What are people telling us about accessing and paying for social care?
Social care is a vital service that provides long-term support to over 818,000 adults in England to live as independently as possible.
However, unlike the NHS, social care is not free at the point of delivery. It is a means-tested service, and once your local authority has assessed your needs, most people end up contributing to the cost of their care.
Three big challenges facing social care
- Rising demand: In recent years, there has been a rise in demand for social care due to an ageing population and the growing number of adults with disabilities. Local authorities received nearly two million requests for adult social care in 2021-22.
- Delays: Waiting for assessments, reviews, care, and support or direct payments can take months, leaving almost 500,000 people waiting for more than half a year.
- Staff shortages: There is also a shortfall in social care workers, resulting in over half a million hours of care not being provided to people who need it. In the meantime, unpaid carers often bear the brunt of long waiting times and cuts to adult social care local authority budgets.
What are people telling us?
When we reviewed recent feedback about social care, it was clear that good social care support makes a life-changing difference, helping people to be as independent and fulfilled as possible.
On Valentine's Day, the entertainment manager of the care home arranged a romantic dinner for Mum and Dad. The head housekeeper and chef did a lively job of decorating the room with hearts etc. Mum wasn't looking her best when I arrived but one member of staff took the trouble to wash and blow dry her hair and put her in a dress. Mum looked in the mirror and said "Don't I look pretty!" There was even a red rose for Dad to give to Mum and a bottle of non-alcoholic champagne on the table. The whole event was very special and the staff went above and beyond.
- Story shared with Healthwatch Waltham Forest
But, as well as positive stories, we also heard about the problems some people can face when accessing social care.
Long waits
Individuals have reported experiencing long waits for assessments, reviews, or care. In the meantime, they have to rely on their families and make do without adequate or even any support.
I have been assessed as being eligible for 6 hours a week sit-in service, but for months I have only been able to access 3 hours due to staffing shortages. I understand the pressures services are under but I provide constant care for my husband and I need that time to regroup and be myself again.
Not enough staff
We've also heard about the impact of staffing shortages on social care provision. Disabled people have told us that they are not receiving the care that they need due to the lack of staff.
Individual's adult daughter has a continuing health care plan. She needs 2:1 carers 24 hours a day but they have found it really hard to find enough people to fulfil these care needs - and the right kind of people. They currently receive a Personal Healthcare Budget to organise the care themselves. They currently are not spending the money in their budget because they cannot find the carers. Her husband has given up his job to care for their daughter and they are at the point of financial difficulty where they may lose their house.
- Story shared with Healthwatch East Sussex
Understanding the costs
We also heard about people wanting to find out about the cost of social care and whether they could get any help with it.
People have said they find it challenging to find information about the costs and how to find good social care providers. They find themselves passed from pillar to post.
My wife had dementia for 18 months and I cared for her at home. It was hell, there were so many different departments. There should be a guide that takes you through the process.
How to find Age UK, Alzheimer's Society, Dementia Hub. It's a learning process, there are bits everywhere. I didn't know about direct payments, and I was referred everywhere. Its piecemeal.
The Duty Social worker told me:' You're one of hundreds of cases.' I had to get everyone I knew in different services to send emails to unblock things. The Financial Assessment information is all online which can make it easier. Otherwise you have to try and find you way around 60 pages. It's so complicated. So much bureaucracy all the time.
- Story shared with Healthwatch Waltham Forest
How can we make social care better?
In recent years, we have produced several reports highlighting what is working and what needs to be fixed, regarding social care.
With service facing such significant challenges, we have:
- Called for councils to get the resources and support they need to provide proactive information and advice services to their communities;
- Supported calls for care home residents to have a legal right to care support workers and visitors (such as family and friends); and
- Supported calls for social care reform, increased service investment, and a renewed focus on implementing previously announced reforms.
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