The care and support older people receive increasingly depends on where they live and how much money they have rather than their needs, according to a new report into social care cuts by The King’s Fund and the Nuffield Trust.
Six consecutive years of cuts to local authority budgets, rising demand for services and shortages of staff have left the social care system increasingly unable to meet the needs of the older people who depend on it. The report finds that this is placing an unacceptable burden on unpaid carers and is leaving rising numbers of older people who have difficulty with the basic activities of daily living – such as washing, dressing and getting out of bed – without any support at all.
Social care for older people: Home truths highlights evidence that reductions in fees paid by local authorities and other cost pressures, such as the National Living Wage, are squeezing the incomes of residential and homecare providers. It warns that an increasing number are likely to leave the market or go out of business as a result, potentially leaving older people without the care they depend on.
The squeeze on care providers’ budgets is also prompting some providers in affluent areas to step back from providing care for people funded by local authorities, leaving those who depend on council funding reliant on an increasingly threadbare safety net. At the same time, more people are having to pay for their own care as a result of cuts to local authority services.
The report highlights a growing funding gap within the existing, inadequate system, which will reach at least £2.8bn by 2019/20 as public spending on adult social care shrinks to less than 1% of GDP. If the Government is unwilling to properly fund and expand the current system, the report says it must be honest with the public about what they can expect from local authority services, so they can plan ahead and make their own arrangements. It calls for a fresh debate about how to pay for social care in the future.
The report launch coincides with the publication of new research commissioned by the Richmond Group of Charities and supported by the British Red Cross and the Royal Voluntary Service. Real Livesdocuments the experiences of a number of older people with the social care system and the myriad challenges they face in getting the support they need. It highlights the human reality of a system struggling to cope.
Richard Humphries, Assistant Director of Policy at The King’s Fund said, ‘The failure of successive governments to reform social care has resulted in a failing system that leaves older people, their families and carers to pick up the pieces. Putting this right will be a key test of the Prime Minister’s promise of a more equal country that works for everyone – there is no more burning injustice in Britain today than older people being denied the care they need to live with independence and dignity.’
Ruth Thorlby, Deputy Director of Policy at the Nuffield Trust said, ‘No one can predict whether they will have care needs later in life. But if they do find they need help with the basics – eating, washing, going to the toilet – most will discover that unlike a health problem where care is free, they somehow have to manage themselves.
‘Our research found that local authorities have done their best to make savings while protecting funding for the poorest, but care providers are struggling on the low fees councils can afford. Shortages of homecare staff and affordable care home places mean older people are often stuck in hospital, putting both their lives and vital NHS processes on hold.
‘The number of older people needing care is increasing and yet we are continuing to put less money in. Unmet need is rising, providers are threatening to pull out of contracts, the wellbeing of carers is deteriorating, access to care is getting worse. A Government that wants to create “a country which works for everyone” should not tolerate the oldest and most vulnerable falling into a social care system riddled with holes.’
Responding to the report, Phil McCarvill, Deputy Director of Policy at the NHS Confederation, said, ‘Insufficient social care funding is now the most urgent threat to the NHS and the wider health and care system.
‘In August, we told a Commons Select Committee that too little money is being provided for social care and this is putting increasing pressure on the NHS.
‘In the run-up to last year’s Spending Review, we urged the Government to stop seeing the NHS, social care and public health as three separate funding streams and instead view them as part of a single system. If we are to truly join up health and care then we need to support people to receive the care when and where they need it. Inadequate funding in one part of the system has a profound impact on the other parts to deliver the right care. Without this, local co-ordination and planning will become increasingly disjointed and the care individuals receive will suffer.
‘Our members in partnership with social care organisations are working hard to transform services in their local communities but it’s vital that the Government supports this work by providing the funding social care so desperately needs.’