Almost twenty per cent has been wiped off adult social care budgets in England since the coalition government’s programme of spending cuts began in 2011, the Association of Directors of Adult Social Services has revealed.
Its latest budget survey found that councils have reduced their adult social care budgets by £800m in 2013-14, bringing the total level of real-terms spending cuts to £2.68bn since 2011, almost one-fifth of the £14.6bn that was spent by councils in 2010-11, net of client contributions.
Behind the Adass figures
In 2010-11, English councils spent £14.6bn, net of service user charges, on adult social care, according to official figures.
Adass’s three budget surveys since then have found that £2.68bn has been cut from this total. The actual total is likely to be a little higher as none of the surveys received responses from all 152 local authorities; 145 responded this year, for instance.
However, the £2.68bn figure does not mean that budgets have been reduced by this amount in cash terms. The reduction is net of both inflation and funding to cover demographic pressures, the rising number of older and disabled people with eligible care needs. This is justified on the basis that increases to cover inflation and demography simply enable councils to “stand still”.
While most of this year’s reduction is coming from efficiency savings (82%), 13%, or £104m, derives from reducing the level of services provided to individuals or restricting eligibility. Thirty per cent of directors surveyed by Adass said that one impact of savings made to date is that fewer people can access services, while a similar proportion said that people were receiving personal budgets of reduced value.
Efficiency savings hurting providers
And efficiency savings, which have accounted for the bulk of savings made since 2011, also appear to be taking their toll, particularly those accrued by limiting or denying increases in fees to care providers to keep up with the costs of care. Forty five per cent of directors polled said they did not increase fees to care homes to cover inflation this year, while nearly half (48%) said that providers in their areas were facing financial difficulties as a result of savings made by councils.
And directors are predicting worse to come over the next two years with the government imposing deeper-than-planned cuts on its funding to local authorities in 2014-15, with further reductions pencilled in for 2015-16, the level of which will be confirmed on 26 June. Half of directors said they expected that fewer people would be able to access adult care as a result of cuts in the next two years, and a similar proportion said that the value of personal budgets would be reduced.
Eighty six per cent of directors said that actions they had taken to date had not resulted in deteriorations in quality of life for service users, compared with 8% who thought quality of life had deteriorated. However, while 55% thought quality of life would not worsen for families over the next two years as a result of cuts, 19% thought that it would.
‘Serious reductions in services’
Adass president Sandie Keene warned ministers that further cuts could have seriously adverse consequences for families. “It is absolutely clear that all the ingenuity and skill that we have brought to cushioning vulnerable people as far as possible from the effects of the economic circumstances cannot be stretched any further, and that some of the people we have responsibilities for may be affected by serious reductions in service – with more in the pipeline over the next two years.”
The Local Government Association warned the government that it needed to ensure protection for adult social care when it announces spending levels for 2015-16 next month. “We need an urgent injection of money to meet rising demand in the short term and radical reform of the way adult social care is paid for and delivered in future, or things will get much worse,” warned Zoe Patrick, chair of the LGA’s community well-being board.
Meanwhile, the United Kingdom Homecare Association raised concerns about the reported impact on providers’ finances. “There is a clear message from both Adass and providers that further cost-cutting either threatens access to sufficient care, or perpetuates a race to the bottom on price and quality,” warned UKHCA policy and campaigns director Colin Angel.
Queen’s Speech to include social care bill
The survey is released on the day that the government announces a Care and Support Bill, designed to transform social care from a crisis response service to one focused on promoting well-being, in the Queen’s Speech. This will be through new duties to provide preventive services, information and advice to local people and support to carers with eligible needs and promote a diverse and high-quality market in local services.
However, Adass and the LGA have repeatedly warned that the bill’s aims will not be achieved given levels of under-funding in the system, and that the government’s own estimates of the costs of implementing the legislation fall short of what is required.
Social care cuts: the good, the bad and the worse to come