Harold Bodmer, President of the Association of Directors of Adult Social Services (ADASS) and Director of Community Services at Norfolk County Council, presents key messages from the ADASS budget survey report 2016.
This presentation was filmed at our event A new future for social care? on 12 July 2016.
Everybody across the sector acknowledges that Adult Social Care is underfunded but that acceptance doesn’t translate, or hasn’t translated, into more resource. We had an increase in budget last year, about £170 million, we went into the year £168 million overspent. So taking account of demography, taking account of the national living wage, taking account of the pressure of Deprivation of Liberty Safeguards applications, we need £1.1 billion more this year to retain the level of service at the same as it was last year.
We had the Adult Social Services precept, Adult Social Care precept, very, very welcome, 2%, but overall that came to £380 million. And of course there’s an issue about the fact that it raises least in areas of the greatest need. The total cost of the national living wage, including compliance with the national minimum wage, we calculate is at least £600 million this year. The precept raise is less than two thirds of this. The national living wage was not funded fully.
Our savings for this year for Adult Social Care are £941 million, 8% of the net Adult Social Care budget and 29% of total council savings. Our confidence as directors in making these savings is falling. Last year 45% of us said we were fully confident that we could meet all of those planned savings, this year that’s reduced to 31% and of course as you go forward it reduces to 6% for next year. We’ve been making reductions for six years so any savings that were easy to make were long since made. In additional of course we’ve seen the huge and welcome impact of the Care Act but we’ve also seen the application for Deprivation of Liberty Safeguards rise more than tenfold. So put together with all of those, only a third of us, 36% of us, slightly over a third, are fully confident of being able to deliver all of our statutory duties this year. And, again, if you move that forward that reduces to just 8%.
Adult Social Services has led the way in the last six years in transforming council services, in making very, very significant changes, and we’ve done that keeping user satisfaction remains constant. So in some senses we may have made this look easy, it is far from easy, and I think it would be dishonest of us at this stage to pretend that what we’re doing now really won’t have an impact on individuals.
39% of this year’s savings will come directly from cutting services or reducing personal budgets of people who receive care and support. Given that we’ve taken £5 billion out over the last six years, of course we’ve tried to protect direct services to people, and then you reach a point where, frankly, there’s nowhere else to go.
82% of us increased fees to providers this year and nearly a quarter of us by more than 5% but 80% of us report the providers in our areas are facing financial difficulties now. We know that providers are selling up, closing homes, and we also know, and there’s been some well reported examples of this, that home care providers in some cases are handing back contracts because they can no longer manage them. We know that we should be supporting people in their communities, we know that we should be diverting people where we can by making sure that their needs are met, through informal means if at all possible, and we know that that requires investment. But directors of Adult Social Services and councils feel between a rock and a hard place here; we have our statutory duties to fulfil but we also have responsibility to manage our budgets. We’ll be spending 4% less on prevention this year, we are finding it harder to manage this, and so we’re prioritising services to people most at need from services that have a greater discretionary element.
85% of us felt that the NHS locally was under pressure, 85% of us felt that the care market faced significant quality challenges as a consequence of the financial pressure and 84% of us felt that providers are facing financial difficulty. You could be forgiven for feeling that this is a sort of negative presentation. We’re anxious about it, for sure, but we’re not depressed really, our determination to improve the lives of the most vulnerable and disadvantaged people in our society remains undimmed. We are calling for £700 million of the money that’s backloaded for 2019/20 to be brought forward now. That’s not sufficient in the scheme of things but it would make a huge difference to the lives of thousands of people right now. Thank you very much.