Summarising the effects of increasing cost pressures, reduced support from the government and the workforce crisis on adult social care.
Impact of Covid
Covid hit adult social care services hard. In 2020/21, 39,000 people died in residential and nursing homes. This high Covid mortality rate had the dual effect of reducing the number of people in care and discouraging older people from seeking it, but care needs didn’t just go away. There are already indications of a pent-up demand for adult social care. At the same time, the workforce crisis is now worse than ever, with the highest vacancy rate on record. The cost of care is also rising and with central government Covid support ending, it is now up to providers and local authorities to meet any funding shortfalls, raising questions about sustainability of the provider market.
Increase in spending
Local authority Covid-related spending on adult social care amounted to £5.3bn over 2020/21 and 2021/22. Spending on ‘supporting the market’ – to prevent providers going out of business – made up the largest proportion in both years, at 39.5% and 39% respectively. The dual effects of increasing cost pressures and reduced support from central government is already being felt: 67% of councils reported that care providers had gone out of business or handed back contracts in the six months to March 2022, compared to 25% in the six months before March 2020. Local authorities may struggle to continue supporting the market without additional resources from central government.
The annual vacancy rate for care staff reached 10.7% in 2021/22 – the highest level it has been since Skills for Care started collecting data. This is the result of people leaving the adult social care workforce, including a reduction of 35,000 carers, and vacancies remaining unfilled. It has severe implications for the functioning of the service. A range of factors are driving this exodus including “chronic stress”, the impact of Brexit on EU workers, poor training and progression, and poor pay.
Increase in demand
Despite a growing 65+ population, the number of requests for care fell in 2020/21 compared to 2019/20, down to 1.34m from 1.37m. This decline could lead to pent-up demand for adult social care and there is some indication of this already. The Association of Directors of Adult Social Services (ADASS) estimates that as of April 2022, 294,449 people were awaiting assessment for care, up from 70,000 in September 2021. Part of the reason for this delay in assessments is a decline in social workers from 17,500 in 2020 to 17,300 in 2021. While not a large drop (only 1.1%), this does mean that fewer workers are now carrying out a greater volume of work, leading to a bottleneck before people even reach care.