Government lacks understanding of adult care risks, warns spending watchdog

The government does not know how much longer the adult social care system can cope with rising demand and falling budgets, the National Audit Office has warned.

In a report on adult social care in England, the central government auditor said national decisions on adult social care are being based on incomplete information.

It found that while some departments are working together well, others are not.

Problems include the Department for Work and Pensions’ failure to supply the Department for Communities and Local Government (DCLG) with its estimates of how benefit changes for disabled people would burden local authorities.

The NAO also reported that adult social care has experienced a 8% real-terms cut between 2010/11 and 2012/13 despite rising demand for its services.

The report said councils have gotten better at controlling spending by negotiating bulk purchasing discounts and lower fees for private and voluntary care providers.

But, the lower fees for care providers has caused some to struggle to meet all but the most basic needs and to fund staff training.

The NAO also found that over the past decade councils have raised care thresholds so that 87% of adults now live in areas where local authorities only provide care to people with ‘substantial’ or ‘critical’ needs.

The Care Bill may also add to the pressure, it warned, because of a lack of evidence about effective approaches and the short timescale for implementation.

Councils also have little knowledge about adults who fund their own care and so will struggle to plan for the new responsibilities they will have for self-funders once the Care Bill comes into force.

Amyas Morse, head of the NAO, said: “Adult social care, including care of an ageing population, is one of the big issues we face at present.

“It is important to understand this in the context of the wider healthcare system of acute and primary care. There are no easy answers, but we need to think clearly and in a joined-up way about the predictable and growing challenges in years to come.”

Labour MP Margaret Hodge, chair of Parliament’s public accounts committee, said she was concerned by how the government was relying on incomplete knowledge when making decisions about adult social care.

“The Department of Health and the DCLG are changing the adult social care provision when they have no idea whether the changes will actually deliver savings,” she said.

“The result is unnecessary stress and an unfair financial burden on those who need care and the 5.4m unofficial carers who already contribute £55bn worth of care every year.

“The fact the departments do not know how much longer the entire care system can cope under the mounting pressure makes for a worrying picture.”