Adult social care 'perilously close to becoming unsustainable'

By agency reporter
October 12, 2017

More than half of councils expect to overspend their adult social care budgets this year by up to nearly £21 million each, while all local authorities face having to help pay a potential adult social care bill of nearly £270 million to fund six years of backpay for sleep-in shifts, according to a new survey published by the Association of Directors of Adult Social Services (ADASS).

The poll shows that sleep-in pay costs are the second biggest concern – after ring-fenced investment money – for directors of adult social services directors in England as they approach winter pressures facing the sector.

The survey found that the average cost – for councils, providers and self-funders, per council area –  for six years of backpay for sleep-in shifts is £1.78 million. If this figure was applied to the 151 councils in England providing adult social, care the total would amount to £269 million.

The potential bill comes as more than half (53 per cent) of Directors forecast an overspend on adult social care budgets this financial year. The average estimated overspend is £2 million, with the highest at £20.8 million.

Other findings in the Autumn Survey of Directors, published during the National Children and Adult Services Conference (NCASC), which opened yesterday (11 October 2017) in Bournemouth, include:

  • 67 per cent of councils reported provider closures in the first five months of the financial year (April to August)
  • 48 per cent of councils reported homecare providers handing back contracts (April to August) – an increase from 37 per cent who said the same over a six-month period in the main ADASS Budget Survey earlier this year
  • 94 per cent of councils reported they had experienced quality challenges (April to August) – an increase on the 74 per cent who said the same in the main ADASS Budget Survey
  • Councils say the hardest care service to obtain a place in is a nursing home (52 per cent), followed by home care (46 per cent) and a residential home (20 per cent)
  • Only 52 per cent of councils believe their agreed delayed transfer of care targets are realistic for both social care and the NHS
  • 16 councils were fined for delayed transfers of care in 2016/17, with individual fines as high as £280,540. Ten councils paid the fine. In 2017/18, eight councils have been fined, with fines as high as £99,970. Six councils have paid the fine.
  • Only 18 per cent of councils are confident (14 per cent) or very confident (4 per cent) that their Sustainability and Transformation Plan (STP) will deliver its aims

Margaret Willcox, ADASS President, said, “Our latest survey findings should act as a fresh wake-up call to government that adult social care is coming perilously close to becoming unsustainable.

“The extra £2 billion in funding, while welcome, is simply a short-term fix and cannot hide the fact that by the end of this financial year, £6 billion has been cut from councils’ adult social care budgets since 2010 – with demand for our services growing all that time. 

“This is simply unacceptable and needs to be addressed, not only in the Autumn Budget, but also in the promised consultation on the future of adult social care, because we cannot continue without sufficient and sustainable resources.

“Our latest survey makes this clear and paints a bleak picture. More than half of councils are already forecasting an overspend in adult social care budgets for this financial year and their top two concerns are both funding-related.

“Dedicated care workers deserve recognition and reward, but the Government needs to fully fund historic back-pay for care workers who have done sleep-in shifts or this could severely impact on the care of thousands of older and disabled people. Councils continue to prioritise delayed transfers of care, but the idea of imposing further sanctions on already cash-strapped councils seems frankly bizarre.

“Sustaining the increasingly fragile homecare sector gets more difficult by the day and is another major concern.

“Despite the significant challenges facing the sector, adult social care has a great deal to be proud of. The recent annual Adult Social Care Survey highlighted people’s happiness with both their choice of services and those they receive, while the latest Care Quality Commission’s State of Care report shows that nearly four in five adult social care services were rated ‘good’ and many others have improved, although we recognise that more needs to be done.

“However, the time is ticking on the tipping point for adult social care. If councils are to be able to provide personalised, reliable care for people when and where they need it, the Government needs to bring forward its forthcoming consultation on establishing a long-term solution for adult social care, which supports the needs of young adults as well as older people.

“ADASS stands ready to work with Government to help establish a better social care system for the rising numbers of people who need it now and in the years to come.”

HMRC enforcement activity concerning payment of sleep-in shifts by social care providers was due to be implemented on 2 October 2017 but has been suspended for a month.

* Association of Directors of Adult Social Care https://www.adass.org.uk/home


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