Directors of Adult Social Services warn of potential failure to meet statutory duties

A survey of social care leaders has found most councils lacked confidence they could offer minimum social care support in their communities due to a combination of a record NHS backlog, rising mental health needs, support for people suffering domestic abuse and carer breakdowns.

The Local Government Association (LGA) called this “deeply concerning” as it meant some councils might not deliver statutory services.

The survey by the Association of Directors of Adult Social Services (ADASS) of 153 directors of adult social care in England found care waiting lists remained far too high and could rise again this winter unless more staff were recruited.

While short-term funding boosts from the Government have helped reduce the number of people waiting for care - and increased support for people at home - these were still not keeping pace with increased needs.

ADASS called on the Government to commit to invest in support that helped people avoid the need to go to hospital or a care home, and help to recover at home for those who did enter hospital.

It also wanted increased support to carers and improved workforce pay and “a fully funded, long-term plan to transform social care to ensure everyone in England can get the care and support they need when they need it”.

Rebuilding efforts by social care teams after the pandemic had seen waiting lists fall from 542,000 in April 2022 to 430,000 in March 2023.

Thousands of people though deteriorated while they waited for assessments, care or direct payments, with some having to go to hospital or a care home instead, so increasing costs for the NHS and councils in the long run. 

Three quarters of councils told ADASS the size of care packages for people being discharged from hospital had increased and more than half saw increased numbers of people needing social care due to delays to hospital admissions or not being admitted at all.

Among directors, 81% either ‘strongly agreed’ or ‘agreed’ that increased NHS pressures would lead to adult social care taking responsibility for services which previously the NHS would have arranged or delivered. 

Directors reported a growing need for social care support to help people with poor mental health, homelessness and domestic abuse, noted by 81%, 51% and 64% respectively. 

Staff recruitment and retention continued to undermine progress, and overseas recruitment was judged an unsustainable response.

More than 500,000 hours of home care could not be delivered due to lack of staff, equivalent to around £14.7m worth of care that could have helped people stay independent at home. 

ADASS president Beverley Tarka 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.”

Ms Tarka said the social care sector needed “a skilled and valued workforce…bringing pay in line with equivalent posts in the NHS is important first step”.

She said in the short-term the Government should unlock £600m of social care reform funding “they have held back”.

David Baines, vice-chair of the LGA Community Wellbeing Board said: ”The fact that directors are having to plan savings of £806m 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.”

Mr Baines said the findings showed “the impact of a chronically underfunded system and the pressures councils continue to face”.

William Burns, social care policy advisor at the Chartered Institute of Public Finance & Accountancy, said: “What we need is a fully-funded, long-term plan to make the social care sector resilient in the face of increasing pressure.

“Certainty of funding would enable local authorities to better plan for care and improve outcomes for everyone who draws on care and support.”

Mark Smulian