The forgotten story of social care

Foreword

disabled adults need to be as large a part of the agenda for Integrated Care Systems as for local authority cabinet meetings. The findings contained in this document are designed to start debate on how future reform of the social care system can properly address the needs of the diverse range of individuals up and down the country who rely on the support of these vital services to ‘live their best life’ and push the limits of their potential. The work represents only the start of a journey which CCN and Newton intend to continue into 2025, looking more deeply into specific areas of this wide-ranging collection of services. That this report has come at a particularly propitious time was unexpected when this work was commissioned – at that time councils were still focused on preparing for previous proposals for social care reform that had been due to come into effect in 2025. Now that these have been abandoned and the new Government is embarking on its own review before determining ways forward for the social care system, we sincerely hope that this timely study can feed in and help to inform next steps in the development of this crucial area touching the lives of so many of our most vulnerable in society. Councillor Martin Tett County Councils Network Spokesperson for Adult Social Care and Leader of Buckinghamshire Council

The findings in this report highlight some crucial learning for policy makers and professionals alike. Whilst the size of the working age and lifelong disabled cohort has remained static in recent years, spending on many individual packages of care has continued to rise – partly driven by the recent period of inflation, but also by statutory increases to the minimum wage which the social care sector is particularly sensitive to given the rates paid to many of the workforce, and by increases in the average level of support provided per person. There are also grounds for considering how far the number of working age and lifelong disabled individuals needing social care support may rise in the coming years. In particular the dramatic increase in need for children with Special Educational Needs and Disabilities (SEND) over the past decade v , as well as the widely reported crisis in mental health among young people, suggests that there may potentially be a commensurate increase in demand for support for adult social care around the corner as these children move into adulthood. In particular, better co-ordination and support for transition between children and adult services needs to be a priority for central and local government alike. Similarly, multi-agency working both within and across councils, and with the NHS, are crucial – the report argues for a more preventative approach to supporting these individuals from an early age. The needs of working age and lifelong

Given that many people think of their local authority’s responsibilities as primarily collecting waste, repairing roads, or maintaining parks, it can often come as a surprise that it is actually social care which makes up the vast majority of upper-tier councils’ activities. It also makes up the majority of upper tier councils’ spending – figures published earlier this year by the County Councils Network showed that across its 37 member authorities, social care for adults and children accounted for 69% of their total budget on average, rising to over 75% for some county councils (where some services such as planning and housing are delivered across a parallel network of District Councils). i The larger part of this social care budget is spent on support for adults, which is most often perceived as being services to support older people in their declining years of life. Indeed as the public discussion over reforming social care has increased in recent years, almost all of the debate has been concentrated on this cohort, with particular focus on what point, and how much, people should be expected to pay for their care. Yet, again, many people are unaware that in reality, over half of the overall budget for adult social care services is actually spent on adults of working age and those with a lifelong disability. This includes those with a wide range of long-term physical disabilities, mental health conditions or learning disabilities. Despite this group containing some of the most vulnerable people in the country, minimal focus has been given to them in recent conversations about social care reform – an oversight compounded by the fact that charging reform will make hardly any difference to this cohort given that the vast majority do not have assets that would set them above any threshold for self- contributions to their care. This report aims to start to rectify this oversight by shining a spotlight on this neglected area. Following previous successful collaborative reports including The Future of Social Care ii , Preparing for Reform iii , and Finding A Way Home iv – all of which have helped to shape national and local policy for social care – the County Councils Network has again partnered with Newton to explore the present situation on the ground.

Councillor Martin Tett

The findings in this report highlight some crucial learning for policy makers and professionals alike.”

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