Social care reforms could make local care markets ‘unsustainable’, report warns


The government’s social care reforms will protect more people from large care costs but will not improve access to care and could make local care markets ‘unsustainable’, a report has warned.

The State of Care in County & Rural Areas report by the County Councils Network (CCN) and Rural Services Network (RSN) expresses concern that the majority of funding from the Health and Social Care Levy will go to the NHS.

Councils warn that the proposals will not improve eligibility for thousands currently below the criteria to access care services. Their analysis shows 58%, or 545,000, of people who made a request for care were refused last year because of tightening eligibility due to financial pressures.

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While welcoming a cap on care and a means-test threshold, as well as the intention to publish a White Paper, the report warns the reforms will not address existing problems in the sector while making local care markets unsustainable by allowing private fee payers access to council arranged care at lower fee levels.

Self-funders cross subsidise the market by paying 40% on average more than councils for care, creating a £761m fee gap.

Councils say it is uncertain whether the £5.4bn committed for reforms and paying for a ‘fairer price for care’ will be enough.

Between 2018 to 2021, 227 care homes closed in county and rural areas, with more potentially to come.

Councils are also concerned that the impact of the National Insurance rise could incur bigger costs for care fees in the short-term, and negatively impact on pay for carers, exacerbating issues within the social care workforce which already has thousands of vacancies.

Cllr Martin Tett, County Councils Network Adult Social Care Spokesperson, said: “Unlike successive governments, this administration has grasped the nettle and set out the first attempts at reforming the adult social care system in a generation.

“However, these reforms, and the sums committed, fall short of truly addressing all the issues within the social care system and could have unintended consequences, including destabilising county care markets. They will not address existing challenges, not least in improving eligibility for the hundreds of thousands unable to access to services.”

A Department for Health and Social Care spokesperson said: “We are committed to the delivery of world-leading health and social care across the whole of the UK and the new £5.4bn funding for the sector announced last week will allow us to begin a comprehensive programme of reform for adult social care.

“As part of this additional funding we have committed to support local authorities to move towards paying a fair rate for care. We will continue to work with the sector on reform and will publish further details in the White Paper later this year.

“To support the adult social care sector through this global pandemic we have provided over £2bn in specific funding, in addition to more than £6bn that has been made available to local authorities to address pressures on their services.”

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The author Lee Peart

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