Social care funding in the spotlight: ADASS Budget Survey 2018

ADASS survey reveals ongoing concerns over budget cuts, demographic pressure and staff recruitment and retention in "increasingly fragile and failing"…

Executive summary

The adult social care market is “increasingly fragile and failing” according to a survey of council leaders. The Association for the Directors of Adult Social Services (ADASS) has published results of its annual budget survey which reveals ongoing concerns over budget cuts, demographic pressure and staff recruitment and retention.

The report

The ADASS annual survey analyses feedback from each of England’s 152 councils to assess the current state of adult social care finances in England. The 2018 survey has described the care market as “increasingly fragile and failing in some parts of the country” and has found that 78% of directors are concerned about their ability to meet their statutory duty to ensure care market stability. While councils are expected to increasing spending from £20.8 billion in 2017/18 to £21.4 billion in 2018/19, ADASS does not believe that this will be enough to offset rising inflation costs and heightened demand. The National Audit Office has warned that, at the current rate of spending, around one in ten councils will exhaust their reserves within three years.

The ADASS survey cites demographic pressures and an increase in the number of people requiring care needs as two of the main reasons for concern. Another factor is the difficulty in recruiting and retaining staff at the levels required in one of the lowest paid workforces in the economy. Unsurprisingly, directors believe that increased salaries are the most important means of resolving these staff issues. Pressure on and from the NHS also ranks high in directors’ concerns. Less work on early prevention and intervention has placed pressure on both the health and social services but the survey reveals concerns that the social care crisis could suffer from being “less visible” than the pressures on the NHS. To illustrate recent social care struggles, 48 councils indicated that they had seen home care services close or cease to trade in the last six months and a further 44 had contracts returned to them from providers who were no longer able to carry out the work. The report concluded that “The overall picture is of a sector struggling to meet need and maintain quality in the context of rising costs, increasingly complex care needs, a fragile provider market and pressures from an NHS which itself is in critical need of more funding”.

As councils aim to find savings of £700 million in adult social care in 2018/19, ADASS has warned that savings must be made in a positive way. 75% of directors have said that reducing the numbers of those receiving care is important or very important to allow them to make the necessary savings and nearly half have said that they will introduce higher charges. ADASS has stressed that any reduction in care must be achieved in the right way by focussing on prevention and early intervention rather than risking leaving people without much needed care and services.

Looking ahead

As councils look to the year ahead, directors eagerly await the government’s Green Paper on social care which is expected to be published in autumn 2018. ADASS has called for the government to include plans for a long-term, sustainable solution to fund a vibrant social care market which will give people meaningful choice and control over their care.

Aside from the Green Paper, ADASS has also stressed the importance of more short-term funding for adult social care, such as the emergency relief granted by the Improved Better Care Fund and one-off grants which provided £2.3 billion in extra funding for 2017/18. ADASS president Glen Garrod said that a reduction in delayed transfers of care last year showed that the emergency funding had been a positive investment and had allowed adult social care to avoid a possible “tipping point”. He has asked for short-term funding to continue until the government’s Green Paper initiatives have been implemented.

Comment

Only 9 directors from all of the councils in England expressed optimism about the financial state of the wider health and social care economy. This is not surprising in the current political climate, particularly when providers find themselves faced with the inescapably harsh – and worsening - realities of the demographics with which they are obliged to grapple on a daily basis. All eyes will be on the forthcoming Green Paper for anything which may offer a glimmer of hope amid the present gloom.

If you have any questions or would like more information about our update, please get in touch with your usual Weightmans contact, or Morris Hill (Associate).

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