Closures and soaring waiting lists: crunch time for social care services

‘Red lights are flashing’ warns care boss, in advance of the government’s social care white paper

Social care services across England are “rapidly deteriorating”, with waiting lists soaring and councils struggling with care home closures, social services chiefs have warned.

Long-term waiting lists have almost quadrupled and 1.5m hours of necessary home care were not delivered in the three months to November, amid a deepening staffing crisis going into winter.

“Red lights are flashing right across our dashboard,” said Stephen Chandler, president of the Association of Directors of Adult Social Services (Adass), which ran a survey of 85 councils. “Older and disabled people are suffering.”

Half of councils have had to respond to a care home closure or bankruptcy in the last six months.

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The bleak assessment comes ahead of the government’s social care white paper, scheduled for Tuesday, which is expected to propose a new strategy for pay and career development for care staff amid an exodus of workers, who currently earn on average just over £9 an hour, to higher-paying employers including Amazon.

Downing Street is under growing pressure to deliver on Boris Johnson’s promise in 2019 that he would “fix the crisis in social care once and for all”. Last week details of a plan to cap care costs at £86,000 sparked a Tory backbench rebellion when it emerged that England’s least wealthy people would still face the sale of their homes to pay for care, while richer people would get to keep a greater share of their wealth.

Sajid Javid, the health secretary, promised council leaders last week the imminent reforms would mean everyone had the choice and control to live independent lives, everyone could access outstanding personal care, and that adult care and support would be there for everyone who needed it. But the government has so far only pledged £1.8bn a year in additional money for social care after the Covid pandemic exposed its fragility. MPs and care experts believes the sector needs an extra £10bn a year.

Adass’s snapshot survey covering the period from August to October suggests close to 400,000 people are now waiting for an assessment for their needs. The number waiting for six months or more has surged from 11,000 reported in September to over 40,000 now.

“This survey confirms our worst fears,” said Chandler. “The government must now acknowledge the scale of the crisis and step in with emergency funding and measures to ensure we can get through the winter ahead.” It is calling for urgent £1,000 bonus payments to retain exhausted care workers. £500 payments have already been made the devolved health and care authorities in Scotland and Wales.

There are well over 100,000 vacancies in England’s social care workforce, and tens of thousands of staff who declined to be double-vaccinated can no longer work under legislation making jabs a condition of employment. Not-for-profit care home chain MHA, which lost 150 staff to the vaccine mandate, is among operators to close some of its homes to new admissions because of staff shortages, which in turn blocks up the NHS discharge system.

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A survey of care workers by the trade union Unison also found that staff shortages meant people were “dying without dignity” and in some cases there were not enough staff to sit with people in their final hours. A third of those surveyed said staffing levels were “dangerously low”.

Javid told council leaders last week that when the social care white paper is published, “people will see how serious we are about the workforce”, and he said “as the NHS was born out of the second world war”, the government wants to “make a change that lasts for generations”. He said he had been concerned to see a young care worker on a BBC TV documentary, fronted by Ed Balls, say he was planning to become a paramedic or nurse because of the lack of career paths in care.

A government spokesperson said: “We are committed to delivering world-leading social care. That’s why we are investing an additional £5.4bn over three years, which will allow us to build our comprehensive adult social care reform programme. Care homes and home care providers are already benefiting from the new £162.5m workforce retention and recruitment fund to assist local authorities and care providers in working together to ease workforce pressures in a variety of ways.”