Government must "switch focus" to community care from DTOCS, warns ADASS

The Government must “switch focus” from reducing delays in transfers of care to ensuring community care is fully resourced, following the strong track record of social care in reducing delays, the Association of Directors of Adult Social Services (ADASS), warns today.

A survey by ADASS of Social Care Directors from across the country revealed that only focussing on reducing delays, and tying money and resources to doing so, has had a host of side effects, to the detriment of the long term health and wellbeing of those being cared for, including:

• An overspend of approximately £894k each by the end of 2018/19. After eight years of funding shortfalls, growing complexity and demand, councils face increasingly challenging circumstances. 89 per cent of Directors had either no confidence or limited confidence that their social care budget would be enough to enable them to fulfil their statutory duties to ensure care markets are sustainable by the end of 2019/20. They similarly had no, or partial, confidence that they will be able to could meet their wider duties towards prevention and wellbeing, with 76.9 per cent saying it would difficult to achieve. 
• An increase in short-term stays in care homes following hospital care becoming long-term stays as a result of the haste for discharges. 82.3 per cent of social care directors said that they had seen an increase in the number of people who had ended up staying in care homes on a permanent basis when they were originally intended to only be there a few weeks. This often happens because hospitals are so overwhelmed with demand at critical periods that alternatives to residential care are not pursued and capacity in the community struggles to cope.
• An increase in the number of hospital admissions which could have been avoided through enhanced capacity in community care. 72.9 per cent of respondents said that there had been an increase in the number of admissions to hospital that would have been avoidable had there been sufficient social, primary & community services.

As care markets become ever more fragile as funding for adult social care diminishes, increasingly people in need of care will find their choices reduced and experience delays, and the risk of inappropriate care increases significantly. 

ADASS has frequently highlighted the positive role that social care has played in reducing delays to care transfers but wants to see a better balance between acute and community – it wants the Government to switch focus towards helping ensure effective community care encourages independent living, which in turn can play a greater role in reducing pressures on the health service.

A good first step towards doing this would be to allow the £240 million funding announced last week to social care to be put towards local services in the community, and not to be tied to stringent conditions that focus on DToC performance.  

ADASS is arguing that the Government’s upcoming green paper, which is due to set out a long-term funding solution for adult social care among other measures, should be brought forward as soon as possible to address some of the challenges highlighted in today’s published survey.

Glen Garrod, President of the Association of Directors of Adult Social Services, (ADASS), said:

“Social care has done a brilliant job in bringing down delays to transfers of care. This hard work of my colleagues across the country working with social care providers and the skilled social care workforce has delivered real results, which means people can transfer from hospital to an appropriate care environment as soon as possible.

“Directors are concerned about how a shortfall in long-term funding is impacting their ability to deliver statutory duties for people needing care and support today. Too often, social care  finds itself moving resources to meet DToC targets and this is having very real unintended consequences on emergency admissions and waits for people at home in need of community care.

“Together, there has been real progress in reducing hospital delays by a significant amount – think what we could do if we put social care on a truly sustainable footing, and enabled local government and NHS colleagues communities to plan for the care needs of their area with money they can spend locally.

“That’s why it’s essential that the £240 million announced last week for social care is made available to local care teams, so they can make choices in their own communities about how best to provide care that enables independent living. This would not only reduce pressures on the NHS but enable the people in our care to live the most fulfilling lives possible.”

NOTES TO EDITORS