Over a million elderly people missing out on help they need due to dire state of social care system, watchdog warns

National Audit Office calls for urgent action and says severe staff shortages exacerbated by cuts and Brexit are to blame

The number of people over the age of 65 whose needs are being unmet jumped by 200,000 in the last year alone (Getty/iStockphoto)

More than a million vulnerable elderly people are missing out on help they need because of the dire state of the social care system, the UK’s spending watchdog has said.

The National Audit Office (NAO) called for urgent action as it published a detailed report citing evidence showing the number of people over 65 with unmet care needs jumped by some 200,000 in the last year alone.

The body said a spiralling turnover of poorly paid staff and increasing job vacancies are at the root of the problem, which is being worsened by ongoing deep cuts and fewer employees from the European Union since Brexit.

In particular, the NAO struck out at the Department of Health and Social Care (DHSC) for being unable to demonstrate how it is going to fund care for the elderly in the face of burgeoning future demand.

Ministers know working out how to pay for social care is one of the biggest challenges they face, but have been unable to bring forward clear proposals of how to meet it.

The report said the DHSC’s own modelling had shown the number of full-time jobs in the care system would need to rise by some 2.6 per cent per year until 2035 to meet increased demand.

But the annual growth in the number of jobs since 2013 has been two per cent or lower.

The report said: “The failure of formal care to meet this increased demand may have contributed to the growth in individuals’ care needs not being met.

“Age UK estimated that 1.2 million people over the age of 65 had some level of unmet care needs in 2016/17, up from one million in 2015-16.”

The NAO found that In 2016/17, the annual turnover of all care staff was 27.8 per cent – with care workers and registered nurses roles a particular problem.

The proportion of vacancies in care rose from 5.5 per cent in 2012/13 to a peak of 7 per cent in 2015/16, falling slightly to 6.6 per cent in 2016/17.

For frontline care workers in particular, vacancy rate was 7.7 per cent and turnover was 33.8 per cent in 2016/17.

Around half of them were paid £7.50 per hour or below, while the National Living Wage was set at £7.20 in that year.

The vacancy rate for registered nursing jobs in care was nine per cent in 2016/17, while the report said that since July 2016, following the Brexit vote, the number of nurses joining the UK register for the first time from the EU has dropped.

The report then highlighted that between 2010 and 2017, spending on care by local authorities and the NHS reduced by 5.3 per cent in real terms.

Spending power for local authorities, in total, is forecast to reduce a further 0.2 per cent in real terms between 2017 and 2020, despite rising demand, increased complexity of care and pressure from the minimum wage.

The NAO found four-fifths of local authorities are paying fees to providers that are below the benchmark costs of care.

Without urgent ministerial action, the sector will continue its slow-motion collapse

Unison’s assistant general secretary Christina McAnea

The report concluded: “Despite these highly visible challenges, the department does not have a current workforce strategy – and key commitments it has made to both enhance training and career development and tackle recruitment and retention challenges have not been followed through.

“There is no evidence that the department is exercising oversight over local authorities and local health and care partnerships for their responsibilities relating to the adult social care workforce.”

It added: “The department needs to address this challenge urgently and give the care workforce the attention it requires, so that the sector has the right people to provide consistently safe and high-quality care.”

Age UK charity director Caroline Abrahams said the report is a “damning indictment of the failure of successive governments” to carry out workforce planning.

She added: “The end result is the dangerously fragile situation we see today – one that means that in some parts of the country there are not enough care staff to give older people the support they need, even if they are willing and able to pay top rates for it.”

Unison’s assistant general secretary Christina McAnea said: “This damning report exposes the Government’s lamentable approach to social care, which is letting down elderly and disabled people, as well as the dedicated staff looking after them.

“Years of underfunding mean local councils can no longer put enough money into care to meet the needs of an ageing population.”

She added: “Without urgent ministerial action, the sector will continue its slow-motion collapse.”

A Department of Health and Social Care spokesperson said: “Everyone is entitled to good-quality care and we recognise there are challenges – that’s why we will shortly publish a health and care workforce strategy to address these issues.

“We’ve provided an extra £2bn funding to the sector, and this week announced a further £150m for next year – in the summer we will outline plans to reform social care to ensure it is sustainable for the future.”