RWK Goodman - October Bulletin
The CQC State of Care report opens with a rather bleak statement:
“The health and social care system is fragmented and under severe strain as it prepares for a major shift from hospital to neighbourhood care… Community services need significant investment in both capacity and capability to deliver the transformative shift called for in the government’s 10-Year Health Plan for England.”
None of that is news to providers, who have been crying out for the investment they need for, quite frankly, years.
But what about the detail? Well, as far as adult social care goes, the headline points are:
Demand for local authority-funded adult social care support rose by 4% in 2023/2024 compared to the year before (and by 8% since 2019/2020).
There has been a growth in demand for support for adults of working age (requests per 100,000 people are 14% higher than four years ago).
The proportion of older people receiving local authority-funded long-term social care has fallen to 3.63% (from 8.2%).
New requests for care rose by 4% and were 8% higher than in 2019/2020.
The number of new requests for support that resulted in no service being provided has risen by 27% over the last five years.
Vacancy rates are three times higher than the wider job market – but have continued to fall.
Many providers are handing back contracts due to costs.
In a nutshell, more people are seeking help and fewer are getting it. Who is filling the gap? Largely families and unpaid carers, but what about those people who don’t have a support network around them? It does not take a genius to see the link between the lack of support and the mental health crisis that is rampant in the UK.
The difficulties facing the sector are not new. Providers have been very clear about the challenges they are facing – they are being asked to provide more with less, and that is simply not sustainable.
With local authorities increasingly squeezing budgets, it does not seem that the investment that is so desperately needed will be coming any time soon. Similarly, it seems we have a government that is determined to keep its eyes and ears shut to the pleas – who will no doubt be “utterly shocked” when things come crashing down.
So what can providers do? Well, it is not all doom and gloom – the State of Care report highlighted that there is evidence of innovation and improvement making a positive impact.
Practically, here are my top tips for providers to navigate the no doubt stormy waters ahead:
Make your views heard – the CQC consultation on their new assessment framework is open, and I would urge all providers to contribute to that discussion.
Consider innovative approaches to recruitment (e.g., partnerships with local colleges, flexible working, enhanced staff support).
If you are feeling the financial strain, gather evidence of your cost pressures and the impact on service delivery – especially the people you help – to inform discussions with local authorities.
Keep up to date – there is a lot happening and changing in the sector, and providers need to be ready to adapt.
The 2024/25 State of Care report is a stark reminder of the pressures facing adult social care. By understanding the report’s findings and engaging with the CQC and local authorities, providers can help shape a more sustainable, equitable, and person-centred future for social care.
Keara Bowgen-Nicholas is a Senior Associate in the Dispute Resolution team at RWK Goodman. Further information can be found at: Keara Bowgen-Nicholas | RWK Goodman