Half a million people in England waiting for home care and 'situation is getting worse not better'

Over half a million people in England are waiting for home care, an adult social care assessment, a review of their care or a direct payment to begin and the ‘the situation is getting worse not better’.

The findings from ADASS (Association of Directors of Adult Social Services) reveal that as of 28 February 2022, a total of 506,131 people were waiting for assessments, reviews, and/or care support to begin.

This is nearly double the 294,353 people reported as waiting in September 2021. In addition, ADASS found nearly 170,000 hours a week of home care could not be delivered because of a shortage of care workers during the first three months of 2022, a seven-fold increase since Spring 2021.

Sarah McClinton, ADASS president said: “We have not seen the bounce back in services after the pandemic in the way we had hoped. In fact, the situation is getting worse rather than better.

“Social care is far from fixed. The Health and Social Care reforms go some way to tackle the issue of how much people contribute to the cost of their care, but it falls short in addressing social care’s most pressing issues: how we respond to rapidly increasing unmet need for essential care and support and resolve the workforce crisis by properly valuing care professionals.”

Over six in 10 councils that responded to the survey by ADASS say they are having to prioritise assessments and are only able to respond to people where abuse or neglect is highlighted, for hospital discharge or after a temporary period of residential care to support recovery and reablement.

ADASS warns that the growing numbers of people needing care and the increasing complexity of their needs are far outstripping the capacity to meet them and more people are being left without essential care to maintain their health, and dignity and lead good lives in their communities.

Dr Jane Townson, chief executive of the Homecare Association pointed out that the vacancy rate in home care has continued to rise over the last year, with the latest data from Skills for Care showing a new high of 13.5 per cent.

Workforce shortages plus the impact of Brext, Covid and international conflict leading to a rise in the cost of living are all affecting care providers.

Dr Townson added: “Many homecare providers are operating with slim margins and are unable to charge their customers high enough fees, as the latter are public sector organisations with monopsony purchasing power.

"Far from fixing social care, the government’s policies are steadily weakening it. This affects all of us. In addition to high levels of unmet need in the community, NHS hospitals are struggling to discharge people back home due to inadequate capacity in home care. Prolonged stays in hospital when people are ready to go home increase the risk of infection and deterioration in physical and mental health."

'Grim reading'

Caroline Abrahams, charity director of Age UK called the figures of people waiting for care “grim reading” and added “behind them are real older and disabled people whose lives are being sadly diminished by lack of essential support.

“They highlight how desperate things are at the moment in social care, because of shortages of money and staff, so I hope ministers will stop trying to claim that they have 'fixed' social care.”

Dr Rhidian Hughes, chief executive of the Voluntary Organisations Disability Group (VODG), said: “It is crucial we do not ignore the picture these words paint about delayed assessments and care. We are facing the very harsh reality of preventative and community services being pulled back, which will have profound consequences on the quality of life for disabled people and their families.

“Today, the government can choose to prioritise social care funding and enable essential services to be put back on a sustainable footing. The call being put forward by directors of adult social services across the country for a longer term funded plan is exactly the right one, and we hope the government chooses to heed their message and take urgent action.”

Not only are people waiting longer for care assessments, reviews, care packages and personal budgets, but family carers are having to shoulder greater responsibility and are being asked to take paid or unpaid leave from work when care and support are not available for their family members.

Cathie Williams, ADASS chief executive said: “Without action to prioritise care and support in people’s homes and local communities, it will take years rather than months to fully recover.”

“We need a funded plan so that we can ensure that everyone gets the care and support they need, with more of the Health and Social Care Levy being used to fund care and support in people’s homes and communities over the next two years. People cannot wait for funding trickle into adult social care and wider community services.”