A Technical Annex (pdf) to go with CQC’s State of Care 2012/13 report, you say? How could I possibly resist?!
Below are some highlights from the annex looking specifically at the funding of adult social care. (These figures will be familiar to folks who pore over the HSCIC releases every quarter, but I take the view you can never get enough of info like this.)
Total and type of spend on adult social care:
- Spend on adult social care has risen in cash terms – from £16.8bn in 2009/10 to £17.2bn in 2012/13, but there has been a real terms decline. Adults under 65 with a learning disability where the only major user group to see a real terms rise in expenditure from 2009/10 to 2011/12.
- The following proportions were spent on the following client groups in 2011/12(figures include Supporting People monies, which was presumably found down the back of the sofa in the last year or so
- 53% of spend was on older people
- 31% on adults under 65 with learning disabilities
- 9% on adults under 65 with physical/sensory impairments
- 7% on adults under 65 with mental health problems
Direct Payments expenditure:
- Expenditure on direct payments for adults increased in both cash and real terms. £360m was spend on Direct Payments in 2006/07 and reached £1.1bn in 2011/12
- This is a real terms increase of 175% and is 6% of all gross adult social care spend.
Unit costs of different types of social care are fascinating. Really.
- The average cost per adult supported in residential care, nursing care or intensively in their own home was £608 per person per week in 2011/12 – a 5% real terms cut
- The average cost of providing day care for adults (including older people) was £213 per person per week
- The cost of home care per person per week for all adults was £206.
- This one surprised me: the overall proportion of people who indicated that they (or their family) ‘top up’ their care has increased from 38.1% in 2010/11 to 38.8% in 2012/13. This probably isn’t as much as I thought it would be.
To summarise, there’s less money in real terms, no matter what anyone else tells you.
For those folks who want extra geek points – and, frankly, who doesn’t? – it’s well worth reading CQC’s technical funding annex in conjunction with the King’s Fund’s submission (pdf) to the Health Select Committee’s Inquiry into public expenditure on health on social care. In social care, it notes:
The number of older people receiving publicly funded services has fallen by 26 per cent since 2009/10, with an equivalent reduction of 21 per cent among working age adults over the same period. Given the overriding imperative to provide care closer to home and reduce the need for residential care and hospital admissions, it is particularly worrying that the largest reduction has been in the use of community-based services such as home care (down 25 per cent) compared to nursing home care (down 4 per cent) and residential care (down 1.7 per cent).
Their numbers on the NHS are just as frightening.
So, to summarise again:
- There’s less money in adult social care
- There are less people getting adult social care
- The number of people getting fewer services is rising quicker than the rate at which money is being taken out of the social care system
- Money is being cut from services which cost less and people prefer quicker than it is being cut from services which cost more and people prefer less
- The NHS is fairly buggered, or at least faces the biggest financial challenge it has ever faced.
What could possibly go wrong?