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Kings Fund - Older people are paying the price for cuts to social care

The care and support older people receive increasingly depends on where they live and how much money they have rather than their needs, according to a new report by The King’s Fund and the Nuffield Trust.

Six consecutive years of cuts to local authority budgets, rising demand for services and shortages of staff have left the social care system increasingly unable to meet the needs of the older people who depend on it. The report finds that this is placing an unacceptable burden on unpaid carers and is leaving rising numbers of older people who have difficulty with the basic activities of daily living – such as washing, dressing and getting out of bed – without any support at all.

The report highlights evidence that reductions in fees paid by local authorities and other cost pressures such as the National Living Wage are squeezing the incomes of residential and home care providers. It warns that an increasing number are likely to leave the market or go out of business as a result, potentially leaving older people without the care they depend on.

The squeeze on the budgets of care providers is also prompting some providers in affluent areas to step back from providing care for people funded by local authorities, leaving those who depend on council funding reliant on an increasingly threadbare safety net. At the same time, more people are having to pay for their own care as a result of cuts to local authority services.

The report highlights a growing funding gap within the existing, inadequate system which will reach at least £2.8 billion by 2019/20 as public spending on adult social care shrinks to less than 1 per cent of GDP. If the government is unwilling to properly fund and expand the current system, the report says it must be honest with the public about what they can expect from local authority services so they can plan ahead and make their own arrangements. It calls for a fresh debate about how to pay for social care in the future.

The report launch coincides with the publication of new research commissioned by the Richmond Group of Charities and supported by the British Red Cross and the Royal Voluntary Service. Real Lives documents the experiences of a number of older people with the social care system and the myriad of challenges they face in getting the support they need. It highlights the human reality of a system struggling to cope.

Richard Humphries, Assistant Director of Policy at The King’s Fund said:

‘‘The failure of successive governments to reform social care has resulted in a failing system that leaves older people, their families and carers to pick up the pieces. Putting this right will be a key test of the Prime Minister’s promise of a more equal country that works for everyone – there is no more burning injustice in Britain today than older people being denied the care they need to live with independence and dignity.”

Ruth Thorlby, Deputy Director of Policy at the Nuffield Trust said:

“No one can predict whether they will have care needs later in life. But if they do find they need help with the basics - eating, washing, going to the toilet – most will discover that unlike a health problem where care is free, they somehow have to manage themselves.

“Our research found that local authorities have done their best to make savings while protecting funding for the poorest, but care providers are struggling on the low fees councils can afford. Shortages of home care staff and affordable care home places mean older people are often stuck in hospital, putting both their lives and vital NHS processes on hold.

“The number of older people needing care is increasing and yet we are continuing to put less money in. Unmet need is rising, providers are threatening to pull out of contracts, the wellbeing of carers is deteriorating, access to care is getting worse. A Government that wants to create ‘a country which works for everyone’ should not tolerate the oldest and most vulnerable falling into a social care system riddled with holes.”

Ann Tomline lives in Oxfordshire and cares for her husband, who has memory loss and severe anxiety. She said:

“The system is too complex; it’s not very user friendly and lots of money is wasted. There are so many people who don’t know how to get support. We need a simpler and more flexible system so that more people get the help that they need.”

Notes to editors: 

  1. To book interviews with Richard Humphries (The King’s Fund), please contact Claire Francis, Press and Public Affairs Manager, The King’s Fund tel: 020 7307 2603 or (if calling out of hours, please ring 07584 146035).
  2. To book interviews with Ruth Thorlby (the Nuffield Trust), please contact Katherine Jarman at the Nuffield Trust on 020 7462 0555, or Mark Dayan on 020 7462 0538.
  3. The research for this report took place between September 2015 and June 2016 and comprised a literature review; analysis of national data; semi-structured interviews with representatives from health and social care in four case study sites (including commissioners, providers and patient representatives); and narrative interviews with older people who have used social care services in recent years. The research was guided by an external reference group, which included members from ADASS, LGA, CQC, the Department of Health and representatives from health and social care provider organisations and patient advocacy groups.
  4. The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.
  5. The Nuffield Trust is an independent health charity. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
  6. The Richmond Group of Charities is a collaboration of 12 of the largest health and care charities in the UK. We come together as a collective voice to better influence health and social care policy and practice, with the aim of improving the care and support for the 15 million people living with long term conditions whom we represent. ‘Real Lives’ captures the experiences of people aged over 65 with recent experience of the social care system via seven interviews. It was commissioned in partnership with the British Red Cross and the Royal Voluntary Service. For more information about the Richmond Group of Charities, and to download a copy of ‘Real Lives’, go to For interviews, please contact Ben Furner on or 07946 355795; or Chris Mahony on or 07812 692722.

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