Adult social care risks creating unfair ‘two-tier’ system

Ministers have been warned that the growing crisis in adult social care risks creating a ‘system for the rich’ that leaves poor communities unable to access the essential help they need.

For every new care facility that opens, two care homes are closing as providers attempt to stay afloat amid a multibillion-pound shortfall in funding. Further investigations have found that places are disappearing from care homes that already have a shortfall of beds, while new facilities are opening for those who can pay their own way.

The social care trade body Care England has stressed that there was a real risk of a two-tier system emerging that would see the poorest suffer the most.

The data follows the announcement of new immigration rules which have been widely criticised for the negative impact the could have on an already struggling sector. Care workers can earn as little as £16,000, well below the £26,500 threshold for entry required under the Prime Minister’s proposals.

Research by the CSI Market Intelligence consultancy found that there were 111 new care homes registered with the Care Quality Commission, the lowest number since 2015 and about 12 per cent down on the previous year.

Experts warn that private investment continues to flow into expensive facilities, which risks creating huge disparities in the care given to rich and poor. The CQC has warned of cases in which care providers will not support people funded by local authorities because the fees they receive from councils no longer cover the costs of delivering the care.

Martin Green, Care England’s chief executive, said: “If you go to some places there are no new care homes being built and the stock available is running to the end of its life, or not fit for purpose. It’s not just about capacity dwindling – there is nobody coming in those areas to replace them. It will be an attrition process. You end up with a social care system for the rich, and really poor experiences for the poor. There is a huge amount of external investment ready to go into this sector. But, of course, it’s all based on high-end, high-quality, self-funding clients. The challenge is to make sure social care is available to everybody.”

The government has confirmed an additional £1.5 billion for social care in 2020-21, but councils warn it is far from enough. The Health Foundation think tank it would cost £4.1 billion to stabilise the system to meet demand pressures by 2023-24.