65,000 adults waiting at least six months for assessment as unmet needs mount, warns ADASS

2 million hours of home care could not be delivered in first quarter of year due to lack of capacity, signalling urgent need for government cash, say directors

Jigsaw puzzle showing supply demand gap
Photo: IQoncept/Adobe Stock

Story updated 16 May 2022

Sixty five thousand people in England have been waiting at least six months for an adults’ services assessment as unmet needs mount, directors have warned.

The figure, dating from the end of February, is six times that recorded in September last year, and comes with most directors reporting they have had to prioritise assessments for cases of suspected abuse or neglect, hospital discharge or reablement following a temporary residential care stay.

The Association of Directors of Adult Social Services’ (ADASS) latest snapshot survey on the state of the sector also found that, while more care home care was being delivered than last year, an estimated two million commissioned hours went undelivered in January to March this year due to a lack of workforce capacity. This is up 671% on estimated levels for February to April 2021.

ADASS May 2022 survey: key findings

  • 506,131 people were waiting for an assessment, care package, direct payment or review on 28 February 2022, up 28% on November 2021 (395,845).
  • 64,772 people had been waiting at least six months for an assessment as of February 2022, up 26% on November 2021 (41,192).
  • 61% of directors said they had to prioritise assessments for people where there was suspected abuse or neglect, for hospital discharge or to support reablement after a temporary period of residential care, between 23 February and 11 March.
  • 40,288,271 home care hours were delivered from January to March 2022, up 16% on February to April 2021 (34,635,217).
  • 2,206,187 commissioned home care hours went undelivered from January to March 2022, up 671% on February to April 2021 (286,148 hours).

Ninety four councils (62% of the total) answered the survey in April 2022 and their responses have been extrapolated to reach the totals above.

Workforce situation continues to worsen

The ADASS figures follows on the heels of Skills for Care’s latest data on the state of the workforce, which showed vacancies continuing to increase, hitting 10.3% in April – and 13.5% for domiciliary care.

The association linked the huge increase in commissioned care hours to a lack of workforce capacity.

It said the results signified a social care system whose capacity was increasingly being outstripped by demand, and urged an immediate injection of government funding, a point echoed by several charities.

In response, the Department of Health and Social Care pointed to the £5.4bn in additional funding it had allocated to adult social care across the UK over the next three years.

A DHSC spokersperson added that its white paper on reform, published in December 2021, “sets out an ambitious 10-year vision for adult social care – ensuring that people have the choice, control and support they need to live independent lives, can access outstanding quality and tailored care and support, and find adult social care fair and accessible”.

However, ADASS pointed out that little of the £5.4bn was dedicated to meeting immediate needs.

The bulk (£3.6bn) will go on introducing a cap on care costs and extending state-funded support by making the existing means-tested system more generous, from October 2023, and ensuring councils take steps to pay providers a fair rate for care. The remainder (around £1.7bn) will be spent on a range of initiatives to improve the quality and accessibility of care, including £500m on supporting the wellbeing and training of the workforce.

Funding ‘falls short of addressing most pressing issues’

ADASS president Sarah McClinton said the government’s plans “[fall] short in addressing social care’s most pressing issues: how we respond to rapidly increasing unmet need for essential care and support and resolve the workforce crisis by properly valuing care professionals”.

Her comments were echoed by several other social care bodies.

On behalf of independent sector providers, Care England chief executive Martin Green said: “Without immediate government intervention the adult social care sector will snap under the pressure to meet growing public need. It is vital that the government address the issue of unmet need and ensure that the social care sector is robust and sustainable, so that it can continue to support citizens with a range of complex needs.”

In reference to the government’s reforms, Age UK charity director Caroline Abrahams said the introduction of a cap on care costs and the more generous means-test for care next year would not address older and disabled people’s biggest concerns.

Reforms ‘do not address availability or quality’

She added that they “really only relate to how much financial support people get in paying for their care, they won’t do anything to expand the help available or improve its quality and reliability, and that’s what many older people and their families tell us worries them the most”.

She added: “After all, what’s the point of having the reassurance that you won’t face unlimited bills for your care, if there’s no one to provide it for you in the first place?”

Carers UK chief executive Helen Walker said ADASS’s figures illustrated that even more pressure was being loaded on “exhausted” carers who were already at “breaking point”.

She added: “With hundreds of thousands of people now waiting for an assessment or service, sustainable funding for social care is essential, without which many thousands of carers and families will simply be unable to cope much longer. Together with the impact of the cost of living crisis, we’ll see the unacceptable inequalities that unpaid carers and their families already face, widen.”


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4 Responses to 65,000 adults waiting at least six months for assessment as unmet needs mount, warns ADASS

  1. Adil May 14, 2022 at 11:10 am #

    Anybody care to talk about zero hours contracts, no sick pay, no travel allowance?

    • Mavs May 15, 2022 at 9:04 pm #

      Doubt it. Also doubt they want to talk about total lack of governance and monitoring of many of the agencies contracts given to. For the vulnerable and unpaid kin carers is a lose lose situation.

  2. Anonymous May 30, 2022 at 6:23 am #

    Why doesn’t anyone ever ask about overdue annual reviews???. I imagine the number to be staggering. The lack of workforce in Aduts social work is shameful. Councils can pick and choose which duties they want to meet, and just hope no-one complain because they understand there’s no money.

    I hope CQC will start to address this.


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