Nearly 250,000 people awaiting adult social care needs assessment – report

A nurse holding an old person's hand

Nearly a quarter of a million people in England were waiting to have their care needs assessed by the end of summer, according to a report which warns of ongoing “significant budgetary challenges” impacting on the social care sector.

Almost a third of directors of adult social care services said they had been asked to make savings collectively totalling £83.7 million for the year to March 2024, research by the Association of Directors of Adult Social Services (Adass) said.

The organisation, which has published the results of its autumn snap survey – sent to every director in the 153 English councils with adult social care responsibilities – said those savings come in addition to the £806 million in savings which directors across England already committed to make in their budgets this year.

The organisation said its findings, from a survey carried out between the end of September and middle of October, come amid a challenging environment of high inflation, increasing demand for services and complexity of need, workforce challenges, and a “welcome but costly” rise in the National Living Wage.

It said 249,589 were waiting for an assessment of their care needs as of August, up from 224,978 people at the end of March.

This figure is part of the total of 470,576 people who were waiting either for care to start or for a review of their care plan, up by 8% since March but down slightly (by 20,000) on the same time last year.

Adass said it means “there are still nearly half a million people who are not getting the support they need or whose needs may have changed since their last review”.

The organisation’s president, Beverley Tarka, said that while extra funding from Government this year had helped, “this survey shows is while that’s stopped the ship sinking, it hasn’t moved us out of the storm we’re trying to navigate”.

She added: “Social care leaders and their teams are struggling to find savings and meet people’s needs at least minimally, but they can’t perform miracles from already overstretched budgets.

“Thousands of people are waiting for their council to assess their care needs and some of these people will reach crisis point and end up in hospital this winter, because they haven’t got the support they need in time.”

Adass is calling for an additional £900 million, as it looks towards Chancellor Jeremy Hunt’s autumn statement next week, which it said could “stabilise adult social care, helping us to recruit and retain more care workers and support more people that need care and support now”.

The Local Government Association said councils are facing “severe funding and demand pressures, meaning finances are under strain like never before”.

David Fothergill, chairman of the LGA’s Community Wellbeing Board called for “immediate investment” in the autumn statement “to address unmet and under-met need and ensure timely access to social care for all who need it”.

The association, the 2,000-strong membership body for UK homecare providers, said its 2023 analysis had shown that only 5% of public organisations paid the minimum price for homecare.

It said its research, which included data from all 276 public bodies in the UK that buy homecare from independent providers, suggested the fee rates they are paying are, on average, 25 to 35% below the amount needed to pay care workers fairly.

It said the rates allowed nothing to cover other costs such as training, recruitment; PPE and insurance.

The organisation’s report said: “In our view, it should be unlawful for public organisations to commission and purchase homecare at fee rates which create a high risk of providers being non-compliant with employment or care regulations, or of becoming insolvent.”

Homecare Association chief executive, Dr Jane Townson, said “successive governments have starved councils and the care sector of the funding vital to achieve” shared aspirations on good quality personalised care and a sufficient workforce “to meet the growing need for care and support”.

Miriam Deakin, director of policy and strategy at NHS Providers, said: “Yet another report exposes the effects on people’s health and wellbeing of the lack of adequate investment in social care.

“Social care, whether for people in their homes or in the community, is severely overstretched with chronic workforce shortages and a lack of investment.

“Thousands of people could be recovering at, or closer to, home with support from social care or community health services but are delayed in hospital.”

Simon Bottery, senior fellow at The King’s Fund think tank, said: “Today’s reports outline the sheer scale of the social care challenges facing Victoria Atkins, the new Secretary of State for Health and Social Care.

“It is particularly worrying, as we approach winter, that directors of adult social care say nearly 250,000 people are waiting for social care assessments.”