UK

4,450 more social work staff needed to implement ‘unfunded’ cap on care costs, analysis finds

County Councils Network urges further delay to reforms after survey finds almost nine in ten authorities 'not well prepared' to deliver charging changes in October 2025 due to funding uncertainty, high demand and workforce shortages

by Mithran Samuel on July 19, 2024 in Adults, Workforce

Photo: IQoncept/Adobe Stock

The government must delay “unfunded” adult social care charging reforms by at least a year as most local authorities are not prepared to deliver them by the target date of October 2025, county council leaders warned today.

Authorities would need an additional 4,443 social work staff to deliver the reforms, which include an £86,000 cap on people’s lifetime personal care costs. This is up from a 2022 estimate of 4,300 additional staff, found updated analysis by consultancy Newton for the County Councils Network (CCN).

Separately, a CCN survey of 35 of the 37 county authorities found 86% were “not well prepared” to deliver on the reforms, which would make many more people eligible for state-funded care, by next October.

Two-year delay to reforms

That date was set by the previous Conservative government in November 2022, when it delayed its previous implementation target by two years following calls to do so by CCN and other council bodies, who said they were not ready.

In doing so, it recycled £3.14bn of the £3.6bn it had allocated for implementing the reforms into grant funding to help councils shore up their day-to-day social care services for adults and children from 2023-25. The rest of the money is being used to help councils work towards paying providers a ‘fair cost of care’, an element of the reforms (see below).

What social care charging reforms consist of

• Putting an £86,000 cap on people’s lifetime liabilities for their personal care, based on how much the person’s council would – or does – pay for meeting these needs, except where the person is receiving means-tested support, in which case only their individual contributions count towards the cap.
• Implementing section 18(3) of the Care Act 2014, enabling self-funders to request that their council arrange a care home placement for them, meaning they can benefit from the typically lower rates councils pay for care, compared with private payers (the so-called ‘self-funder subsidy’). This would ensure that the costs that count towards the cap are those that the person actually pays.
• Funding councils to pay providers a ‘fair cost of care’, to avoid the implementation of section 18(3) and the removal of the self-funder subsidy making providers unsustainable.
• Raising the upper capital threshold, above which people are charged for their care, from £23,500 to £100,000, allowing many more people to claim state-funded support. The lower capital threshold, below which people make no contribution to their care from their assets, would rise from £14,250 to £20,000. Both thresholds have been frozen since 2010.

During the election campaign, the Conservatives and Labour both committed to implementing the reforms in 2025 if elected. However, think-tank the Institute for Fiscal Studies pointed out there was no funding allocated to do so.

£30bn cost over nine years 

Newton’s analysis for the CCN found that the total cost of the reforms over nine years was £30bn, up from its 2022 estimate of £25.5bn. This comprises:

• £18.6bn (up from £13.9bn) to fund care for people made eligible for support through the more generous means-test and the cap.
• £9.2bn (down from £9.7bn) to fund a fair cost of care for residential care providers.
• £2.2bn in operational costs (up from £1.9bn).

The latter is driven by the increase in the number of needs assessments, financial assessments, reviews and care and support plans required for self-funders who become eligible for funded care or to have their placements arranged by their local authority, or who want to take advantage of the cap in future.

More social work staff needed

Newton’s original analysis said councils would need an additional 4,300 social work staff, along with 700 financial assessors, to cope with the additional workload.

It has now increased the social work requirement to 4,443, though, as with the previous analysis, this is based on operational processes remaining as they are, without more efficient ways being delivered. This figure compares with a current adults’ social worker workforce of 18,500.

In response to CCN’s survey, 86% of councils said they were not well prepared to implement the reforms and 92% backed a delay of a year or more.

Almost all respondents (97%) said they were “very concerned” about the shortfall in funding and 80% said they predicted that they would not be able to fulfil their Care Act duties if existing social care resource was repurposed to fund the charging reforms.

‘Impossible to implement reforms by target date’

“To put it bluntly, it will be impossible to implement these reforms next autumn in the current timescales and with no funding committed to the reforms,” said the CCN’s adult social care spokesperson Martin Tett.

“Equally, the government cannot take money currently being spent on day-to-day adult social care services for these reforms, with our survey showing it will have devastating consequences for councils and the thousands of people who rely on local authority care.

“We have always supported the principles of the reforms, as they will make the system fairer. But if the government is to proceed with the reforms, then it must delay them by at least a year – but likely more – to reassess the real costs and set out a way to fully-fund them.”

Labour’s post-election social care actions

Since Labour won power, health and social care secretary Wes Streeting has asked his officials to provide a progress update on implementation of the charging reforms (source: Channel 4 News).

The new government has also included plans for a fair pay agreement for adult social care staff in an Employment Rights Bill announced in this week’s King’s Speech.

However, this will cost money – as yet unallocated by the government – because it will require councils to increase fee rates to providers to enable them to pay their staff more and invest more in training.

This casts doubt on its ability to fund the charging reforms as well, particularly given its commitment not to raise income tax rates, national insurance, VAT or corporation tax, fiscal rules limiting public borrowing and several other calls on public spending, such as NHS and defence.

Also, the Times has reported (behind paywall) that Labour is considering setting up a cross-party Royal Commission on the future of social care which, should it happen, may also prompt it to pause the charging reforms.

History of delayed reforms

The reforms were themselves the result of an independent commission – led by economist Andrew Dilnot – which reported in 2011, with its proposals enacted in the Care Act 2014.

The then government had planned to implement the changes in 2016, but this was then put back to 2020, before the idea was scrapped in 2017 under Theresa May’s premiership before being revived by Boris Johnson in 2021.

Responding to CCN’s call to delay the reforms, a Department of Health and Social Care spokesperson said: “We know that people are suffering without the care they need, and we are committed to ensuring everyone lives an independent, dignified life.

“We are going to grip the social care crisis, starting with the workforce by delivering a new deal for care workers. We will also take steps to create a national care service underpinned by national standards, delivering consistency of care across the country.”