Just over half of people receiving council-arranged long-term care had a review of their support plans in 2021-22, official figures have shown.
Councils told the statistics body that the situation was caused, in part, by the deprioritisation of reviews during Covid-19 and staff shortages, NHS Digital said in its annual adult social care activity and finance report.
While annual reviews of care and support plans are not a legal requirement, the Care Act 2014 statutory guidance states that “it is an expectation that authorities should conduct a review of the plan no later than every 12 months”. Councils must follow the guidance unless they can demonstrate legally sound reasons for departing from it.
The figures follow Association of Directors of Adult Services reports of waiting lists for assessments, care packages, personal budgets and reviews reaching 542,000 in April 2022, up 37% on six months previously.
Spending rising but fewer receiving support
NHS Digital reported that overall spending on adult social care rose by 3.8% in real terms, to £26.9bn, including resources provided by people using care and support and the NHS.
However, while there was also a 3.3% rise in requests for support, to 1,978,550, there was a fall of 4.3% (7,255) in the number of requests resulting in the person receiving long-term care, to 162,590.
This contributed to a fall of 2.8% (23,325) in the overall number of people receiving long-term care, to 817,915, the lowest number since records began in 2015-16. This was almost entirely driven by falls in the number of older people receiving long-term care, which fell by 4% to 529,010.
NHS Digital said councils attributed the falls to reduced service capacity or availability and staff shortages, reflecting other data, including the 50,000 fall in the number of filled adult social care posts over the same period recorded by Skills for Care.
However, expenditure on long-term care rose by 6.5% in real terms, to £16.6bn, because of rises in the unit costs of care.
Spending on short-term care grew by 13.2% in real terms, to £767m, just over half of which went on reablement and other services designed to maximise independence, for which there was a growth of 2.3% in the number of episodes provided.
Ongoing fall in support for carers
Real-terms expenditure also went up on support for carers, by 13.4%, to £176m. However, the number receiving direct support continued to fall. When those receiving information, advice, universal services or signposting are excluded, the number being directly supported by councils fell from 108,520 to 101,925, continuing a drop from 121,520 in 2015-16. The number (33,300) receiving respite from their role was steady compared with 2020-21.
In a report this month released before NHS Digital’s latest data, think-tank the Nuffield Trust said the drop in the number of carers supported represented a failure to live up to the promise of an increased policy focus on carers, including the introduction of a right to support under the Care Act 2014.
The trust attributed this “mismatch” to factors including a lack accountability within central and local government in relation to delivering for carers, insufficient consideration of the impact of other policies on the group and council budgetary constraints.