A man has described how the crisis in social care funding is causing his brother with Down’s Syndrome to “slowly spiral” as new research reveals a third of social care organisations have considered closure due to cost pressures.
Jon Williams, whose 52-year-old brother Alun has been living in supported housing for people with learning disabilities for more than 30 years, told i he is struggling to get additional help for his brother despite him exhibiting signs “self-neglect”.
According to Mr Williams, his brother Alun, who has Down’s Syndrome, needs extra care to address issues including hoarding and a failure to look after himself – which has led to him losing all of teeth – but his local council is yet to agree to fund additional care for him.
He is not alone. Nearly half of social care providers in England have been forced to close part of their organisation or hand back contracts to councils as a result of cost pressures in the last year, i can reveal.
Social care is primarily funded by local authorities, who have a duty to organise and fund support for adults in need who are not able to pay for it themselves. Most councils commission charities to provide this care.
However, councils have faced significant real-terms cuts to their funding over the past decade, which has resulted in many local authorities struggling to properly fund these services.
Jon Williams’ 52-year-old brother Alun has been living in a supported living service in Bristol for people with learning disabilities since he was 19.
Mr Williams said his brother has been “content” and is part of a community there, but he has struggled with issues including agoraphobia, self-neglect and hoarding, which got worse during the pandemic.
“He’s lost all of his teeth, he looks a bit unkempt, he doesn’t change his clothes very often, he doesn’t shower,” Mr Williams said, explaining that his brother barely leaves the house anymore.
Alun is also struggling to cope with the death of his Mum, who passed away in December.
The accommodation he is living in is run by Hft and the charity provides support, including with meals and shopping.
In response to Alun’s increasing support needs, Hft made a request to Bristol Council in February 2022 to fund additional care for him. However, the council is yet to agree to this request.
“Alun is in a place where he is not looking after himself and is neglecting himself and his living environment is not safe or clean,” said Mr Williams, adding that he needs support from someone who is trained on Alun’s specific issues and can take “extra time” to address them.
“I just see it spiralling down for him slowly but surely, because they can’t put the resources in and the self-neglect will continue to be as bad as it is and the hoarding will continue.”
He added: “I have a deep sense of frustration because how is this actually properly resolvable? The council could somehow figure out the resources for us, which would be lovely and great, but does that mean somebody else isn’t getting those resources?”
A survey of almost 200 adult social care providers has found that a third considered closure in 2022, including nearly half of all smaller providers, as the fees they are being offered by councils does not cover their costs.
The research, which has been shared exclusively with i, found that 42 per cent of organisations were forced to close down some services or hand back care contracts to local authorities last year.
The report was commissioned by Hft, a national charity supporting people with learning disabilities, and Care England, which represents the adult social care sector.
It found the most significant cost pressure facing social care organisations was workforce pay, with 92 per cent of providers citing annual increases to the National Living Wage as the most significant workforce-related cost pressure.
Over four fifths (81 per cent) of the social care providers who responded to the survey said local authority fees did not cover the increased cost of workforce pay in 2022.
Tim Cooper, chief executive at United Response, a charity that provides support to people with learning disabilities, autism and mental health needs, said the organisation was forced to use its charitable reserves to fund pay uplifts for staff over the past two years.
He said the charity will run a “substantial deficit” this year and cannot afford to use its reserves to fund pay increases for a third year running.
“There is a certain level of service that we will not go below and so we are making decisions that where we can’t deliver a service safely or to the right level of quality then we will hand back services or close them,” he said.
United Response has handed back a number of services to local authorities in the past six months and is in the process of closing a residential care home, while “other difficult decisions will have to be made over the next six to 12 months”, Mr Cooper said.
“There’s definitely an increase in charitable and private providers making decisions to either close or hand back services and I’ve noted certainly over the past six weeks an even stronger sense of resolution on the part of my peers in the sector that they have reached a point in which they can’t subsidise the state any longer,” he added.
“I’ve spent over 30 years in the sector, starting from closing down the old institutions. We’ve made tremendous gains over that period in terms of people’s independence, their quality of life, their ability to live lives as citizens in their local communities.
“I think there is a risk that we lose those gains. Not overnight, but incrementally that level of support, the number of hours of support people get is reduced, the choice about where they can live is reduced and the quality of support that they get is under threat.”
Kirsty Matthews, chief executive at Hft, said the research “paints a picture of a quietly crumbling sector” that “can no longer bridge the funding gap that decades of under-investment by the Government has left”.
She added: “Last resort actions such as handing back contracts, offering care to fewer individuals and even considering exiting the market are all too common, and cumulatively impact the ability of our sector to meet the needs of those who rely on our care and support.
“I can’t emphasise enough the detrimental impact this has upon individuals who draw upon social care, their families, communities and the NHS, but at present this plight seems utterly unrecognised.
A Department for Health and Social Care spokesperson said: “We recognise the pressures faced by the adult social care sector and are committed to working closely with providers to ensure people receive the highest-quality care. Thanks to these efforts, the number of registered adult social care locations has remained stable.
“The government is making up to £7.5 billion available to support adult social care and discharge over the next two years – the biggest funding increase in history. This will help local authorities address waiting lists, low fee rates, and workforce pressures.
“They should spend this funding to support their communities and improve social care services, including those for people with learning disabilities and autism.”