ADASS report finds over half of adult social care directors see an increased need for care

New findings from a survey of social care leaders shows short-term funding boosts from the UK Government has helped reduce the number of people waiting for care and increased support for people at home.

A huge effort by social care teams to rebuild services after the challenges of Covid-19 has reduced care waiting lists from a high watermark of 542,000 in April 2022 to 430,000 at the end of March 2023.

However, increases in care delivered are not keeping pace with increased needs, a new report by the Association of Directors of Adult Social Services (ADASS) reveals.

According to ADASS’ report, despite the progress, care waiting lists remain far too high, and it warns that the numbers could rise again this winter without more staff.

In response to the findings, Beverley Tarka, ADASS President, said: “Our findings show that a short-term funding boost from the Government and the hard work social care teams have done to rebuild services after the pandemic is making a difference to thousands of people needing support and care, but we’re not out of the woods yet. Leaders tell us they are paddling hard to keep up against a tide of increasing and complex needs.”

ADASS notes a record NHS backlog, rising mental health needs, support around domestic abuse of people with care and support needs, and carer breakdown mean most councils are not confident they can offer the minimum social care support in their communities required by law.

This means the health and wellbeing of many thousands of people continues to deteriorate while they wait for assessments, care, or direct payments.

The association says that because of this, some will end up having to go to hospital or a care home instead, undermining their independence and costing the NHS and councils much more in the long run. It warns that the UK will likely go into this winter with waiting lists still higher than in 2021 and these could rise further during the winter.

Plus, the survey unveils that more councils overspent on their adult social care budget last year and there was a worrying increase in those relying on reserves to fund these pressures. Directors have had to identify an increased level of savings from their social care budgets for 2023/24, putting further pressure on the support they can offer people.

In the battle to free up NHS acute beds, the report details that council social care teams are needing to support more people coming out of hospital with complex health and support needs.

Three-quarters of councils say the size of care packages for people being discharged from hospital and the number of hours and numbers of carers needed have increased. Over half say they have seen an increase in the numbers of people needing social care due to delays to hospital admissions   not being admitted at all.

Moreover, 81 percent of directors either strongly agreed or agreed that increased NHS pressures will lead to adult social care taking responsibility for services that the NHS would have previously arranged or delivered.

In addition, family and unpaid carers are bearing the brunt of an under-resourced and over-stretched system. Carer burnout was the number one reason directors gave for breakdown in unpaid carer arrangements. A further 91 percent of directors said that unpaid carers are coming forward with increased levels of need in their local area.

It is likely that as more people reach crisis point, there will also be a rise in carers forced to reduce hours or leave work. This data demonstrates the importance of social care in supporting people to continue working, which has the potential to further boost the economy, says ADASS.

Further findings reveal recruitment and retention of care staff remains a challenge and continues to undermine progress, despite some difference being made through recruitment of care workers from other countries which, though welcome, is unsustainable, the association cautions.

Social care leaders say they are caught in a vicious cycle of struggling to prioritise support to keep people healthy, independent, and working, so they can continue to contribute to the economy and communities, which would also reduce the number of people with higher needs in future.

According to ADASS, this is being exacerbated by the lack of capacity in NHS community health services, leaving more people becoming unwell and going to hospital or into a care home.

To improve social care, boost the economy, and enable carers to continue working, social care leaders are calling on the UK Government to commit to investing in support that helps people avoid the need to go to hospital or a care home and support for people to recover, get back on their feet, and back home after hospital during this winter.

Beverley added: “While the focus on people coming out of hospital is important, we need to focus more funds on keeping people independent and out of hospital in the first place so that they don’t end up needing more costly and complex medical care, which is bad for them and for the public purse.

“To meet the challenges, we need a skilled and valued workforce to do this – bringing pay in line with equivalent posts in the NHS is important first step. And we need to offer investment in training and real career prospects in the profession so we can compete with other sectors.

“In the short-term we are urging the Government to unlock the £600m social care reform funding they have held back so we can improve both staffing and support carers to help keep people in their homes. But to make real progress, we need a long-term plan for investment like the one in the roadmap we published in April, and the political will to make social care a priority over the next ten years so everyone can get the care they need, when they need it in the future.”

Other ADASS suggestions include increasing support to carers and improving workforce pay. International recruitment is not a long-term fix; a long-term plan to transform social care to ensure everyone in England can get the care and support they need when they need it, the association underlines.

Cllr David Baines, Vice-Chair of the Local Government Association’s Community Wellbeing Board, responded to the report launch: “This crucial annual report gives a comprehensive view of the many pressures facing social care, their consequences for people, the workforce and providers, and the legitimate and serious concerns of directors of adult services.

“While the decrease in the number of people waiting for care assessments is a positive and notable achievement, a record NHS backlog, rising mental health needs, support around domestic abuse of people with care and support needs, means that demand continues to rise for councils.

“The fact that directors are having to plan savings of £806 million as part of wider council budget-setting in 2023/24, further demonstrates the extremely challenging situation adult social care is facing.

“It is deeply concerning to see that most councils are not confident they can meet all of their statutory duties required by law. This, partnered with the increase in the number of unpaid carers reporting burnout, could have serious impacts for many people who draw on care and support.

“This report shows the impact of a chronically underfunded system and the pressures councils continue to face. We support the recommendations of this report and urge the Government to implement a fully costed, long-term, sustainable plan to fund social care.”