This month's major report by independent public spending watchdog the National Audit Office (NAO) has revealed how efforts to reform and plan for a long-term social care sector remain hamstrung by short-termism and fire-fighting.

The report reveals over £1 billion of the £1.7 billion committed to adult social care reform in December 2021 has been diverted just to stabilise the sector. Just over half (58%) of planned funding may now be spent on reform between 2022 and 2025, the report warns.

The NAO reveals a picture of a sector on a cliff edge, with around a quarter of local authorities struggling to keep up with the cost pressures they face this year, and one in six expecting demand for adult social care to exceed capacity this winter.

Waiting lists, meanwhile, increased by 37% between November 2021 and April 2022, with the number of people waiting more than six months in March 2023 for a care assessment almost double – at around 82,000 – what it was at the end of 2021. 

Additionally, vacancies in adult social care in England increased by 173% in the past decade and, despite a recent fall, stand at around 152,000 (a 10% vacancy rate) with around 70,000 staff having been recruited from outside the UK in the past year.

On the delivery of reform, the government’s progress is mixed at best with, most notably, plans to cap lifetime care costs delayed until October 2025.

The government completed its cost of care exercise in March 2023, with Care England analysis revealing local authorities were underfunding care homes by over £2 billion in 2021/22 or in excess of £200 per week per home.

Spurred by these findings, local authorities offered double-digit fee increases this year in a bid to close the gap. However, despite this, care market expert Carterwood has noted it would take sizeable increases over many years to get to the acknowledged fair cost of care.

Delivery elsewhere has been patchy at best, with progress on only two of eight workforce reforms on supporting and adult social care volunteering and the remaining six in development.

The government has much to do to achieve its 10-year ambition of reforming the sector with no overarching programme to co-ordinate its reforms, the report concludes.

With the run-up to a general election, to be held by January 2025, further progress on the politically toxic issue of social care charging reform looks set to remain in the long grass for the foreseeable future – leaving the sector to limp along and make the best of inadequate resources as it has had to do for decades.

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