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New adult social care report flags up increase in demand from 18-64-year-olds 

25th March 2021 about a 4 minute read
The figures reveal a large decrease in older adults supported in the community and a small increase in those receiving care in a residential or nursing home.

A new report aims to provide a snapshot of adult social care in England through the lens of data collected by NHS Digital.

It reveals growing demand on local authorities for social care support with social care expenditure continuing to rise.

Meanwhile the number of older adults receiving local authority long-term support has decreased, although short-term support has risen.

Numbers of staff directly employed by local authorities in the care sector have increased, and vacancies have decreased.

The report charts trends over the last five years up to the latest available data (2019-20), but also includes some early figures from mid-year 2020-21.

It highlights a lack of data for the adult social care sector compared to the health service. This makes it harder to understand how the two overlap or integrate. 

The authors note: “This has especially been brought to the fore during the coronavirus (COVID-19) pandemic. It will take significant investment and a long time to address the data gaps fully”.

The report highlights the fact that there are close to 2million requests for support with social care services for new clients each year. This demand is growing in line with population increases.

Over the last five years, there has been a striking increase in new requests in the 18-64 age group.

Other types of demand for local authority social services, such as adult safeguarding and applications to authorise deprivations of liberty (DoLS), have also increased.

However, early indications for April-September 2020 are that new referrals for safeguarding and DoLS have slowed or fallen. This may be as a result of the knock-on impact of the coronavirus pandemic.

A far larger number of clients receive ongoing long-term support compared to those receiving short-term support. But the number and proportion of older people receiving state-supported long-term care is decreasing.

It is not clear if this results from prevention work, early intervention and promoting independence, or whether it represents unmet need.

The figures reveal a large decrease in older adults supported in the community. There has been a small increase in 2019-20 for those receiving care in a residential or nursing home.

Early indications for 2020-21 suggest that there have been further decreases in the number of clients, especially older people, in receipt of long term social care support. 

This is especially evident towards the end of the first national lockdown in June 2020.

In terms of the main reason for local authorities supporting clients, decreases are seen for older adults receiving physical support such as support for personal care.

Expenditure has risen by 6% in real terms (above inflation) in the last five years, to £19.7bn, following a period of decline after 2010... this is likely to have been influenced by the introduction of the national living wage and the addition of the social care precept to council tax in 2016.

Workforce

The increased expenditure in recent years is in-part driven by more spending by local authorities on outsourced provision, from 74% in 2015-16 to 77.4% in 2019-20.

Numbers of jobs in local authority adult social care have increased in the last three years, and vacancies have decreased.

The type of role employed directly by a local authority has changed slightly – moving away from direct care staff towards other types of role, including managerial and professional.

User experience

The report notes that satisfaction of service users with their care has been relatively stable over recent years.

Adults aged 18-64 have consistently been more satisfied than older people.

A majority of service users have positive feelings about how they are treated and how much choice they have over the services they receive, although this has decreased slightly in the last two years.

In the latest year the proportion of delayed transfers from hospital into social care has increased slightly. The report says this increase is not attributable to adult social care services.

In 2020-21 this figure will be greatly impacted by operational protocols used in the pandemic.

Carers

The report points to evidence that carer quality of life scores are decreasing over time. Just over 50% of unpaid carers reported a negative impact on their health, and almost 20% have experienced financial difficulties.

Satisfaction levels of unpaid carers (which relate to the support they receive as a carer, or the services that their cared-for person receives) have fallen.

Carers in the younger age category are less satisfied than older adults.

Data gaps

The report authors also highlight significant data gaps. They say in order to better understand the picture of adult social care, more data is needed in the following areas:

  • Demand – Local authorities do not have sufficient data on unmet need, informal care or self-funders/part funders.
  • Providers of adult social care – There is a lack of data from care homes, domiciliary care organisations and charities.
  • Outcomes – More data is needed to measure quality of care and also short-term care.

The authors add that more needs to be done to include seldom listened to groups such as service users without mental capacity and those whose first language is not English.

A copy of the full report is available here