The social care debate is all too often focused on ‘care for the elderly’. But the reality is that growing numbers of disabled younger people, often with very complex needs, are using social care at a time when the sector is under severe pressure.
As the government moves towards its promised consultation and review of adult social care it is key that we all remember the true breadth of the sector, and the growing pressure it is working under.
To do this we must gather an accurate understanding of the state and the direction of social care, to achieve this we must look to the numbers, and try to decipher what they mean.*
More money is being spent on social care, but it’s still not enough
Last year £17.5 billion was spent on social care, an increase of 3% compared to the previous year.
This means that an additional £556 million was spent on social care by councils last year. A considerable cash injection.
However, the cost of providing care also increased. When we account for this rising cost, the increase in spending was, in fact, less than 1%. It is also important to view spending in historic terms.
The Association of Directors of Adult Social Services (ADASS) have reported that, since 2010, a total of £6.3 billion has been cut from social care budgets in England.
Given the considerable spending reductions we have seen over recent years, this small increase in expenditure does relatively little to address the financial deficit in social care. In fact, it highlights the urgent need for a sustainable, and long-term funding solution.
Fewer people are receiving social care overall
The very small increases in expenditure we observed over the last year are reflected in the fact that there has been almost no change in social care activity or the number of people receiving social care.
Last year 868,000 people received long-term social care, a drop of less than 1% compared to the previous year. But looking back further, this is a drop of over 25% since 2010.
We know that more people need social care, compared to 2010, so it seems counter intuitive that the number of people using social care has dropped so drastically.
What this means, in practice, is that more and more people are living with unmet social care and support needs. Sense has calculated that there are over 108,000 adults with severe learning disabilities who get no support whatsoever.
More working age disabled people are using social care
While we have seen a drop in the total number of people using social care services overall, there has been a rise in the number of working age people receiving care services, which has been offset by a larger drop in older adults getting social care.
Last year, 291,000 working age adults received long-term social care, an increase of 1.5% compared to the year before. Conversely, the number of older people using social care dropped by 1.7% to 578,000.
This means that over one third of people who use social care are younger adults. This ratio has shifted over recent years, as the number of working age people using social care has increased as a percentage of the total.
Often pressures on social care are ascribed to ageing, and the fact that our population is getting older. However, the reality is that pressures are equally, if not more attributable, to the fact that there are growing numbers of disabled younger adults with complex needs.
This is borne out in the experiences of councils who deliver social care. ADASS reported earlier this year, that for the first time ever, pressures associated with younger adults who used care services outstripped pressures caused by ageing.
We are seeing increases in complexity of need
All of this suggests we are seeing a long-term shift in the social care sector, where general level of need is increasing, and becoming more complex.
In 2010 the average cost of providing social care to an individual was £12,136 per year. That figure has now risen to £20,181 per year.
This means that while total spending has decreased since 2010, spending per person has increased by almost 40%.
There is a clear trend then, where fewer people are eligible to receive social care services from their council, but the people who are eligible have more complex needs. This group is growing in size and tends to be made up of younger adults.
Given this clear trend and the pressures associated with it, it is concerning that the social care debate has often focussed on ageing, overlooking working age disabled people.
As the government moves towards consulting on the future of social care, and reforming the system, it is vital that they remember social care is about so much more than care for the elderly, it is a complex and diverse sector.
As the social care sector continues to work with the government to achieve meaningful reform and improvement, we must all remember the diversity of the sector and of the people who benefit from it.
In doing this, we can realise the ambition of a social care sector that works for everyone.
* Unless otherwise stated, all statistics quoted are taken from, NHS Digital, Adult Social Care Activity and Finance Report, England, 2016-17.