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Social care services: funding cuts are biting hard


When we were writing last year’s Social care 360 report we found an appropriate name for a key, v-shaped graph showing the divergence between the number of people requesting social care support from councils and those receiving it. We called it the ‘crocodile’s mouth’ graph, partly because the slightly sinister tone (never smile at a crocodile) reflected a rather worrying trend – more people were asking for support but fewer were receiving it.

The bad news is that the latest data for 2018/19 shows the crocodile’s mouth has opened even wider. Compared to 2015/16 (the last year for which we have equivalent data), requests have grown by six per cent but the number of people receiving formal care packages has fallen 2 per cent.

Line graph showing More people are requesting adult social care support but fewer people are receiving it

However, the ‘crocodile’ name is also appropriate because, like the animal’s reputation for fake tears, the graph is somewhat deceptive. Combining the numbers for both working-age adults and older people, obscures two rather different trends.

For working-age adults, the trend is one of a large increase in demand (ten per cent since 2015/16), with the number receiving long-term care up three per cent (six per cent if short term care is included). For older people requests for support are up four per cent since 2015/16 but the number receiving long-term care is down seven per cent (five percent including short term care). These trends tell different stories (and only the graph for older people looks like our old friend, the crocodile’s mouth).

Two line graphs showing The pattern in the trend for requests versus receipt of social care support is different for working age adults and older adults

We said in Social care 360 that the differing trends might be explained, at least in part, by differing rates of reported disability among older people and working-age adults (and we also touched on possible reasons for the wider trends on access). We’ll examine this further in our 2020 report, when we will have the most recent data on disability prevalence.

This deceptive difference between working-age adults and older people is also in evidence when we look at the newest figures on costs to local authorities of purchasing residential and nursing care. Here, the trend for both is going in the same, upward direction – both have increased faster than inflation, as commissioners respond to providers leaving the market or handing back contracts (in turn driven in part by the extra costs of staff).

Yet the increase for over-65s at more than 10 per cent since 2015/16 is far higher than for 18–64 year olds. One reason for this difference may be that costs of placements for working-age adults are so much higher to begin with – virtually double that of placements for older people. Local authorities may feel there is more scope for cost-minimisation with these packages than with those for older people.

Still, with costs of both increasing faster than inflation it puts one final trend into perspective. Total expenditure by councils has risen since 2014/15, as government has recognised the crisis in the sector and responded with short-term cash for local authorities. Yet, as with the crocodile graph, this is somewhat deceptive. First, much of that expenditure will, inevitably, have been on the increasing costs of purchasing care rather than providing it to more people. And second, despite these increases in expenditure, real-terms spending is still £300 million below where it was in 2010/11.

Very little, then, to smile about.