Adult care waiting lists down but service pressures remain, survey shows

Increases in adult care service delivery are not keeping pace with increased needs, according to a new survey of social care leaders in England.

A report by the Association of Directors of Adult Social Services (Adass) found that short-term government funding boosts have helped cut the number of people waiting for care and increased support for people at home.

woman in black leather jacket wearing white framed eyeglasses covering her face

But despite the progress, care waiting lists remain high, with Adass warning they could rise again this winter without more staff.

Amid a record NHS backlog, rising mental health needs, support around domestic abuse of people with care and support needs, and carer breakdown, most councils are not confident they can offer the minimum social care support in their communities required by law.

Adass called on the government to commit to:

  • Invest in support that helps people avoid the need to go to hospital or a care home
  • Increase support to carers and improve workforce pay instead of relying on international recruitment
  • A fully funded, long-term plan to transform social care to ensure everyone can get the care and support they need when they need it

Care waiting lists have fallen from a high of 542,000 in April 2022 to 430,000 at the end of March 2023. But the health and wellbeing of many thousands of people continues to deteriorate while they wait for assessments, care or direct payments. Adass warned that some would end up having to go to hospital or a care home instead, undermining their independence and costing the NHS and councils much more in the long run.

Three quarters of councils said the size of care packages for people being discharged from hospital – the number of hours and numbers of carers they need – has increased. Over half said they had seen an increase in the numbers of people needing social care due to delays to hospital admissions or not being admitted at all. More than 80% of adult care directors either strongly agreed or agreed that increased NHS pressures would lead to adult social care taking responsibility for services which previously the NHS would have arranged or delivered.

Social care leaders reported a growing need for social care support to help people with poor mental health, homelessness and domestic abuse.

Meanwhile family and unpaid carers are bearing the brunt of an under-resourced and over-stretched system – carer burnout was the number one reason adult care directors gave for breakdown in unpaid carer arrangements. A further 91% of Directors said that unpaid carers were coming forward with increased levels of need in their local area.

Recruitment and retention of care staff remains a challenge and continues to undermine progress. This is despite some difference being made by recruiting care workers from other countries. There has been a significant increase in the delivery of homecare hours since the pandemic, over half a million hours of homecare were unable to be delivered across the English regions due to lack of staff.

The survey revealed that more councils overspent on their adult social care budget last year, with an increase in those relying on reserves to fund these pressures. Directors have had to identify an increased level of savings from their social care budgets for 2023/24, putting further pressure on the support they can offer people.

Adass president, Beverley Tarka, said: ‘Our findings show that a short-term funding boost from the government and the hard work social care teams have done to rebuild services after the pandemic is making a difference to thousands of people needing support and care, but we’re not out of the woods yet. Leaders tell us they are paddling hard to keep up against a tide of increasing and complex needs .

‘While the focus on people coming out of hospital is important, we need to focus more funds on keeping people independent and out of hospital in the first place so that they don’t end up needing more costly and complex medical care, which is bad for them and for the public purse.’

Image: engin akyurt


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