighted and short-term. It must also be short-lived if we are going to avoid further damage to the lives of older and vulnerable people who often will have no-one else but social care to turn to.”
Caroline Abrahams, director for Age UK, said: “The service is already pared to the bone with hundreds of thousands of older people with a social care need unable to get any help. We are also hearing of growing numbers of care workers voting with their feet and taking better paid jobs in supermarkets, leading to staff shortages.
“Unless government acts to restore stability to social care funding there is now a real risk that provision could collapse in some places. That would be disastrous for older people and their families and pile further stress on our already hard pressed NHS.”
Richard Humphries, assistant director of policy at The King’s Fund, said that six consecutive years of budget cuts had left social care “at a crossroads”.
“It is at risk of becoming a residual service, available only to those with the lowest incomes and highest needs, leaving thousands of people and their families struggling to meet the costs of care,” he said.
“Social care funding was the ghost at the feast of the election campaign, a subject none of the main parties dared to mention. Politicians must now be honest about the scale of the pressures on services and recognise that additional funding for social care must be a priority ahead of the Spending Review in the autumn.”
Bridget Warr, chief executive of the UK Home Care Association, said: “Local authorities cannot hide from the fact that threatening to find even more savings from limiting homecare will inevitably mean pain for people in vulnerable situations, and for the people who care for them, and it means more cost to them and to the NHS when people need more help further down the road.
“It is crucial that the government takes rapid action to protect people needing homecare by allocating enough money to commissioning local authorities to enable them to meet the real costs of care for those who are unable to pay for themselves. It is not only the right thing for a civilised society to do, but it is also good economic planning. The NHS relies heavily on social care. Additional resources for the NHS will have limited impact if hospital beds continue to be taken by people who could – and would prefer to – be at home with proper support.”
Warr added: “If local authorities cannot pay the costs of good homecare, there is a real risk that in future there will not be enough providers left to deliver this much needed support.”
A government spokesperson said: “We know some councils have managed to make efficiencies at the same time as increasing social care spending but increasing budgets isn’t the only solution. By working innovatively and joining up health and social care we can improve care and also save money.”