Government reforms ‘will not provide extra care or improve quality of life’, directors warn

The government’s proposed reforms to social care funding “will not add a single minute of extra care and support, or improve the quality of life for older people, disabled people and unpaid carers”, the Association of Directors of Adults Social Services (ADASS) has said this week.

ADASS issued the warning in a statement in which it demanded “urgent clarification” about whether the funding package, announced last week, would deliver anything to meet urgent needs this winter or from next April.

The directors’ body’s intervention follows significant criticisms from other sector organisations of the proposals, including that they did not do enough to meet present shortfalls in funding or the needs of working age adults, and that they risked further destabilising the care market.

The government’s planned changes, worth £5.4bn from 2022-25, would:

• Introduce, from October 2023, an £86,000 cap on how much people spend on their personal care, beyond which they would become eligible for full state funding.
• Relax (also from October 2023) capital limits for care funding so no one whose assets, including their home where applicable, were below £20,000 (up from £14,250, currently) would contribute from these to their care costs. There would be potential state funding available for those with savings of up to £100,000 (up from the current £23,250).
• Require councils to arrange care for self-funding care home residents who request this, enabling them to take advantage of the rates authorities pay for care, rather than the higher fees usually levied on private payers.
• Ensure councils pay providers a “fair rate” for care.
• Provide £500m to support the care sector workforce
• Lift the freeze on the minimum income guarantee for home care users and personal expenses allowance for those in a care home, so each rises with inflation from April 2022.

‘Not a single extra minute of extra care’

While welcoming the cap on social care costs and more generous means-test, ADASS warned that the announcement provides “no additional funding to enable us to deal with the overwhelming workforce pressures and increased levels of need that we are experiencing right now and going into what is likely to be one of the most challenging winters on record”.

It added that it was “not clear that there is any new money for adult social care to help improve care and support from April 1^st next year”.

“It will not add a single minute of extra care and support, or improve the quality of life for older people, disabled people and unpaid carers,” the association said.

In the policy paper on the reforms, the government said these costs would need to be met from council tax, the adult social care precept, which enables councils to raise additional funds for the sector, and local government efficiencies. However, it said it would ensure that that local authorities had “sustainable” budgets in the forthcoming spending review, which is due to set public spending limits for the next three years.

Increased waits for care

The scale of the pressures on the current system were illustrated by a snap survey of service directors released by ADASS last week.

Extrapolating from results provided by 45% of directors, ADASS found that about 295,000 people were awaiting assessments, care and support or reviews, a figure which had risen by 26% over the past three months.

It also found 13% of people were being offered care and support, such as residential care, that they would not have chosen had there been an alternative available, while the number of care hours needed which there was no capacity to provide had doubled in the last six months.

Other organisations also highlighted the lack of funding to meet existing pressures in the reforms.

Caroline Abrahams, co-chair of charity coalition the Care and Support Alliance and charity director of Age UK, warned: “Unless the Chancellor delivers substantially more investment into councils’ budgets in the autumn spending review there’s a real risk that the prime minister’s announcement will fall flat.”

Edel Harris, chief executive of learning disability charity Mencap, said: “Today’s announcement won’t be enough to fix the crisis that is happening right now. People who need care are missing out, others are having their support cut and some are being asked to pay towards their care which they simply can’t afford.”

Fee gap

The plans to enable self-funders to request councils arrange their care home care, while also ensuring that councils pay providers a fair rate, drew a mixed response. The package is designed to close the gap between self-funder rates and those paid by councils without pushing providers – many of whom rely on private payers to subsides state-funded residents – to the wall.

In a report this week,  the County Councils Network said while this was “well intentioned”, it could destabilise local care markets by making providers unviable or result in “unaffordable additional costs for councils.”

The CCN report estimated the “fee gap” in county and rural areas was about £761m, which would need to be filled to bring local authority and self-funder fees closer together. It said it was “uncertain” whether the £5.4bn committed for all reforms would be enough to deliver the fair rate plan.

Vic Rayner, chief executive officer of third sector provider body the National Care Forum, also raised concerns about the risks to providers’ bottom lines from the plans.

“It will be essential that providers, commissioners and people who use care and support come together to agree a fair price for care that will ensure there is a stable high quality care provision for all who need it now and in the future. Without this there is a real risk to the viability of providers of care across the country,” she said.

Longstanding needs

Other criticisms included that the reforms were too focused on people who developed care needs in older age having built up savings during their working lives, rather than working-age adults with longstanding needs, who tended to be poorer.

The British Association of Social Workers said: “There is an urgent need for community support for people with learning disabilities and autistic people and they deserve better. People with learning disabilities make up roughly a third of the total of social care needs, while accounting for half the spend, so to have no real detail on if now, or how in the future, the bill will support these people is a major concern and something we will be pressing the government to reveal.”

The CCN cited similar figures on the share of expenditure spent on working-age adults and said that reform plans needed to be balanced across the age span.

“Only a very small proportion of younger adults are likely to benefit from the funding and proposals announced to date,” its report said.

Anna Severwright, a convenor of Social Care Future, which campaigns for social care to be focused on quality of life rather than meeting basic needs, warned: “Disabled adults who may have no savings, will still have to use much of their disability benefits to pay for care.”

A Department of Health and Social Care spokesperson said: “We are working with local authorities and providers to ensure we have the right number of staff with the skills to deliver high quality care to meet increasing demands. This includes running regular national recruitment campaigns and providing councils with access to over £1 billion of additional funding for social care in 2021-22.”