Councils set to further tighten eligibility criteria for social care as part of focus on meeting statutory duties, Directors of Adult Social Services warn

ADASS' annual survey of social care leaders in local authorities across the country revealed that despite a government focus on neighbourhood health and prevention, “overstretched budgets” mean care leaders have reduced spending on early care and support by more than 10% this year, as they are forced to prioritise immediate needs and people in crisis.

The survey estimates that collectively, directors of adult social care were left with “little choice” but to overspend on their budgets by £774mn last year to meet their legal duty to provide care and support, the highest the overspends have been in a decade.

ADASS warned: “This is likely to result in councils further tightening the eligibility criteria for social care, so they can deliver their legal obligations leaving very little left for preventative measures that would likely save the state money in the longer-term and most importantly, improve outcomes for people.”

The survey found that spending pressures include an increase in the size of people’s care packages -indicating the growing cost of providing complex care as people live longer but often with multiple illnesses, conditions and disabilities.

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Meanwhile, 75% of directors said they continue to see increasing numbers of people with the most complex care needs approaching their councils for support, who would have previously had their care funded free of charge through an NHS budget called Continuing Healthcare (CHC).

Data also demonstrated a “postcode lottery” for CHC funding, with people less likely to be successful in obtaining CHC support according to where they live in the country.

In light of its findings, the Association warned that the increase in costs in meeting people’s complex care needs has “not been accounted for” by the Government in the latest Spending Review.

It said: “[The Spending Review] saw social care receiving up to £4bn additional funding by 2028/29 (compared to 2025/26). But uncertainty remains around what this amount covers, including the potential for it to need to be used to pay for measures like a much needed but costly Fair Pay Agreement for care workers.”

It added that this comes after “costly increases” in employers’ national insurance contributions and the national living wage, plus inflation, which have pushed the cost of care up.

It noted that the Spending Review also assumes that every council will increase council tax by 5% to fund that additional spending.

Jess McGregor, ADASS President and Director of Adult Social Care in Camden, said: “We shouldn’t have to choose between helping people with complex needs now and preventing others from getting unwell – we need to support people at both ends of the social care spectrum. But without more investment to keep people well and independent at home, we risk undermining the shift towards prevention and neighbourhood health that Wes Streeting, the NHS and this Government are rightly championing.”

She added: “It’s vital that adult social care leaders who are well versed in delivering support at the community level are meaningfully involved in decisions about where and how resources for neighbourhood health and care are spent. After all, acute hospitals are not best placed to deliver social care at the neighbourhood level – but councils are.”

Responding to the findings of the ADASS Spring Survey, Cllr David Fothergill, Chairman of the LGA Community Wellbeing Board said: “This survey starkly shows councils are caught in the impossible position of having to choose between meeting people’s complex care needs and supporting other people’s wellbeing to prevent their needs from escalating. In this situation, councils cannot deliver the Government’s ambition to shift care from hospital to community without sustainable funding for adult social care.

“Councils want to focus on prevention and help people stay independent at home, but rising costs and more people needing access to care is forcing them to prioritise crisis care instead.

“A promise to reform adult social care must be matched by long-term investment so councils can plan, recruit and deliver services that support people to live the life they want to lead and reduce pressure on the NHS. Local government is best placed to lead this shift and deliver neighbourhood-level care, but it cannot do so with one hand tied behind its back by underfunding.”

A Department of Health and Social Care spokesperson said: “We inherited a social care system in crisis but in our first year of government we have taken immediate action to improve this.

“The Spending Review will allow for increased funding for social care by £4 billion, we have legislated for the first ever fair pay agreement for care workers, and Baroness Casey has begun her work on the independent commission into adult social care to build a National Care Service that is fair and affordable for all.

“We have also invested £172 million extra in the Disabled Facilities Grant to deliver around an extra 15,000 home adaptations and given unpaid carers a £2,000 uplift to their allowance.”

Lottie Winson