Public Views Needed As Adult Social Care Reaches Breaking Point

Residents and community groups are invited to take part in a major national consultation by the Local Government Association into how to pay for adult social care and support for older people, working-age adults with mental or physical disabilities and unpaid carers.

The LGA estimates that adult social care services face an annual funding gap of £3.5 billion by 2025.

Years of significant underfunding of councils, alongside rising demand and costs for care and support, has pushed adult social care services to breaking point. More and more people are unable to receive good, reliable care, such as help with getting washed and dressed, and funding is increasingly having to be diverted from other vital council services, such as parks, leisure centres and libraries, to plug growing adult social care funding gaps.

The LGA’s eight-week consultation is open to all members of the public – regardless of whether they are directly affected by or receive adult social care and support – and community groups. The findings will be used to help influence the Government’s own green paper and its spending plans.

Josie’s story 
At the moment, I get three short visits a day from a care worker to cook my meals, help me shower, and keep the house clean. I get two hours every two weeks ‘social’ time which at best on a good day gets me over to the park and back. It’s not long enough to join in any activities but I value this time hugely as it’s uninterrupted time with actual real conversation, not just “what do you need to eat?” or similar.

Cllr Izzi Seccombe Chairman of the Local Government Association’s Community Wellbeing Board, said:

“Finding a long-term funding solution for adult social care and support has been kicked into the long grass by successive governments for the past two decades and has brought these services to breaking point.

“Our green paper is the start of a nationwide public debate about the future of care for all adults and we encourage as many people and organisations to have their say on how we pay for it and the responsibilities of national government, local councils, citizens, families and communities.”

The LGA’s green paper consultation is available here. The consultation closes on 26 September. Possible solutions to paying for adult social care in the long-term outlined in the consultation include:

Increasing income tax for taxpayers of all ages – a 1p rise on the basic rate could raise £4.4 billion in 2024/25
Increasing national insurance – a 1p rise could raise £10.4 billion in 2024/25
A Social Care Premium - this would be a contribution, such as an addition to National Insurance or another mechanism, paid by employers and people over 40, including over 65s. If it was assumed everyone over 40 was able to pay the same amount (not the case under National Insurance), raising £1 billion would mean a cost of £33.40 for each person aged 40+ in 2024/25. This is a purely illustrative figure and would not be the cost to individuals if the premium was attached to National Insurance given that a person’s employment status and/or how much they earn determines the amount they contribute to National Insurance.
Means testing universal benefits, such as winter fuel allowance and free TV licences, could raise £1.9 billion in 2024/25
Allowing councils to increase council tax – a 1 per cent rise would generate £285 million in 2024/25

Vicki's Story
"I was diagnosed with Muscular Dystrophy when I was young. As a degenerative condition, every day is an increasing challenge. I am now 36 years old and I need assistance to get out of bed, to eat, to use the bathroom and to leave the house. I need someone with me day and night."

Frequently Asked Questions

1. What is a Green paper?

A green paper is a report, usually by government, which offers ideas and options around a particular issue for debate and discussion.

2. What is adult social care and support?

Adult social care and support helps both older people and working age adults who have disabilities, mental health conditions or are generally frail, as well
as unpaid carers.

3. Who receives social care?

Adult social care is provided for people who need personal or practical support to live in the community.

4. Who provides adult social care?

Adult social care is commissioned by councils but the majority of actual care services are provided by independent providers of care. The workforce includes a range of roles, for instance, social workers, occupational therapists or care workers – the people that work for home care agencies or in care homes, residential or nursing and people who deliver services like meals on wheels. Friends and neighbours also provide unpaid care.

5. Why is adult social care important?

Adult social care is an essential public service. First and foremost it provides support to help people live the life they want to live. It is particularly important
given that our population is ageing – not just older people, but adults living longer with a disability. Living longer is something to be celebrated but we must
aspire to add life to years and not just years to life.

6. How much help do people get?

This depends on the level of your need as assessed by social services, and on the value of your assets, such as savings or property.

7. Is social care free like the NHS?

Many people think that it is, but it is not. Instead, if your needs are assessed as ‘eligible’ you will need to complete a financial assessment to determine how
much, if anything, you need to pay to contribute to the costs of your social care.

8. What costs are involved?

Broadly speaking for residential care, if you have savings and assets worth more than £23,250 (including the value of your home) you will need to pay for all of your care costs (often referred to as being a ‘self-funder’).

9. How is adult social care different to the NHS?

Adult social care focuses on providing care for people in the community or home to help them have the best quality of life possible.
The NHS provides treatment for illnesses, injury or disability, and the care or aftercare of a person with these needs, normally in a hospital or GP surgery. It is usually free as and when people need it.
Unlike NHS treatment, adult social care isn’t free for everyone and how much you contribute to your care will depend on your financial situation.

10. Why is adequately funded adult social care important for the NHS?

Adult social care and the NHS both care for people who need it and the work they do is often interdependent.
For example, if someone is ready to be discharged from hospital but needs a full care package at home before they can leave, it is social care which provides
this support at home. If the council cannot provide this, people can end up staying in hospital longer than necessary.

11. What are the challenges facing adult social care?

The challenge of meeting increasing demand and rising costs with reduced resources has very real consequences across the system. There is already starting to be an impact on the quality of and access to care, a growing number of people who need social care but can’t get it, instability for care providers, an inability for councils to spend money on the sort of thing that stops people needing social care in the first place and a reduced ability of social care to help manage pressures on the NHS. Most importantly of all, this is impacting on people’s quality of life and their ability to live the life they want to lead

Since 2010, councils have had to bridge a £6 billion gap in social care just to keep the system going. The Local Government Association estimate that the adult social care gap will rise to £3.56 billion by 2025. This is more than five times the amount spent annually on councils’ park services, and close to the total cost of councils’ waste management for a year (£3.6 billion).

This means councils will have to find £3.56 billion through further savings or by providing less services to residents, just to be able to provide the same level of social care as they do now. This can have an impact on any other local service, such as filling potholes, collecting waste or keeping libraries open.

Meanwhile the population ages and pressure on social care grows. Because councils legally have to balance their books it becomes harder each year to fill the social care funding gap. As many savings have now been made, it is much harder to find new savings. Councils must increasingly make cuts and reductions to services.

12. What has the Government done to address the issues facing adult social care?

In the 2015 Spending Review, the Government announced the introduction of an adult social care council tax precept. This means that from 2016 the 152 councils which provide social care, including Central Bedfordshire, could add up to 2 per cent (3 per cent in some years) onto their council tax bills to raise money to be spent just on it.

The Government has said that this will provide an extra £1.8 billion for social care in 2019/20, compared to 2015/16. But this is based on the Government assuming that all councils responsible for social care will introduce the maximum precept every year until 2019/20. It is not possible to predict whether this will happen or not. As important, the value of the precept varies greatly based on the strength of a council’s tax base. Areas facing the greatest demand for services are those that are able to raise the least amount of money through the precept. It means that the issue of tackling social care funding is shifted to councils and their residents.

In recent years the Government has given money to social care in one-off grants and increases in improved Better Care Fund funding (a joint fund for social care and the NHS).

In the 2017 Spring Budget, they announced a further £2 billion for adult social care but this funding is spread out over three years and runs out next year.
With an overall funding gap of £7.8 billion by 2025 councils will still need to make cutbacks to local services including social care over the coming years.
While any additional funding for adult social care has been helpful, these types of measures only deal with the short-term problems and don’t consider what will happen further into the future.

Steve’s story

I was living with my partner, running a B&B when I had a serious stroke and later two minor heart attacks. After four months in hospital, I was depressed, frail and my memory and cognition had deteriorated.

We knew I needed more support with daily living than my partner could provide. I was unable to return home and it made me frightened about my future, with clinicians uncertain about my further recovery.

I wanted to live locally, so I could continue seeing my partner and I missed my dogs. The Shared Lives scheme matched me, with two trained and approved Shared Lives carers who shared my sarcastic sense of humour, had dogs, and lived close by. They helped me through it all. When I arrived at their home, I never dreamt of being so independent again. I couldn’t walk down the drive. Now I can nip up to town.

My Shared Lives carers helped me gain strength and confidence, walking a little bit further each time, until I could walk independently again. They helped me adapt to my memory loss with strategies for managing money and banking,
and supported me to make meals and manage my diet.

Since then I have booked a holiday and travelled on my own. I am very optimistic about life and planning a move into my own flat.

Without the Shared Lives scheme I would have undoubtedly spent longer in hospital, had less choice about where I lived, and had a slower recovery. It is so important that money is available to ensure that schemes like this exist.

Sandy’s story

"Mum was diagnosed with dementia in her early 70s. Dad cared for her at home for many years until the stress became too much and he had a heart attack. We then tried to access home assistance from the local council, but this proved impossible.
The only real option was to move Mum into a care home. Dad sold the family home and bought a small bungalow nearby. We all contributed to the top up fees for over seven years, amounting to hundreds of thousands of pounds.
We then tried to access NHS funding for Mum, who was by now in an advanced stage of dementia. [She was] doubly incontinent, no longer able to communicate verbally and unable to feed or dress herself. The funding was refused. We couldn’t understand why.
Eventually, we negotiated social care funding for Mum. However, the amount the council pay is significantly less than the fees charged. This subsidisation by private payers is another example of a system riddled with inequalities.
Our Mum is elderly, vulnerable and unable to vote. She no longer has a voice and has become effectively disenfranchised. So we must speak for her and others like her. Society is judged by its treatment of the elderly and this state of affairs is nothing less than shameful. Dementia is an illness. We cannot throw
our hands up and say it’s all too difficult.
Governments can no longer turn a blind eye and say we can’t afford it. We have to act now to ensure that people affected by dementia are treated fairly and properly. We must fund a social care programme which will allow the most vulnerable in our society to be cared for in an environment which allows them to live with dignity. The government must step up to the plate and be honest with the electorate.
This situation is not going to go away. Everyone affected by dementia, either those living with the disease or their carers and relatives, deserves so much

Information supplied by Local Government Association.