Three quarters of directors of adult social care consider reducing the number of people receiving care important in order for necessary savings to be made, a survey has found.
However, there are warnings reductions in care for the sake of making savings could be unlawful.
The annual budget survey by the Association of Directors of Adult Social Services (Adass) has revealed councils are facing care market failures across the country and reduced investment in prevention.
Three-quarters of councils said they expect providers to experience financial difficulties over the next year, with two-thirds expressing concern those pressures could impact on the quality of care and directly affect thousands of people who need those services. A total of 78% of councils reported concern about their ability to meet the statutory duty to ensure care market stability within existing budgets.
The survey also found councils are experiencing “knock-on effects” from NHS pressures, such as an increased focus on delayed transfers of care from hospital and a reduction in NHS spending on continuing health care.
Only 12% of the 150 respondents said their greatest concern about budget pressures related to older people, with a third saying working age adults were of the greatest concern and 56% reporting concern about both groups.
Respondents said they were most concerned specifically about the unit price for care packages to support people with increasingly complex care needs. Of the 150 directors who responded, 75% reported that reducing the number of people receiving care is either important or very important for them to achieve required savings.
The budget survey report said: “This approach risks falling the wrong side of a fine line: if a reduction of those in receipt of care is an outcome of a strategy to develop asset-based, preventive approaches, this is a positive aspiration, but if it is about gatekeeping resources then it risks people in need being left without services, which would be unlawful and financially risky.”
Despite the introduction of the improved better care fund and the ability for councils to raise the council tax precept, just over half of councils overspent their adult social care budgets in 2017-18. Of these, half of councils will finance the overspend from reserves, with plans to spend £58m from this source. A further 31 councils reported they plan to fund overspends by making savings in other council departments.
Adass president Glen Garrod said the forthcoming green paper must deliver reform “that the people we care for, and our skilled and dedicated workforce, are crying out for”.
He said: “There is an undeniable, urgent and imperative requirement on the government to act to ensure interim funding continues until the green paper is implemented, that the social care workforces receive the wages and esteem it deserves, that the care market is safeguarded, and that the long-term funding solution that social care desperately needs is finally delivered.
“We cannot go on like this. How we help people live the life they want, how we care and support people in our families and communities, and how we ensure carers get the support they need is at stake – it’s time for us to deliver the secure future that so very many people in need of social care urgently need.”