Ten years of the Care Act 2014: ‘the right legislation, undermined by a lack of funding’

The Care Act 2014 remains the right legislation for social care sector and has led to progress, but its aims have not been realised because of a lack of funding.

That was the verdict of sector experts who contributed to a Local Government Association report to mark the tenth anniversary of the Care Act becoming law and designed to influence the general election expected this autumn.

The act consolidated and modernised adult social care law into a single statute, shorn of outdated language and underpinned by an overarching purpose of promoting individual wellbeing.

What the Care Act changed

It also brought about significant legal changes including putting safeguarding adults work into law for the first time; setting a national eligibility threshold for access to care; introducing rights to advocacy for people who would otherwise struggle to be involved in assessments and other processes; giving carers equivalent rights to assessment and support as adults, and requiring councils to provide preventive services.

To mark the act’s 10th birthday, the LGA spoke to representatives from local government, the social care workforce, the voluntary sector, provider bodies, partner organisations, think tanks and politics.

The association said that its contributors were clear that the legislation remained right for the sector and had achieved some gains but were equally clear that it had not achieved its aims in full, principally because of a lack of resource.

The act was implemented at the height of the then government’s so-called austerity programme, with budgeted expenditure on the service having fallen by 12.3% from 2010-11 to 2014-15. Funding has recovered since, with budgeted spend rising by 11.4% from 2014-15 to 2018-19 and by 11.5% from 2018-19 to 2023-24.

‘Serious underinvestment and severe recruitment challenges’

However, the report stressed that over the whole period as a whole spending had not kept pace with estimated increases in demand. This had led to:

• “A serious underinvestment in prevention and early intervention services”, contrary to section 2 of the Care Act, which requires councils to provide or arrange preventive services.
• “Severe recruitment and retention challenges in the care workforce”, undermining the legislation’s emphasis on person-centred care and choice and control.
• “Unsustainable pressure on providers”, affecting implementation of councils’ section 5 duty to promote diversity and quality in the provision of services.
• Rationing of care and support, leading to unmet and under-met need.
• Growing and increasingly unsustainable pressures on carers.

The report was also highly critical of the way the government had funded adult social care over the past decade, through authorities raising funds through council tax – including the ring-fenced adult social care precept – and the use of short-term grants.

“A hand-to-mouth financial system based on short-term funding injections is not a sustainable or efficient model for the future of adult social care,” it added.

‘Politicisiation’ of social care

The impact of the act has also been affected by a lack of public understanding of, and support for, adult social care, and the politicisation of the issue, leading to a failure to obtain consensus for long-term reform, said the report.

The latter is evident in the successive failure of governments to implement the act’s reforms of adult social care charging to create a more generous means-test to access support and cap people’s lifetime liabilities for their personal care.

Both the government and Labour parties are formally committed to implementing the changes but neither has set out how they will be paid for at a time of significant fiscal constraint.

The report urged the parties not to dispense with the Care Act as it “remains the right legal framework for care and support”, but said they needed to fund adult social care adequately and sustainably.

Call for significant funding boost

While the LGA said the exact funding requirement should be identified through a collaborative process, it added that it supported think-tank the Health Foundation’s analysis last year of what was required:

• An extra £0.6bn in 2024-25 and £8.3bn by 2032-33 to meet future demand alone.
• An extra £3.1bn in 2024-25 and £11.6bn by 2032-33 to meet future demand and make some improvements in access to care.
• £5.4 billion extra in 2024-25 and £14.6bn by 2032-33 to meet future demand and cover the full cost of care.
• £8.4 billion more in 2024-25 and £18.bn by 2032-33 to meet future demand, cover the full cost of care and improve access to care.

It also suggested alternative ways of resourcing the sector, including bringing all adult social care funding into a single pot, given to councils with no or only limited conditions, and ending reliance on council tax and the adult social care precept to finance services.

‘Early decision’ needed on charging reforms

The report also called for an “early decision” on whether the adult social care charging reforms would be implemented and urged a pump priming of investment in preventive services, along with improvements in care worker pay and conditions.

It also said the parties should “commit to sustained and authentic coproduction with people who draw on care and support” and “end the politicisation of adult social care.

“The Care Act was a beacon of hope for those needing care and support but this hope has faded. A decade on, people are still facing long waiting times for assessments and support, and not getting the full care and support they need,” said LGA social care spokesperson David Fothergill.

“This simply isn’t good enough. It isn’t good enough for people who draw on care and support and it isn’t good enough for the care workers who work incredibly hard for very little financial reward.

“Adult social care needs urgent attention. This must be top of the in-tray for any incoming government.”