With the budget fast approaching, the funding of social care should be uppermost in the Chancellor's mind, and in particular the proposed cap on the cost of care.
This idea to cap the lifetime cost of care gained wide support when it was first proposed four years ago. Government set out plans to introduce a cap from April 2017, and subsequently decided to bring this forward to 2016. However, in the intervening four years the social care system has been under sustained pressure and the expectation is that cuts in local government funding will continue to increase. Anyone who knows what the social care system looks like on the ground will realise this is unsustainable, even without adding further pressure of a cap.
The Association of Directors of Social Services (ADASS) recently published their annual budget survey http://www.adass.org.uk/budget-survey-2015/ which makes sobering reading. 400,000 fewer people receive care and support than five years ago. That represents a growing number of people without support to do basic things like get up, get dressed and go out of the house. It also represents a growing number of unpaid carers filling the gap, often at a cost to their own health and well-being.
There has been a lot of talk about the promise of prevention to deliver long term savings, both in social care and in health. But a look at the budget survey shows that local authorities are not investing in prevention. In fact, spending on prevention has fallen by 6% in the last year. This is unsurprising and is the inevitable result of continued underfunding of a vital service. Faced with a statutory duty to meet rising levels of need, but falling levels of funding, authorities increasingly feel they have no choice but to cut the areas that are discretionary, such as prevention.
Directors understand it's not a sensible decision. Prevention is the most commonly cited method by which authorities plan to deliver savings and yet they are cutting it. That might explain why the number of Directors fully confident of delivering the necessary savings next year plummets from 45% this year to just 7% next year. 16% of authorities have no confidence in their ability to deliver savings in two years' time.
What will happen in the 16% of authorities which are unable to deliver the necessary savings if they also have to implement a cap? And more importantly, what will happen to the people in those authorities who need support and don't have the money to pay for it. What can those who reach the cap and are therefore entitled to state funded support expect if the state funded system in their area has run out of money?
Most local authorities have been doing what they can to find efficiencies and protect frontline social care support, although there have also been cuts to services. But there are limits to what can be done and the ADASS budget survey shows we are reaching those limits. To introduce a cap in these circumstances would be dangerous.
Any announcement in the coming budget that the government intends to do so risks being an empty promise unless the underlying funding crisis is addressed at the same time. Far better to take time to plan a long-term solution. Put the timetable for the cap back to the original implementation date of 2017 and use the intervening time to work out a sustainable solution to social care.