News Story

Why our care system is in crisis

July 21, 2011

The Care & Support Alliance has published an analysis of why the social care system is in urgent need of reform.

A series of recent horror stories have all pointed to a crisis in our care and support system: parents forced to consider putting their disabled children in care because they cannot get support with caring, abuse of disabled people in residential care, care homes at risk of shutting due to financial mismanagement and care services so poor they breach the human rights of older people.

But the truth is that our social care system has been at breaking point for years:

  1. Families are shocked to find that care is an expensive postcode lottery
  2. They face catastrophic care costs under the current system
  3. Current funding for care and support cannot cope with rising demand and cuts have pushed it beyond breaking point
  4. Families are being left to care alone.

1. Families are shocked to find that care is an expensive postcode lottery

If you are ill, you know that, wherever you live, you are entitled to free NHS treatment. But if illness, disability or frailness mean that you need care, like help with washing, dressing and eating; many families are shocked to find that it will cost them. Where you live dictates what care you get and how much it costs.

Need help at home with personal care? In one area you’ll get it for free, but, down the road in another council area, you could be charged £20 an hour[1].

In some parts of the country, councils provide a range of support, including low-level services like meals-on-wheels to help people stay independent in their own homes; whilst in other areas, councils only provide critical services for people who need full-time care.

If you need care or support with daily living there is no national system setting out what you get and whether it will cost you. Families face a lottery which could leave them without the support they need or paying massive bills for basic care.

2. They already face catastrophic care costs

Currently, if you have housing, savings or income over £23,250 you will be charged for the full costs of your care and get no help from the state. These costs can be catastrophic.

  • Care at home, like support to eat, prepare food and with personal care can cost £500 a month[2]
  • The cost of residential care starts at £550 a week[3] and can rise to as much as £700[4]. A quarter of people spend over three years in residential care[5]. The Alzheimer’s Society describes a ‘dementia tax’ at an estimated £35,000 for residential care for someone with dementia[6].

The bill you could face if someone in your family has dementia?

  • Four years of care and support in your own home: over £24,000[7]
  • Three years of residential care: at least £109,200[8]
  • Total over their lifetime: £133,200

These costs would wipe out the savings of most families and force many to sell their homes to pay for care. When the savings of the person needing care run out, families often end up reaching into their own pockets to pay thousands of pounds a month for care.

3. Current funding for care and support cannot cope with rising demand and cuts have pushed it beyond breaking point

Our population is ageing rapidly, 11 million people alive today will live to 100[9]. But this debate is also not just about older people – the care and support system relates to everyone over 18 who needs support, and people are living far longer with illness and disability. This includes people who have suffered injuries, or who have physical disabilities, people with long-term conditions or illnesses like cancer, multiple sclerosis or mental health conditions. Nearly two thirds of state social care spending on the working-age population is on those with learning disabilities and, because of falling mortality, the number of working-age adults with learning disabilities will rise by almost a third over the next 20 years[10].

Whilst the NHS has seen increased funding to help cope with this increase in demand, social care has been forgotten. Since 2004, whilst spending on the NHS has risen by £25 billion, spending on social care rose by just £43 million (0.1% per year in real terms)[11].

Age UK report that 800,000 older people who currently need care, receive no formal support from either the state or private sector agencies[12].

Yet services which already cannot meet demand, are facing cuts:

  • Social Services Directors report that the total cuts to all adult social care reach £1 billion this year[13].
  • This week, Age UK released research showing that net expenditure on older people’s social care this year is falling by £610 million, or 7.1%. They estimate that cuts will mean within four years one million people who need care will be getting nothing[14].
  • A Learning Disability Coalition survey of councils showed 57% of councils were increasing charges or raising eligibility criteria, or consulting on doing so. A survey of people with learning disabilities and their families showed that 1 in 5 had been told their hours of care would be reduced[15].
  • A survey by the Care and Support Alliance in 2011 showed that services to 24% of disabled adults had already been cut, even though their needs were the same or had increased[16]

4. Families are being left to care alone.

Caring for ill, frail or disabled friends or family members is pushing families into ill health, financial hardship and isolation. A Carers UK survey of over 4,000 carers showed that:

  • 67% of families were caring without any support from social services. 38% of carers care completely on their own with no support from family or social services.
  • 4 out of 5 (78%) had seen their health worsen as a result of caring.
  • 43% were in debt as a result of the costs of caring[17]

Over 1 million people have given up work or reduced working hours to care for ill or disabled loved ones[18]. Without more support, families, business and the economy will losing an estimated £750 million and £1.5 billion[19] a year in earnings because the social care system cannot support families to juggle work and care.

On top of the costs of expensive equipment and bills for the people they care for, carers face huge costs just to get a few hours rest. Caring full-time for a disabled child or elderly parent and need to take a day off? It could cost you over £100 to get someone to look after the person you care for. If they need nursing care the bill could double.

[1] Home Care Charges Revealed (2011) Which? www.which.co.uk/news/2011/01/home-care-charges-lottery-revealed-by-which-242460
[2] Ibid.
[3] Impact of changes in length of stay on the demand for residential care services in England: Estimates from a dynamic microsimulation model (2011) Forder, L. and Ferandez, J-L., PSSRU www.pssru.ac.uk/pdf/dp2771.pdf
[4] The Dementia Tax (2011) Alzheimer’s Society
[5] Impact of changes in length of stay on the demand for residential care services in England: Estimates from a dynamic microsimulation model (2011) Forder, L. and Ferandez, J-L., PSSRU www.pssru.ac.uk/pdf/dp2771.pdf
[6] The Dementia Tax (2011) Alzheimer’s Society
[7] Based on £500 a month charges
[8] Based on £700 a week charges estimated in The Dementia Tax (2011) Alzheimer’s Society
[9] Number of Future Centenarians by Age Group (2011) DWP
[10] Estimating Future Need for Adult Social Care Services for People with Learning Disabilities in England (2008) CeDR
[11] Care in Crisis (2011) Age UK
[12] Care in Crisis (2011) Age UK
[13] ADASS Budget Survey 2011 (2011) The Association of Directors of Adult Social Services
[14] Age UK (2011) www.ageuk.org.uk/latest-press/spending-on-older-peoples-care-to-be-cut-by-84/
[15] Social care – the continuing crisis: from the perspective of local authorities in England The Learning Disability Coalition Local Authority Survey 2011 (2011) Learning Disability Coalition
[16] Submission to the Dilnot Commission Call for Evidence (2011) Care and Support Alliance www.carersuk.org/professionals/resources/research-library
[17] State of Caring (2011) CarersUK
[18] One Million Give up work to Care (2009) Carers UK, Ipsos MORI and DWP
[19] The case for social care reform – the wider economic and social benefits. HCMS and IASS, University of Birmingham (2010) Glasby, J., Ham, C., Littlechild, R. and  McKay, S.