News / King’s Fund report criticises inactivity on social care reform

A lack of action by successive governments has caused adult social care to stagnate, according to a new report by The King’s Fund. Social care 360 criticised the lack of reform, as adult requests for social care hit a record high of two million.

Requests from older people (65+) were the key driver of the increase in 2022/23. Overall requests were equivalent to nearly 5,500 every day of the year and, with 1.46 requests per person, the total represented requests from 1.37 million people. The number of people receiving publicly funded short- and long-term care also went up year-on-year – although the long-term trend is a reduction in the numbers receiving care. 

Compared with 2015/16, 2% fewer people were receiving support in 2022/23 despite 11% more people requesting it. This fall in the numbers receiving care over time is even more stark when increases in population are taken into account.

The report highlighted the key trends in social care for 2022/23 financial year. It pointed to the  continued tightening of financial eligibility for adult social care. The upper financial threshold, which sets the level of savings and assets people can have while still qualifying for publicly funded care, has not changed since 2010/11. Had the social care means test threshold kept pace with inflation since then, the King’s Fund said it would have been £7,080 higher in 2022/23, meaning more people would qualify for support. 

Local authorities are also facing increased costs, as the cost of purchasing care continues to increase faster than inflation. The report highlighted that the average weekly fee for working-age adults (in real terms, taking inflation into account) increased from £1,400 in 2015/16 to £1,540 in 2022/23, the average weekly fee paid for older people increased from £670 to £840, and the average hourly rate for home care increased from £17.50 to £20.60.

The report also focused on social care workforce vacancy rates, which are at their second highest-ever level, despite the arrival of around 70,000 overseas workers between March 2022 and March 2023. In this period, the number of UK domestic workers fell by 30,000. This situation could be set to worsen, however, as the government has announced a ban on overseas care workers bringing their families to the UK with them, starting on 14 March, in a move likely to make it harder to attract international staff to fill these gaps.

Finally, the report stated that there are approximately 19,000 fewer unpaid carers receiving direct support than in 2015/16, and 21,000 fewer people receiving respite care over the same period. According to the report, unpaid carers contribute the equivalent of four million paid care workers to the social care system, and without them the system would collapse. 

The number of carers receiving direct support from local authorities was lower in 2022/23 than it was in 2015/16, and there was also a change in the type of support they received, with fewer carers receiving paid support and more receiving ‘advice, information and signposting’. The report blamed this long-term fall in support for carers, at least in part, on pressure on local authority budgets, which has also impacted the number of people receiving long-term care.

Inertia in government is to blame for these issues, according to the King’s Fund. ‘For decades social care reform has been promised by governments but consistently dodged or delayed,’ said Simon Bottery (pictured), senior fellow at The King’s Fund and lead author of the report. ‘The latest figures make clear that the sector is showing little sign of improvement, leaving thousands of people without the support they need.

‘There are severe financial pressures on local authorities, who fund adult social care, and no sign that national government will step in to help. Nor is there a credible longer term plan to recruit and retain the staff needed. 

‘At a time when adult social care has never faced more profound problems, with record numbers of people requesting support, this is surely the time for the next government, whatever colour it may be, to make social care a priority.’

Unison pointed the finger at the current government in its response to the report, highlighting the meagre resources given to local authorities to tackle the issue. 'Care has gone into a tailspin on this government’s watch. A litany of broken promises and a complete absence of action best sums up ministers’ appalling neglect of the sector,' said the union's head of social care, Gavin Edwards.

'Cash-strapped local authorities have been pushed ever closer to the edge by spiralling care costs. The blame for the crisis in care lies entirely with the government. Ministers have failed to ensure council funding bears any relation to the harsh economic reality.'

The King’s Fund report concluded with a three-point plan for the next government to help fix social care. This included: increasing funding to stabilise the sector and enable providers to attract, retain and train the staff needed to meet demand; implementing funding and eligibility reforms to make the system fairer; and undertaking reforms to improve quality and outcomes.