With the right level of funding, councils can continue to make a positive difference to people’s wellbeing.
But the challenge of meeting increasing demand with dwindling resources has taken adult social care to the brink.
Since 2010, councils have had to make savings and reductions of £6 billion to adult social care services in an effort to balance the books. However, the proportion of councils’ budgets that are spent on adult social care has actually increased as councils have sought to protect care and support – from 36.9 per cent in 2017/18 to 37.8 per cent in 2018/19. By 2019/20, 38p of every £1 of council tax will go towards funding adult social care.
Creativity and innovation have helped councils deliver more for less but the impact of austerity is catching up with councils and threatening services that many of us rely on to improve our lives and communities.
This is particularly so in the case of social care. Underfunding is leading to real and significant consequences across the system. We are seeing greater concerns about the quality of and access to care, a growing number of people who need social care but can’t get it, instability for care providers, greater strain on the workforce and unpaid carers, and an inability for councils to spend money on the sort of things that help prevent people needing higher level adult social care or health services in the first place.
But the adult social care challenge is not just about the austerity of recent years.
Local government overall faces a funding gap of £7.8 billion by 2025, just to sustain current – and much reduced – levels of service.
This includes, within adult social care, a funding gap rising to £3.56 billion by 2025, due to an ageing population, inflation and other financial pressures. This is purely to stand still – to deliver what we’re already delivering, not to be able to support those who currently need support but can’t get it.
To put this in perspective, £3.56 billion is more than five times the amount spent annually on councils’ park services, and close to the yearly total cost of councils’ waste management.
Adult social care faces an immediate and annually recurring funding gap of £1.44 billion for care home providers and companies who supply carers; the difference between the estimated costs of delivering care and what councils pay.
While additional funding for adult social care has been helpful, these types of measures only deal with the short-term problems and don’t consider what will happen further into the future.
There is still not enough funding to fill the gap in social care funding which means that services for people who need care and support will inevitably be reduced. Councils will also have to make difficult decisions about which other valued and loved services that residents rely on like libraries and youth clubs can be cut to pay for adult social care.
The cost of unmet need
The funding challenge facing local government has been partly responsible for an increase in people not receiving the help they require.
Age UK estimates that there are 1.4 million older people in this category – including 164,217 people who need help with three or more essential daily activities, such as washing, dressing and going to the toilet. The LGA estimates that if councils were to support this group, £2.4 billion of additional funding would be needed.
Unmet (and under-met) need is bad for those people who miss out on support and can lead to their conditions worsening. It is also bad for our economy – supporting people’s wellbeing plays an important role in helping them to stay in employment, or to remain a support for relatives juggling work and family commitments.
Meanwhile, as pressures mount on adult social care, so too does the strain placed on family members and other unpaid carers, which impacts on their own wellbeing. Carers UK say that 72 per cent of carers in England have suffered mental ill health as a result of caring and 61 per cent have suffered physical ill health.
Changing public opinion
Unsurprisingly given how complex it is, few people understand social care or how the system is meant to work. A poll in 2017 found that 63 per cent of those questioned wrongly believed the NHS provides social care for older people, and 47 per cent believed social care is free.
The difficulty in explaining how the existing system works partly explains why governments have struggled to build the momentum needed to make proper and long-term improvements to social care funding. Additionally, some of the solutions that have been put forward by different organisations include tax increases or cuts to other services to pay for them.
But that is no excuse. Public and political opinion is changing, and people who need care and support should not be asked to wait any longer.