Adult social care inquiry reviewed by the Commons Select Committee

The inaugural meeting of the Commons Communities and Local Government Committee took place this week with the inquiry being focused on the financial sustainability of the local authority adult social care sector and the quality of care.

There was a lively discussion about the adult social care sector between leaders in the sector. The witnesses in the first evidence session for the inquiry were Vicky McDermott, Chair, Care and Support Alliance; Dr José-Luis Fernández, Deputy Director, Personal Social Services Research Unit, LSE and Richard Humphries, Assistant Director, The King’s Fund.

Some key points of the opening evidence session for the adult social care inquiry follow: –

  • Traditionally social care was something that was paid for privately;
  • Today 43% of social care is paid for by private individuals if you include top-up payments the figure is 53%;
  • Both the benefits system and the system of housing in the UK are important factors to consider when viewing the social care system;
  • Continuing healthcare assessments often place service users in a tug of war or pass the parcel in relation to finding out who is directly responsible for funding the individual; the local authority or the NHS;
  • It is important to consider the social care system as not one which deals with the healthcare demands of the individual but the consequences that the healthcare problem places on people’s lives;
  • There has been a gradual reduction in numbers of those receiving social care funded in part or fully by the state, the focus of such support has gradually moved to support only those service users with the highest levels of needs;
  • 30% of all users of social care are working age disabled people which might surprise some people who see the social care sector as the reserve of the elderly;
  • Often support provided in a social care setting would involve assisting users with their personal support needs such as toileting and cleaning;
  • There will be a 44% increase in the recipients of social care by 2030;
  • There is a challenge as a country to clarify what we want our care system to do;
  • For many local authorities adult social care is in excess of 50% of their budget;
  • The far-reaching Care Act has added a significant number of duties on local authorities (such as additional considerations of resources in a particular area and identifying people in the local area with unmet care and support needs) and this hasn’t necessarily been reflected in the amount of money they receive to carry out these duties;
  • Interesting clauses in the Care Act places a duty on local authorities to take into account the need for a sustainable social care market. In order to meet this obligation local authorities should not do anything to undermine a sustainable social care market which could mean ensuring that they are paying a fair amount for care;
  • When the welfare state was created in 1948 people did not live to such a ripe old age; what we need now is a fundamental step change in the healthcare system and social care system;
  • The number of elderly people aged in their 80s and 90s have increased by a third over the past decade and many now have multiple healthcare and social care needs;
  • According to ADASS there is a £4.6b gap in local authority funding for care, this gap may rise by a further £1bnthis year.
  • The size of the social care contraction in England cannot be compared with any other similar country. Within the last 5 years 40% fewer people were receiving care supported by the state. A question that remains now is should we carry on with the level of financial support we have been giving or should we change it?
  • Public spending on older people peaked in 2008; by 2010 local authorities were limited to the care provided to those with the highest healthcare needs. The King’s Fund believe the shortfall in social care funding is £1bn per year currently and will increase to £2.8bn by 2019;
  • Social care is about more than stopping people being in hospital – the focus should be on helping those who are in receipt of social care reintegrate into society to give them better life outcomes;
  • There is good evidence that the market is quite competitive; local authorities are doing a good job of keeping the prices down.

All individuals on the panel recognised the challenges the adult social care sector faces at a local authority level and in relation to the level of care that is provided. Richard Humphries, Assistant Director of the King’s Fund stated:-  “The key issues facing the sector largely fall into five categories: Money, demography, needs and public awareness… The Care Act has placed a significant increase in duties of local authorities without necessarily being reflected in the amount of money they are given…The most important pressure at present relates to funding with a particular emphasis on the home care market. Two of the countries biggest care providers in the UK have withdrawn from local authority contracts and a third is planning to do this.  There are reports from local authorities that a large number of providers are handing their contracts back. There is a crisis in the provider sector which is upon us now.  Whilst money is not the only problem it would be impossible for anything to be done without addressing the financial pressures.”

We look forward to further sessions of this committee and any positive impacts that may be forthcoming in enabling the social care sector to deliver for those members of society that require it.

Please follow this link to view the first session of the Committee on adult social care.

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