Introduction

Adult social care cannot be understood in isolation from its wider environment: it functions in accordance with legal requirements; it has, of necessity, relationships with other services, notably, the NHS; it is affected by the wider context of poverty and inequality; and it is shaped by political perceptions of its significance. However, like all policy domains, it requires two prerequisites to be in place: an adequate funding base and effective administrative capacity. Both have been missing in the case of adult social care.

Funding

Inadequate funding is at the heart of policy dilemmas in adult social care. It has two dimensions. First, there is the long-standing squeeze on local government expenditure by central government. This has had the effect of reducing access to services and support for those dependent upon publicly funded care (and other services) and prompting some providers to leave the market. Second, there is the long-running question of finding a long-term solution to the balance of funding responsibility for long-term care between the state, the individual and families.

Local government funding

Around 65 per cent of providers’ income comes from care arranged and funded by local authorities, so the level of council funding is essential to the maintenance of the sector (National Audit Office, 2018a). There is, however, no national budget allocation for social care; instead, it is funded through multiple sources, including both public and private funding. Core funding includes support from central government in the form of a revenue support grant (which is not ring-fenced) provided to local authorities, and additional income generated locally through council tax and business rates. Moreover, unlike the NHS, there is no arrangement for funding over multiple years. Planning and investing for the future is impossible when funding streams are left to annual political caprice.

The current policy is that the main plank of central government support (the revenue support grant) should cease by 2020. Local authorities will then having to rely on local business rates and local council tax but will be able to retain 75 per cent of business rates (up from 50 per cent) through the Business Rates Retention Scheme; the piloting of 100 per cent retention is expected in some parts of the country.