Insights

Mark Raeburn: 7 minute read

How Covid-19 has impacted adult social care budgets

Adult social care is underfunded. This is not news but the fact that Covid-19 has accelerated the problem and propelled it to a new level, where imminent failure is possible, is. According to the recent ADASS Budget Survey, The risk of already fragile care markets failing has significantly heightened as a result of the impacts of Covid-19.

Covid-19 has changed the world in which we live. It has brought with it the immediate need to safeguard widespread parts of society. This we accept and embrace but where there is compassion, there are funding considerations. The unprepared nature in which Covid-19 caught the world meant that the industry was caught unaware. Many unexpected costs such as deep cleaning and additional PPA have co-incided with reduced occupancy and the increase in the national living wage. All of which has been necessary and justifiable but has left many local authorities worried about the future and how they will continue caring for the most vulnerable members of society.

Without government intervention, families will be impacted

Pressure has been placed on adult social care for the last decade. Living with cuts and restrictions is something that has become synonymous with the sector. Departments have been required to think smarter about the services they deliver. Investments in the future rather than the present are prioritised in order to future proof services. This is the focus, to continue delivering services in the best ways possible under shrinking budgets and increased demand. The arrival of Covid-19 has required emergency planning, additional supplies and the withdrawal of savings. Many local authorities have been required to dip into their reserves and this situational is not feasible in the long run.

Without significant financial intervention from the Government, the lives of people who use social care and their family carers will be seriously impacted in terms of their lives and wellbeing.
ADASS Budget Survey 2020

The consistent tightening of the budgetary strings from the government, combined with the arrival of Covid-19 will create a battle for services. Without the money to enable more than just the basic services within each area, people will, as the ADASS report eludes to, be seriously impacted. This is a situation that no-one wishes to consider and without putting actions in the government’s hands, they need to consider the most vulnerable when it comes to the budget. 

Costs to local authorities have outstripped funding available

The emergency funding that has been provided by the government is not enough. The sector will face additional costs relating to Covid-19 of more than £6.6 billion by the end of September. This is according to a high-profile report by industry experts, LaingBuisson, commissioned by the Local Government Association and ADASS.

These costs relate to additional PPE equipment, deep cleans and additional staffing costs. This is more than double the current level of emergency funding that has been made available. As of this month, the government has made £3.2bn in emergency funding available to local authorities, of which, adult social care currently has access to half of this amount. This fund has been set aside to support local government and its response to Covid-19. Along with £600m of funding from the Infection Control Fund, adult social care currently has a funding total of £2.2bn to work with (£600m from the Infection Fund and half of the Emergency, £3.2bn fund, from the government to support local authorities).

From this research we can see a large gap in funding and something will need to give. Cutbacks and withdrawals from emergency council funds will be inevitable. Local authorities will look at every option available but at the time of writing, and without additional funding, some services may be stripped back to the bare minimum. This is also assuming that by delving into emergency pots and non-essential service cuts, local authorities will be able to meet their statutory duties.

Risks to the care market have increased

The margins in which some care homes operate are minor. Between staffing costs, food, activities and care, many have been forced to close their doors over the last five years. According to the Telegraph, over the last eight years care home closures have exceeded the number of new openings. This, in 2019 resulted in the total loss of more than 20,000 beds.

There have been more than 600 openings of care homes in England this year, but in excess of 900 closures, leading to a total loss of 23,452 beds, according to data commissioned by The Telegraph from the Care Quality Commission, England’s health and social care watchdog. 
The Telegraph in 2019, Number of new care homes outpaced by closures

The continued closures are a reflection of a market in turmoil and in direct comparison to a decade ago when more than 7,000 new sites were introduced. Austerity has had a major impact when it comes to the stability of the market. It is something that has been raised before as a cause of concern, the risk of the market collapsing. These risks have been significantly heightened as a result of the impacts of Covid-19.

The increased costs faced by care providers, such as purchasing PPE at an inflated cost and a reduction in the occupancy of care homes in most areas has increased the likelihood of a significant number of providers, or a large provider, going out of business. This will be to the detriment of those people who need to access care and support services.
ADASS Budget Survey 2020

Directors are less than 4% confident

Only 4% of respondents are fully confident that their budget will be sufficient to meet their statutory duties this year, down from 35% in 2019/20.
ADASS Budget Survey 2020

Less than two thirds of Directors being confident in their budgets to meet statutory duties is worrying enough, but lower that down to 4% and the fear digs in. 4% of the Directors questioned for the survey feel as though their budgets will be sufficient. This is worrying and begs the question of how it has gotten to this stage? The true measure of a country is how it treats its most vulnerable members.

The reason for this worry could easily be laid at the doorstep of the government but would that be entirely fair? Individual local authorities need to also be held accountable. Have they invested in solutions that save time and money? Did they focus in the areas required to help those who are vulnerable and rely on services first? Regardless of where the blame lies, in the present, the diminishing confidence of Directors being able to meet their statutory duties is of great concern. This will mean difficult decisions in regard to the number of services provided and for those that are delivered, what level and quality will these be mandated to?

The ability of local authorities to ensure that people have access to social work, care and support and safeguarding services will directly impact on the ability of individuals to lead the lives they want to lead.
ADASS Budget Survey 2020

Those who work in adult social care deserve to be rewarded

Whilst the NHS is traditionally the vote winning entity, the public is beginning to see how important social care is. Not just those who work within adult social care but as a whole. The move towards a living wage is one that we can applaud but there is more than can be done. Even with the move towards a standardised wage, there is still a gap between the money that is provided to those in social care and those in the NHS.

A long-term plan for social care is urgently needed to redress the balance. We have all been waiting for years for the Green Paper and with the arrival of Covid-19, it may be something that is relegated history. The social care workforce needs to be rewarded for their compassionate, committed, highly skilled and essential work. The move towards a living wage is great for workers but if the additional cost for employers leads to the home going out of business, then is it fair? Workers need to be rewarded for their contributions but without input from the government, it will simply lead to additional closures.

The arrival of Covid-19, reduced occupancy, the need for councils to deliver balanced budgets and the National Living Wage are putting pressure on the system. With little committed to the sector over the next year, it is difficult to see any other conclusion than more homes closing, which will lead to longer stays in hospital.

If we truly value our social care workforce, significant additional funding is required to provide a wage deal for our care staff. ADASS would like to see a ‘social care minimum wage’ as well as more funding for training and development, coupled with career progression across the in social care, social work and the NHS.
ADASS Budget Survey 2020

What can we do?

As individuals, see health and social care as a whole, two sides of the same coin, with the same shared desire to care. This will help the issue of lack of social care funding within parliament. Moving it from something that is easy to ignore to something that is on par with NHS funding is the goal here. We need the government to accept that the NHS and social care are as important as each other. Budget cuts lead to the NHS picking up the pieces, which is not fair on anyone, each sector needs to be effectively funded and have plans for the future.

Rather than looking at Health and Social Care in terms of winning votes, they should be seen as essential national assets. We should take lessons from nations such as Japan, who look ten years into the future. To reduce the near 100,000 vacancies in adult social care, we need to look at the long-term future, with the health and social care working in harmony.

At OLM, we join our voices with those from ADASS, when they call for…‘a ‘social care minimum wage’ as well as more funding for training and development, coupled with career progression across the breadth of social care, social work and the NHS.

Working together is what we need to do right now and for the future. Working in isolation can only ever benefit individuals. By looking at problems, drawing on the experience of the many, rather than the few is what will make a difference when it comes to working in health and social care.

To conclude

Covid-19 has not created these short fallings within funding. It has brought them to life and accelerated the failure curve. The gaps that are now glaring back at us are the manifestation of years of mismanagement. Constant calls for long term funding plans have fallen by the wayside in favour of short-term gains. Brexit and Covid-19 have brought to light where the cracks in the system are and now, we need to fill them in.

No longer is it acceptable to look at the short term. There is a need with Covid-19 to look at this but at the back of everyone’s mind should be, how do we get out of this? How do we plan to ensure that those who are vulnerable are safeguarded? This should be the number one consideration that we all have in mind. The short term is critical but even more essential is how do we weather this storm and emerge in 2021 to sunnier waters?

By working together, we can create a future in which funding issues are reduced. We need to invest as a nation to create an identity for ourselves post-Brexit. We need to show that throughout all of this turmoil, we considered those who are vulnerable. This is the long-term future of the United Kingdom, to be one nation that care for all and considers their needs. Cross-party consensus is required to ensure that politics play no part in future funding discussions. This is our chance to show that we care.