Social care for older people is under massive pressure, with increasing numbers of people not receiving the help they need, in turn putting extra strain on their carers.
That is one of the key findings of a new report jointly published by independent health think-tanks The King's Fund and The Nuffield Trust. Called "Social Care for Older People; Home Truths", the 98-page report looks at the current state of social care services for older people in England.
It examines the impact of cuts in local authority (council) spending on social care providers, as well as on older people, their families and carers. The picture that emerges is one of social care providers under pressure, struggling to retain staff, maintain quality and stay in business.
Meanwhile local authorities have to make tough choices about where to make reductions. Elderly patients have to stay longer than necessary in hospital because of a lack of social care for them after discharge. And an increasing burden is falling on the voluntary sector, which is struggling to keep services going even when funding has been curtailed.
The report also found that:
· Access to social care depends increasingly on where people live and what they can afford, rather than on what they need.
· While official Government policy is focused on keeping people independent and out of residential care, the reality is that under-investment in NHS services is undermining that goal.
· The Care Act 2014 has created new demands and expectations for social care providers, but funding has not kept pace.
· Local authorities have little room to make further savings and most will soon be unable to meet their basic statutory duties.
According to the report, the number of over-65s receiving help from councils fell by a quarter in the four years to 2014, despite more people needing help due to England's ageing population. Many more older people now have to pay directly for their care, while many who can't afford it are simply left to do without, or rely on family and friends.
Most worrying of all, the report estimates that a million people with care needs in England now receive no formal or informal help at all – a figure which has increased by 10% in just a year.
Most social care is provided by outside agencies, but as councils have less money to pay these providers then care is increasingly "rationed". Providers have already walked away from council contracts in 59 local authority areas, states the report.
Its authors recommend that to prevent a collapse in social care and to shape its development over the next five years, policy makers must focus on three key areas. These are:
· How to achieve more with less; finding new and more efficient ways to provide care where it is most needed and making limited resources stretch further.
· Being more open with people by making it clear that the primary responsibility for funding care sits with individuals and families. This could encourage more people to plan ahead for their own care instead of expecting outside help which might not be there.
· Reforming the long-term funding of social care so that it can still be provided for those in greatest need, but who do not have the means to fund it.
In response, the Government says it is already investing in the care system, setting aside £5 billion to encourage joint working between the NHS and the private care sector, with another £1.5 billion to be added to that by 2019. It has also authorised local authorities to increase council tax bills by 2% per year to invest in care services.
A spokesman for the Department of Health said: "We understand the social care system is under pressure, and this government is committed to ensuring those in old age throughout the country can get affordable and dignified care."
• The King's Fund is an independent charity working to improve health and care in England by helping inform and shape policy and practice through research and analysis. The Nuffield Trust is an independent health charity which aims to improve the quality of care in the UK by providing evidence-based research while informing and generating debate.