ADASS warns of increased pressure on budgets

ADASS has published its 2018 Budget Survey; an authoritative analysis of the state of adult social care finances in England. The data and analysis are drawn from the experiences of current leaders in adult social care. It provides contemporary, in-depth intelligence on how adult social care is responding to the multiple challenges of meeting increased expectations and need, whilst managing resources in an environment where Local Government funding is reducing, the provider and labour markets are fragile and the impact is affecting, and affected by, what is happening in the NHS.  

The survey shows councils expect to spend £21.4bn this year in England. While this is a rise from £20.8bn last year, the cost of inflation combined with growing demand means this will not be enough, ADASS said. A green paper on social care is expected to be published in the coming months.

Three-quarters of England's 152 councils said they would be cutting the amount of care they provided, while nearly half said they would be introducing higher charges - people are expected to contribute to the cost of care where they can.

Despite short-term injections of funding which avoided an even worse situation (and made a significant impact on Delayed Transfers of Care) many of the warnings that resulted from previous ADASS budget surveys are being realised in the form of:

  • Fewer older and disabled people with more complex care and support needs getting less long-term care. This amounts to a redefinition of the relationship between the state and the citizen, with an increasing move towards a highly targeted ‘offer’ in adult social care.

  • 75% of directors reported that reducing the number of people in receipt of care is important or very important for them to achieve necessary savings. This approach risks falling the wrong side of a fine line: if a reduction of those in receipt of care is an outcome of a strategy to develop asset-based, preventive approaches, this is a positive aspiration, but if it is about gatekeeping resources then it risks people in need being left without services, which would be unlawful and financially risky.

  • Market failure in some parts of the country and fragility elsewhere, with real challenges in recruiting and retaining staff at the levels required. Unsurprisingly, being able to increase salaries for care workers is ranked as the most important factor in recruitment and retention; as councils are aware, there is only so much that can be achieved by other initiatives when the social care workforce is amongst the lowest paid in the economy and unemployment rates are low.

  • Pressure on and from the NHS, particularly in relation to increased attendances at, and admissions, to acute hospitals and resultant increases of people being discharged.