Kings Fund report highlights urgent need for reform to halt ‘deep decline’ of adult social care

More people are requesting social care but fewer are getting the help they need, according to a report calling for urgent reform to halt the sector’s “deep decline”.

Around 120,000 more people had requested social care support from councils since 2015/16, with 14,000 fewer people receiving long or short-term help, according to NHS Digital figures analysed in a report by the King’s Fund.

The think tank’s annual assessment of England’s social care sector, covering the latest available figures up to 2019/20, paints an overall picture of “deep decline, with many key indicators continuing to move in the wrong direction”.

It cited the long-term trend for increasing demand to “outstrip service delivery because local authority budgets cannot afford it”.

Local authority spending on social care was at a similar level to expenditure in 2010/11, but spending per person had reduced when taking into account population growth.

While spending had increased in recent years after a fall, it said much of this extra funding was going towards the increasing costs of providing care, rather than on providing services to more people.

The report also said the failure of a means-tested threshold to keep pace with inflation had resulted in it becoming “even meaner”, and fewer people qualifying for help.

If the upper earnings limit – over which individuals must entirely fund their care – had increased in line with inflation, it would be £5,995 higher than it currently was.

Staff vacancies had fallen but remained at a high level, the analysis noted, and while care worker pay was rising, it was not doing so as fast as in other sectors.

In 2012/13, care workers were paid more than cleaners and sales assistants, but by 2019/20 they had been overtaken, it said.

Care groups, charities and politicians have long been calling for a social care plan for long-term reform, as promised by the Prime Minister in his first speech after being elected in July 2019.

The analysis puts further pressure on the Government to set out proposals in next week’s Queen’s Speech.

On Wednesday, Boris Johnson did not say, when asked, whether he would use this opportunity to detail social care reforms.

Lead author and senior fellow at the King’s Fund, Simon Bottery (pictured), said: “Following a decade of neglect, there is a continuing gulf between what people need and what they receive.

“The latest data paints a bleak picture with few causes for optimism. Even where measures have improved, there are often caveats.

“Local authority spending on social care has finally returned to the levels of 2010/11 but not if you take population growth into account: spending per person has fallen. Care worker pay has improved but is not rising as fast as other sectors so vacancies remain high.

“Demand is likely to go on increasing but local authorities do not have the money to meet it.

“If we are to avoid reporting on a further bleak round of indicators in future years, we urgently need the long-term, wide-ranging reform for adult social care that the Prime Minister promised after the general election.”

The report highlighted six key actions needed to improve the sector, including more funding and wider eligibility for help.

It also called for better pay, training and development for staff, more control and choice over services, a greater focus on prevention and more support for carers.

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