Many care providers in England are living hand to mouth and the Government appears “complacent” about the potential for local markets to fail, MPs have warned.
The coronavirus pandemic has highlighted how “care is not properly funded, lacks transparency and urgently needs reform”, according to the latest report from the Public Accounts Committee (PAC).
The impact of Covid-19 on the social care sector has put many providers at risk of failing, the report says, with care home occupancy having fallen from around 90% at the start of the pandemic to 80% by February 2021.
But it says the Government has poor oversight and “seems complacent about the risks of local market failure”.
A key failure is the Department of Health and Social Care’s “reticence” to challenge local authorities who pay providers low rates for care, the MPs say.
They are calling for long-promised reforms, including a funding settlement and workforce strategy, to be set out by the end of the year.
The Government must lay out in detail how it will help providers move beyond the short-term support that has helped stabilise the sector during the pandemic.
The report, Adult Social Care Markets, says that most local authorities in England are paying providers below the cost of care.
It says this means many providers are forced to live “hand to mouth”, unable to take the long-term decisions which would improve services.
They also warn of a lack of transparency about what people or local authorities get for the money they spend.
The report calls for the Government to assess and outline, by July, the support providers need in the short to medium term.
It also says providers should give clear and comparable information over fees and a breakdown of how this money is spent from next April.
Committee chairwoman Meg Hillier said: “Carers, younger and older adults needing care, and home care have seen decades of neglect, and the 1.5 million who work in care deserve much better.
“The reforms to address this now must include a long-term funding plan that allows local authorities and providers to innovate and improve services. We cannot afford more broken commitments on care.”
If current (pre-Covid-19) patterns of care and current funding systems continue, the Department projects there will be a 29% increase in the number of adults aged 18 to 64 and a 57% increase in the number of adults aged 65 and over requiring care by 2038 compared with 2018.
It comes as the Association of Directors of Adult Social Services (Adass) said local authorities are facing a “deluge” of requests for support as society opens up.
A survey of more than 90 directors between March 19 and April 21 found that 69% are seeing more people referred for support from the community, 68% are seeing more people with mental health issues, and 67% are seeing more people seeking support due to a breakdown in carer arrangements.
They fear people will have to wait longer for less care and support unless the Government steps in with more funding and launches its long-awaited social care reforms.
Adass president Stephen Chandler said: “Some of the numbers we are seeing are phenomenal. The trends are unsustainable and show why the Government must publish its plans for social care as a matter of urgency.
“Our findings demonstrate very starkly that the crisis in social care is not just a crisis in the way we support older people. Half our spending is on help for adults of working age.”
A Department of Health and Social Care spokesperson said: “Throughout the pandemic we have sought to protect everyone working in the social care sector or receiving social care, particularly older people who are more vulnerable to the virus, and have provided almost £1.8 billion for the sector, including infection prevention, control measures and prioritised the sector for the vaccine.
“As previously announced, the Health and Care Bill will introduce plans to develop and support improved adult social care oversight across England.
“We are committed to sustainable improvement of the adult social care system and, as affirmed in the Queen’s Speech, we will bring forward proposals later this year to ensure every person receives the care they need, provided with the dignity they deserve.”