‘Rapidly deteriorating situation’ for social care, finds ADASS

Staff shortages leading to mounting unmet need, shows directors' survey, but government sidesteps call for emergency funding

Stephen Chandler
ADASS president Stephen Chandler

Staff shortages are driving a “rapidly deteriorating situation” for people needing care and their carers, directors warned today.

Waits for assessments and care, commissioned home care left undelivered and provider failure are all increasing, despite more care being provided found an Association of Directors of Adult Social Services survey of members, covering August to October this year.

ADASS president Stephen Chandler said the survey “[confirmed] our worst fears”.

“Red lights are flashing right across our dashboard. Despite magnificent efforts by the committed, courageous and compassionate people working in social care who are delivering extraordinary amounts of care and support, services are failing to meet everyone’s needs and older and disabled people are suffering.

‘Emergency funding’ needed

“The government must now acknowledge the scale of the crisis and step in with emergency funding and measures to ensure we can get through the winter ahead.”

ADASS has previously called for £1.5bn over the winter to tackle workforce shortages and unmet need, plus £1.5bn to support carers.  Its call for more government support over coming months was backed by provider, NHS and union leaders.

However, in its response to the survey, the government sidestepped calls for more funding. Instead, it pointed to the much lower sum – £162.5m – it had allocated for the winter to tackle workforce challenges and its longer-term social care reforms, which start kicking in next April.

Mounting unmet need

The ADASS survey, answered by 85 of the 152 directors between 2 and 18 November, found that, though the sector was delivering more care, this was being outstripped by demand.

Directors reported that 15% more home care hours were being delivered, on average, from August to October than in May to July, based on an ADASS  survey in September.

However, there was a 164% increase in the number of commissioned home care left undelivered between the two quarters. Based on results from 61 directors, they would, if extrapolated across the country, mean 1.5 million hours were left undelivered during the August to October, up from about 580,000 from May to July.

At the same time, the numbers waiting for assessments and care have also grown.

ADASS said that 1,344 people were reportedly on waiting lists for care and support, occupational therapy (OT) or Deprivation of Liberty Safeguards (DoLS) per council, giving an England-wide figure of 204,241 if extrapolated. This is well above the extrapolated figure reported by councils in September – 70,599 – though in the previous survey not all councils reported results for DoLS or OT assessments.

More people are waiting longer too, with an estimated 41,192 people waiting at least six months for an assessment, up from an estimate of 11,000 in September (though with the same caveats in relation to DoLS or OT assessments).

Of those assessed who were waiting for care or direct payments, this averaged 167 per authority, 20% up on the 140 per council reported in September.

More directors said providers closing or ceasing trading over the past six months, compared with the previous six months, with an increase from 35% to 48% of directors saying this about care home providers, and from 21% to 41% in relation to home care organisations.

Staffing pressures 

The backdrop to the results are the significant staffing pressures afflicting the sector, which include:

  • Vacancies up to 9.1% across adult social care in October 2021, from 6.2% in March, according to Skills for Care figures.
  • Filled posts down by 3.1% from April to October 2021.
  • The government’s own estimates showing just short of 40,000 jobs being lost in the care home sector from its introduction of mandatory Covid-19 vaccination for staff this month.
  • Home care providers predicting a significant exodus of staff from the introduction of mandatory vaccination in domiciliary care from April next year.
  • Sickness absence rates for care staff having doubled from 2019-20 to 2020-21, in the light of Covid.
  • A significant drop in the supply of new staff from overseas from 2019 to 2021, following tightened immigration rules.

A consensus has emerged among providers and councils on how to tackle the issue, which encompasses:

  1. Increasing pay for care staff to make the sector more competitive with others, notably the NHS. Such pay parity was ADASS members’ top priority for tackling the workforce situation. Provider bodies, including the Homecare Association and National Care Forum (NCF), has also backed a pay rise, as has UNISON.
  2. Providing care staff in England with a winter bonus of up to £1,000, following the example of Scotland, Wales and Northern Ireland, a move backed by ADASS and the NCF.
  3. Easing immigration rules to allow in more care staff, notably by placing all staff – not just senior care workers, as at present – on the government’s shortage occupation list to enable employers to recruit. ADASS members made this their second workforce priority, and it is also backed by the Homecare Association and NCF.

The government is unlikely to make any changes to immigration rules until then until its Migration Advisory Committee has reported on the the impact of the end of free movement from Europe on social care. This is due next April.

But amid the mounting calls for emergency funding and improved pay, a government spokesperson said: “We are committed to delivering world-leading social care, that’s why we are investing an additional £5.4 billion over three years, which will allow us to build our comprehensive adult social care reform programme.

“Care homes and home care providers are already benefiting from the new £162.5 million workforce retention and recruitment fund to assist local authorities and care providers in working together to ease workforce pressures in a variety of ways.”

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16 Responses to ‘Rapidly deteriorating situation’ for social care, finds ADASS

  1. Ruth Cartwright November 30, 2021 at 3:31 pm #

    Having started in Social Work in the 1980s, I remember literally decades of cuts and tightening of the criteria by which people were eligible for help. For most of this time ADASS seemed to agree with the Government that we were overfunded and incompetent and deserved to lose every penny. In recent years they seem to have realised that this has all gone too far, but I’m not sure the Government will be listening ….

    • Alec Fraher December 2, 2021 at 6:53 pm #

      A long run perspective would be really helpful Ruth. I started as a home care worker in the 80s as a community programme conscript under the then Thatcher Gov. Cherry picking was rife then and remains so now.

      It strikes me as very odd that the contracted and commercial aspect of this sector has been repeatedly over looked.

      How can an industry valued at £8bn in 2008 see a 5 fold increase to £45bn in 2014 and Fáil? In 2007 the contracting landscape makes Enron look like a walk in the park. Standards in Public Life, eh? The only conclusion reached by SOLACE was that ‘we don’t actually care’ a message echoed in high end insider reports to successive governments.

  2. Chris Sterry November 30, 2021 at 4:32 pm #

    This is a Government who are failing to understand the situations in Social Care or not wishing to.

    The staffing crisis is nothing new for there have been staff shortages for many previous years, but the situation in workforce has become even worse an d even so much more urgent due to a number of reasons

    a) the inability for the Government to safeguard care homes during the COVID pandemic by allowing hospitals to discharge COV ID patient directly into care homes, thereby infecting other residents and staff. This caused funding problems in care homes by reducing occupancy rates and also reducing staffing due to deaths from COVID

    b) the abysmal rate of pay for care workers in all sections of social care

    c) reduction in overseas workers coming to the UK due to very restrictive regulations in the Nationality and Borders Bill 2021, https://bills.parliament.uk/bills/3023

    c) care staff sickness rates

    d) the introduction of the requirement of mandatory COVID injections for care workers

    e) poor working conditions for care workers

    The Government appears to have no intention of remedying any one of the above let alone all of them.

    This Government is showing no ‘Duty of Care’ for the elderly and disabled people who have to rely on Social Care and have apparently washed their hands in this matter.

    A total, once again, irresponsible and very uncaring Government.

    • Jo December 1, 2021 at 12:17 pm #

      I agree with you on every point Chris – it’s almost like the Government want this sector to fail!

  3. Jo December 1, 2021 at 12:16 pm #

    sorry, but what did anyone honestly expect? when you tell people that they can’t work unless they have an injection that they don’t want, then they are left with no option than to leave. Surely this needs reporting properly and the elephant in the room needs to be debated? I am talking about the covid 19 injections ..You can’t coerce a workforce into having an injection, still in trials, and expect them to give in. So many people have left their jobs in the care sector because of this and we are not talking about it – why?

    • Carol December 2, 2021 at 10:06 am #

      Or pay these off staff better or at least the same as supermarket staff.

  4. Tahin December 1, 2021 at 2:13 pm #

    It really is a world turned upside down. Would these be the same Directors who spent the past 15 years telling us we need to wean ourselves off from our profligacy and find “better value” by limiting care options? I think they might be you know. Shrilling on the coat-tails of provider companies is not finding an independent professional voice really is it?

  5. Mellisa wnek December 1, 2021 at 10:14 pm #

    I work as a support worker, I often suffer abuse from service user. I am made to use my car and insurance to assist service users. So that they might attend appointments with the doctors. The money I earn isn’t enough to cover my fuel to get to work as I pay £240 per month. I work long hours, which effect my family life. There is no balance with my children ad my sister sees my children more than I see them. I work 48 hours a week and spend 8 hours driving to and from work. I am constantly tired..I now wish to leave the care industry as I can get a lot more money without the responsibility of giveb medication , doing risk assessment . I have started to apply for jobs that are not in care. I believe that every career should be a register, however must we be charged. There is no charge for people who stack shelves. I feel that they make care far too hard. If a support worker lack sympathy no amount of QCF will ever be enough. Trust me I have seen managers with QCF 5 not having a clue how to talk to staff or service users. One always wondered as to how did they manage to get so high.
    I believe everyone has the right to be treated with respect the same as you would like to be treated.
    Kind regards

    • Beth December 4, 2021 at 6:55 am #

      Take care Mellisa. Well said & thank you for such dedication. I can’t blame you looking elsewhere your children should be priority and care although rewarding at times can also be a thankless profession.

  6. Rich December 2, 2021 at 12:55 pm #

    I think Ruth Cartwright and Tahin are being harsh. Directors are the tools through whom Council Leaders control expenditure. I don’t beleive they have the autonomy some think they have so I am less cynical about their ability to act with good outcomes as the priority. We all do as we are told don’t we?

  7. Blair Mcpherson December 3, 2021 at 5:00 pm #

    The ADASS has proved, over many years, to be ineffective at securing adequate funding to support vulnerable people. Far to late in the day they are now speaking truth to power.

  8. Andy December 7, 2021 at 2:37 am #

    Here is a disturbing snap shot of what happens to monies paid by councils, the NHS or residents to residential and nursing homes.
    It’s a BBC article titled “Care homes: Following the money trail”
    Major error opening up social care to the private sector all those years ago.
    “Repent at leisure” as they say.

  9. Tahin December 8, 2021 at 10:55 am #

    ADASS, anything to say about HC-One receiving £18.9 million for infection control while siphoning off £4.8 million to their offshore fund as tax free profit? I recall, you were very loud in your advocay for care companies to get extra cash to buy a mop and bucket because they couldn’t afford to do it otherwise?

    • Annie December 10, 2021 at 9:10 pm #

      Apparently it wasn’t profit and no dividends were paid out. Rather it was a loan interest repayment. Which ofcourse had to be made through an offshore Cayman island account. 🐖 just flew past, fancy that.

  10. Mark December 8, 2021 at 10:20 pm #

    ADASS are just a buggins turn club. Stay silent until the wind settles then conform to whatever the prevailing ideology is. Repeat.

  11. Colin December 9, 2021 at 12:14 pm #

    Rapidly deteriorating? Where has ADASS been for the past 11 years? Hold on, you weren’t waiting for permission from the provider companies to parott the ” we need more funding” mantra we’re you? Is that too cynical and unfair?