dct in Exeter, Devon

Social Care for Older People

This report was produced through a combination of national data and interviews with local authorities, NHS and private providers, Healthwatch and other groups.


Key Findings:


  • The numbers getting help from their council with care had fallen by 26% to 850,000 in the four years to 2014
  • Spending on care by councils had fallen by 25% in real terms in the five years to 2015, to £5.1bn
  • Additional money from the NHS and increased contributions from individuals had topped this up to £7.2bn, but that still represented a cut of 9%
  • 4 in 10 people in care homes pay for themselves
  • One million people with care needs now receive no formal or informal help - a rise of 10% in a year
  • 300,000 fewer people receive council-funded help within four years
  • £100,000 or more is now spent on care in later years for 1 in 10 people
  • Most services are provided by outside agencies - providers had walked away from council contracts in 59 local authority areas


Key messages:

  • The social care system in its current form is struggling to meet the needs of older people. Six consecutive years of cuts to local authority budgets have seen 26 per cent fewer people get help
  • Central government grant reductions to local authorities have been passed on to care providers in the form of reduced fees, or below inflation increases.
  • Combined with shortages of nurses and care workers, higher regulatory standards and the introduction of the National Living Wage, this has put many social care providers under unprecedented pressure.
  • Many social care providers are surviving by relying increasingly on people who can fund their own care, but those dependent on local authority contracts are in difficulty.
  • Home care services face particularly acute workforce shortages and are now in a critical condition everywhere, threatening to undermine policies to support people at home.
  • The possibility of large-scale provider failures is no longer of question of ‘if’ but ‘when’ and such a failure would jeopardise continuity of the care on which older people depend.
  • Local authorities have sought to protect the most vulnerable older people with the highest needs, while at the same time encouraging others to be independent, drawing on the resources of their families and communities, and to reduce dependence on support from the state.
  • Access to care depends increasingly on what people can afford, and where they live, rather than on what they need.
  • The situation for older people has been compounded by pressures elsewhere in the NHS. Under-investment in primary and community NHS services threatens to undermine the policy objective of keeping people independent and out of residential care
  • The most visible manifestation of pressures on health and social care budgets is the rapid growth in delayed discharges from hospital.
  • The funding outlook for the next five years looks bleak. The measures announced by the government will not meet a widening gap between needs and resources set to reach at least £2.8 billion by 2019.
  • Public spending on adult social care is set to fall to less than 1 per cent of GDP. The potential for most local authorities to achieve more within existing resources is very limited and they will struggle to meet basic statutory duties.