Social Care Funding (2019)
On Tuesday 1 October, there will be a Westminster Hall debate at 2.30 on Social Care Funding.
The House of Commons Library has published a number of briefing papers relating to the issue of social care funding in England.
The Library paper Adult Social Care Funding (England) examines the key funding pressures facing adult social care services in England and evidence of the impacts of these pressures on social care and health services. The paper explains the additional short-term, ring-fenced funding that has been committed to adult social care between 2016/17 and 2019/20, and outlines concerns about a social care funding gap and financial uncertainty post 2020. In the September 2019 Spending Round announcement, the Government announced an additional £1 billion for adult and children’s social care in 2020/21, and said it would consult on a further 2% Adult Social Care precept to enable local authorities to access an additional £0.5 billion.
For information on the current social care means-test for individuals, see Social care: paying for care home places and domiciliary care (England). In summary, care home residents with assets less than £23,250, are eligible for local authority funding support for their residential care (care home) (although they are expected to contribute their income towards the cost); those with assets over £23,250 are expected to pay for their care in full. Local authorities have discretion to set a more generous means-tests for those in receipt of domiciliary care. The value of someone's home is only included in the means test for care home residents, subject to some exemptions.
There is no limit on the amount that people can spend on their social care: the recommendations for a lifetime cap on social care spending by individuals, and also a more generous means-test, made in 2011 by the Commission on the Funding of Care and Support (chaired by Sir Andrew Dilnot) were both deferred by the May Government in July 2015 before being indefinitely postponed.
In March 2017, the May Government committed to publish a consultative Green Paper on social care which it said would set out proposals to “ensure that the care and support system is sustainable in the long term”, including how people pay for social care. The Green Paper has yet to be published, having missed five publication dates announced by the Government; the latest position, as first stated in December 2018, is that it will be published at the "earliest opportunity".
However, media reports indicate that the new Prime Minister may publish a White Paper instead, which would be expected to detail the new policy approach. Further information is available in the Library briefing paper, Adult social care: the Government’s ongoing policy review and anticipated Green Paper (England).
The following Library briefing papers look at other proposals made by Conservative, Coalition and Labour Governments in recent years:
- Social care: Government reviews and policy proposals for paying for care since 1997 (England)
- Social care: the Conservative Party's 2017 General Election pledges on how individuals pay for care (England)
- Social care: Announcements delaying the introduction of funding reforms (including the cap) (England)
- Social care: how the postponed changes to paying for care, including the cap, would have worked (England)
The Library paper Social care: care home market – structure, issues, and cross-subsidisation (England) discusses some of the wider issues and pressures faced by the sector, while the Four Seasons Health Care Group – financial difficulties and safeguards for clients paper considers the issues being faced by one of the largest care home providers.
At the Labour Party Conference in September 2019, the party announced that it would introduce free personal care for older people if it came to power.
Social care expenditure
A large proportion of social care funding comes from the local government finance settlement and is not ring-fenced. As such it is not possible to identify an overall funding allocation for social care. However, is it possible to track changes in expenditure on adult social care services over time.
Between 2010/11 and 2018/19, local authority expenditure on adult social care in England increased by 12%, from £14.4 billion to £16.1 billion. However, in real terms this represents a reduction of -2% from £16.5 billion down to £16.1 billion. Real terms expenditure had fallen year on year between 2011/12 and 2015/16. However, since 2016/17 both cash and real terms expenditure have increased year on year.
Sources:
DCLG Local authority revenue expenditure and financing
Scotland, Wales and Northern Ireland
For more information about the system elsewhere in the UK, see:
- the Welsh National Assembly's briefing, Paying for adult social care in Wales: Debate and Reform. The Welsh Government increased the amount of capital that a person can keep without having to use this to pay for their residential care: for more details see this press release from April 2019 and related factsheets.
- the Scottish Government's webpages on Charging for Residential Careand Free Personal and Nursing Care (available for those over 65 years old and assessed as needing care).
- the Northern Ireland Executive’s website on Your home, your assets and your residential care or nursing home fees. Citizen's Advice also has a useful page on Social care and support, which considers the funding of domiciliary care in Northern Ireland.
Parliamentary debates:
- Local Government and Social Care funding, HC deb 24 Apr 2019, volume 658, cc763-846.
- Leaving the EU: Health and Social Care, HC deb, 19 Mar 2019, volume 656, cc266WH-286WH
- Social Care: funding, HC deb 17 Oct 2018, volume 647, cc725-753.
- Social Care: Funding, HL deb 05 Jul 2018, volume 792, cc681-695.
- Adult Social Care: Long-term Funding, HC deb 28 June 2018, volume 643, cc1065-1072.
- The Long-term Sustainability of the NHS and Adult Social Care, HL deb 26 Apr 2018, volume 790, cc1660-1690
- Social Care, HC deb 25 Apr 2018, volume 639, cc931-984
- Social Care, HC deb 25 Oct 2017, volume 630, cc312-358
- Council Funding and Social Care, HC deb 22 Feb 2017, volume 621 cc377-399WH
Further reading
Exiting the EU: supplying the health and social care sectors, National Audit Office, 27 September 2019
The “front door” to adult social care, Wales Audit Office, 12 September 2019
Spending Round 2019: what you need to know, HM Treasury, 4 September 2019
Creating a learning culture in social care. What can we learn from local authority complaints reports?, Healthwatch, August 2019
Social care funding: time to end a national scandal, House of Lords Economic Affairs Committee, 4 July 2019
Adult social care enquiry, All-Parliamentary Group on Adult Social Care, 4 July 2019
One year on: the LGA green paper for adult social care and wellbeing, Local Government Association, July 2019
Care Deserts: the impact of a dysfunctional market in adult social care provision, Age UK, May 2019
Social Care: free at the point of need. The case for free personal care in England, Institute for Public Policy Research, May 2019
Fixing the care crisis, Centre for Policy Studies, 29 April 2019
English council funding: what’s happened and what’s next?, Institute for Fiscal Studies, 29 May 2019
Social care 360, The King’s Fund, April 2019.
The state of health care and adult social care in England 2017/18, Care Quality Commission, October 2018
The lives we want to lead: The LGA green paper for adult social care and wellbeing, Local Government Association, July 2018
Adult social care at a glance, National Audit Office, July 2018
Unpaid Care, Parliamentary Office of Science and Technology, July 2018
Better Health and Care For All: A 10-Point Plan For The 2020s, IPPR, June 2018
Long term funding of adult social care inquiry, Housing, Communities and Local Government Committee, report published 27 June 2018
A fork in the road: Next steps for social care funding reform, King’s Fund, May 2018
Behind the Headlines: the battle to get care at home, Age UK, May 2018
The state of adult social care services, Care Quality Commission, April 2018
Approaches to social care funding, King's Fund, February 2018
The adult social care workforce in England, National Audit Office, February 2018
Carers, House of Commons Library, November 2017
The Long-term Sustainability of the NHS and Adult Social Care, Select Committee on the Long-term Sustainability of the NHS, April 2017
Adult Social Care Inquiry, Communities and Local Government Select Committee, March 2017
State of Care 2016/17, Care Quality Commission, 2017 (in particular pages 52-61)
The state of adult social care services 2014 to 2017, Care Quality Commission, 2017
Older People's Care Survey 2017, Family and Childcare Trust, 2017
'Why call it care when nobody cares?', Age UK, 2016. The results of 127 interviews regarding the quality of social care people have experienced.
The failure of privatised adult social care in England: what is to be done? Centre for Health and the Public Interest, November 2016
Social care for older people, King's Fund, September 2016