What is social care? How many people deliver social care? How much does social care cost individuals and the state?
Our press and public affairs team, library service and policy experts deal with hundreds of enquiries every year. Below are our answers to some key questions that have been frequently or recently posed to us. If you’ve got a question, get in touch with us.
What is adult social care?
Adult social care covers a wide range of activities to help people who are older or living with disability or physical or mental illness live independently and stay well and safe. It can include ‘personal care’, such as support for washing, dressing and getting out of bed in the morning, as well as wider support to help people stay active and engaged in their communities. Social care includes support in people’s own homes (home care or ‘domiciliary care’); support in day centres; care provided by care homes and nursing homes (‘residential care’); short-term ‘reablement’ services to help people regain independence; providing aids and adaptations for people’s homes; providing information and advice; and providing support for family carers.
Who is eligible for publicly funded adult social care in England?
Though some services, such as advice and information, are available to anyone, most publicly funded social care in England is only available to people with the highest needs and lowest assets. People with assets worth more than £23,250 are normally not eligible (for residential care, this figure includes the value of their property, if they have one). People are usually expected to contribute towards the cost of publicly funded services from their income.
Who provides adult social care in England?
Local authorities are responsible for assessing people’s needs and, if individuals are eligible, funding their care. However, most social care services are delivered by independent sector home care and residential care providers, mainly for-profit companies but also some voluntary sector organisations. Many people will also have this care organised and purchased by their local authority, though many people with disabilities directly employ individuals (‘personal assistants’) to provide their care and support.
How much does the government spend on social care?
In England, the 152 local authorities individually decide what they will spend on social care – there is no ‘national’ government budget (though the amount local authorities have available to spend is influenced by the income they receive from central government). In 2018/19, the total expenditure on adult social care by local authorities was £22.2 billion, up £800 million from the previous year. However, in real terms (ie, adjusting for inflation), total expenditure is still £300 million below the level it was in 2010/11, despite increasing demand for services.
Just under half of this expenditure is on working-age adults, with the remainder on older people. For older people, the majority of spending (66 per cent) is for those who need physical support, while for working-age adults the majority (70 per cent) is for those with learning disabilities.
How much do individuals spend on social care?
The National Audit Office has estimated that in 2016/17 people spent £10.9 billion on privately purchased social care.
Many people who receive publicly funded social care are also expected to contribute towards it from their income. In 2018/19, of the total £22.2 billion spent by local authorities on social care, user contributions made up £2.9 billion. This figure has risen in each of the past four years.
What is the cost of receiving adult social care?
In 2018/19, the average cost of a local authority-funded care home place for someone aged over 65 was £636 a week. For working-age adults, the cost was £1,320 a week. In 2018/19, local authorities, on average, paid £16.86 an hour to commission externally provided home care services.
There are no precise figures on spending for people who fund their own care, though the Competition and Markets Authority estimated that care home fees paid by ‘self-funders’ are, on average, 41 per cent higher than those paid by local authorities for places in the same care homes.
How many people receive adult social care in England?
In 2018/19, 841,850 people received publicly funded long-term adult social care, primarily in care/nursing homes or in their own homes. In addition, there were 223,605 episodes of short-term care provided.
Is demand for social care rising?
Yes. Demand for adult social care has been growing in recent years. In 2018/19, there were 1.9 million requests for social care support, more than 100,000 more than in 2015/16. This increasing demand is driven by a growing older population and an increasing incidence of disability among working-age adults.
However, local authorities do not meet all demand for social care. To qualify for publicly funded adult social care, people must have high levels of need and, unlike the NHS, must also have low income and/or assets.
How many people work in social care in England?
In 2018, it was estimated that just under 1.5 million people work in adult social care in England, in 1.1 million full-time equivalent jobs (similar to the NHS). This includes approximately 840,000 care workers, 87,000 senior care workers and 41,000 registered nurses. Most social care staff are employed by small and medium-sized private providers (of which there are around 18,500). There are also approximately 145,000 roles directly employed by individual users of care services.
How many people who request social care actually get it?
In 2018/19, local authorities received 1.9 million requests for support from new clients. Around 3 in 4 people received some help, though only around a quarter were assessed as eligible for formal short-term or long-term care.
550,000 requests were from working-age adults, of which 98,000 (18 per cent) received formal short-term or long-term care, and 1.4 million requests were from older people, of which 401,000 (29 per cent) received formal short-term or long-term care.
Are people happy with the quality of care they receive?
2018/19, 64 per cent of users of publicly funded social services said they were extremely or very satisfied with the services they received and a further 25 per cent said they were quite satisfied. These numbers are broadly unchanged from 2014/15. There are no figures about satisfaction levels of people who pay for their own care.