Social care costs being passed from health service to local authorities due to qualifying restrictions, study finds

A study by the Association of Directors of Adult Social Services (ADASS) has found that more people are being affected by social care providers closing or handing back contracts to councils.

The report, published on 21 June, found that continuing healthcare is “one of the key areas of interface between the NHS and social care which is proving particularly problematic at this time”, noting that if the NHS does not agree to funding or withdraws from it, the council or the individual must pay for it.

The ADASS revealed that in the past six months, 66% of councils that responded to its survey reported that providers in their area had “closed, ceased trading or handed back council contracts”, with over 8,000 people affected in these council areas.

According to the study, 3,113 people have been affected by contract hand-backs by home care providers in the past six months, which is equivalent to 59 people per council.

The ADASS said that this compares to 45 people per council in the four months prior to November 2022.

The survey also found that 63% of councils in England overspent on their adult social care budgets in 2022/23, with 72% of those councils using “one-off reserves to fund the gap”.

A positive finding of the study was that fewer people are now waiting for an assessment of their needs, care and support or a direct payment to begin, or for a review of their care plan than in August 2022.

However, the ADASS said the number is still “extremely high”, with 434,243 people waiting for assessment. The report added that “of those people waiting, those waiting for more than six months has increased.”

There was also a decrease in care waiting lists from 542,000 in April 2022 to 430,000 at the end of March 2023, the report said.

ADASS acknowledged the improvements as a result of the “hard work of adults’ services teams” as well as the consequence of a short-term funding boost from the Government.

However, the association warned that the increases in care being delivered were “not keeping pace with rising levels of need”.

The survey asked Directors which statutory duties they felt “least confident about being able to meet” for 2023/24 and 2024/25.

Deprivation of Liberty Safeguards (DoLS) was the third highest area of concern with 50% of Directors ranking this as a statutory duty they are less than confident in meeting for 2024/25.

The ADASS noted that this is “likely to be affected by the further delay by Government to the implementation of the change from DoLS to Liberty Protection Safeguards”.

In a letter to stakeholders on 5 April, the Department of Health and Social Care (DHSC) announced that it would delay the implementation of Liberty Protection Safeguards “beyond life of this Parliament”.

In response to the findings, Beverley Tarka, President of the Association of Directors of Adult Social Services 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.

“While the focus on people coming out of hospital is important, we need to focus more funds on keeping people independent and out of hospital in the first place so that they don’t end up needing more costly and complex medical care, which is bad for them and for the public purse.

“To meet the challenges, we need a skilled and valued workforce to do this – bringing pay in line with equivalent posts in the NHS is important first step. And we need to offer investment in training and real career prospects in the profession so we can compete with other sectors.

“In the short-term we are urging the Government to unlock the £600m social care reform funding they have held back so we can improve both staffing and support carers to help keep people in their homes. But to make real progress, we need a long-term plan for investment like the one in the roadmap we published in April, and the political will to make social care a priority over the next ten years so everyone can get the care they need, when they need it in the future.”

Lottie Winson