Confidence is “faltering” among councils’ directors of adult social care over delivering on their legal duties, according to the latest annual ADASS survey.
Some 90% of the directors surveyed indicated that they are either ‘partially confident’ or have ‘no confidence’ that their budgets will be sufficient to fully meet their statutory duties in 2024/25. And 60% of directors lack confidence that their budgets will enable them to meet their legal duties relating to care market sustainability.
Reporting its survey findings, the Association of Directors of Adult Social Services (ADASS) said that the financial situation facing directors of adult social care was “as bad as it has been in recent history”. Adult social care budgets in 2023/24 were overspent by £586m – the highest levels for at least a decade, the organisation said. Almost three quarters (72%) of councils in England overspent on their adult social care budgets in 2023/24.
The £903m savings required for 2024/25 are at their highest levels since 2016/17 and there is an increasing reliance on one-off reserves to prop up budgets, ADASS added.
Ultimately, the survey found that there is increasing overall need for more complex care and support due to illness and disability, in part because of an “ongoing push to discharge people from hospital more rapidly”.
But local councils are struggling financially to meet people’s higher-level needs, with higher costs due to increased complexity of need ranked as the greatest concern in relation to financial pressures on directors’ budgets.
ADASS reported a knock-on effect to this, too. As councils provide more hours of complex care and support, those people needing low-level, early support at home – which has gained cross-party support – are at risk of missing out or their needs escalating.
This means that people are more likely to need to access emergency care and hospital treatment, ADASS said, “which is bad for everyone and piles further pressure on the NHS”.
ADASS’ survey also found that 92% of directors indicated that on average the cost of each care package exceeded their assumptions when their adult social budget was set, which had ‘some’ or a ‘significant’ contribution to their overspend.
Some 89% of directors stated that the number of people requiring council-funded long-term care exceeded the numbers assumed in their adult social care budget either had a ‘significant’ or ‘some’ contribution to their overspend.
Responding to the survey, the Local Government Association (LGA) called for “immediate investment” in adult social care to “tackle the urgent issues affecting services and pave the way for a longer-term and sustainable settlement”.
The settlement should be “delivered alongside a long-term care workforce plan and a shift to a more preventative model of health and wellbeing”, the LGA added.
Melanie Williams, president of ADASS, called on the government to shift to “investing in more social care, supporting unpaid carers, and providing healthcare in our local community to prevent people reaching crisis point and ending up in hospital in the first place”.
She stated that without investment in early care and support at home or the community, “spending more on the NHS is like pouring water down a sink with no plug in”.
Williams said: “The next government must have the courage to commit to a long-term, fully funded solution for social care and shift from short-term crisis management, especially during winter, to more care at home in the long term. Care at home is better for all involved, but also makes more financial sense.”
The ADASS survey results are drawn from 95% of councils with responsibility for adult social care across England.
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