The decline in government funding for people with social care needs continues. Recent warnings from ADASS and others over the sustainability of the social care provider market will not seem unduly alarmist to those working in the sector (as outlined in Richard Humphries’s recent blog). Nor will Norman Lamb’s comments, during last week’s Lib Dem party conference, that the health and social care system could collapse within the next two years without a funding increase.
For a couple of years now, we have been commenting on social care spending by local government. We reported that from 2009/10 to 2013/14, net current expenditure on older people fell in real terms by 16 per cent and that spending on home and day care services reduced by almost a third. Such a dramatic decrease does lend some credence to warnings of an imminent threat to the stability of the social care sector.
Last week, provisional spending data were released for 2014/15, alongside an accompanying report that provided a few reflections on the trends over time. However, a change in methodology for how this information is collected means that it will be harder, if not impossible, to compare the amount local authorities are spending on social care services in this level of detail, prior to 2014/15.
This is clearly concerning. Not being able to track spending levels means we will be less able to follow changes and understand their consequences.
However, we have always known that spending data only tell a partial story. For example, they are not able to describe how local authorities, social care providers, NHS providers and the voluntary sector have been working together at the local level to minimise the risk of reduced services to people and their carers.
Nor do they give a clear picture of how these same pressures are impacting on less visible and less vocal groups: those in need of support and their carers.
Last week, the government also released data from its second biennial Carer’s Survey. It sheds some light on how these groups have coped.
A few small but statistically significant changes are worth noting. Carers surveyed indicated that the number of hours spent caring per week has increased – with 38 per cent reporting that they spend over 100 hours per week caring for someone (up from 36 percent in the 2012/13 survey). Unsurprisingly, there was also an increase in the number of people who were unable to work as a result of their caring responsibilities; in 2014/15 one-fifth of carers who responded indicated this was the case.
This increased time spent caring has meant that fewer carers felt able to look after themselves adequately and only 40 percent reported ‘I feel I have encouragement and support’ in their caring role (down from 43 percent). There were also reductions in the proportion of carers who felt able to ‘spend my time as I want, doing things I value or enjoy’ (from 22 to 20 percent of respondents) as well as reductions in the proportion who felt that they had as much control over their daily lives as they wanted (from 29 to 27 percent).
In other words, the situation is getting increasingly difficult for carers.
We know that commissioners and providers are working to mitigate the negative consequences for carers and service users. But we are less certain how they are going about this and what effect these actions are having.
That is why we've just launched a joint Nuffield Trust and The King’s Fund project. We will take a closer look a small number of local authority areas, using qualitative research methods to supplement national and local data, to create a picture of what is happening on the ground to commissioners, providers (social care and NHS), carers and the people in need of care and support.