The Market

Social care is changing – over the past ten or so years there have been significant changes as to how care is being delivered across the UK. With an ageing population there is now more demand than ever for care providers. The traditional methods of providing care for adults are failing to meet the needs of clients and their shortcomings are being noticed by the public. It is likely that the next generation will have even higher expectations, so it is essential for care providers to ensure they offer high quality social care.

Size of the Market

Figures from the National Audit Office show a large market for adult social care in England. From their released report, The Adult Social Care Market in England, we can see the following.

There were 839,000 adults receiving long-term support arranged by local authorities at some point during 2019-2020.
The total net local authority expenditure on adult social care was £16.5 billion in 2019-2020.
As of March 2020, there are an estimated 25,800 regulated adult social care

locations.

The Care Quality Commission oversees the financial sustainability of several difficult to replace care providers, which encompasses 30% of the overall care market, by number of beds.
In 2019-2020, the estimated number of people working in adult social care was 1.5 million.
There is a 29% projected forecast increase in adults aged 18-64 requiring care by 2038 compared to the amount requiring care in 2018.
The projected forecast increase for adults aged 18 to 64 requiring care by 2038 is 90% compared with the costs in 2018.
There is a 57% projected forecast increase in adults aged 65 or older requiring care by 2038 compared to the amount requiring care in 2018.

The projected forecast increase for total cost of care for adults aged 65 or older by 2038 is 106% compared with costs in 2018.

It is apparent from future projections that the adult care market will see a lot more growth in the future as the percentage of our population over 65 grows larger compared to the younger age groups.

Market Structure

Social care is means tested, so care cost help from the local council will depend on how much someone has in capital and savings. If you have between £14,250 and £23,250 in capital and savings, the council will contribute towards your care costs. However, if you own above £23,250 in capital and savings, you will have to fund all your own social care.

Pensions will also affect how much local authorities can provide in social care funding. The more widespread uptake of companies and employees contributing to pension funds is expected to see the next generation of older people have assets that surpass the means tested threshold for access to state funded social care. This will require them to self-fund their care services without care cost help from the council.

Demographics

Britain’s population is ageing – around a fifth of the UK population was over 65 in 2019, rising 23% from 2009*. The faster rate at which older age groups are growing compared to other age groups is a result of people living longer nowadays and having fewer children than previous generations. At present there are now more people aged over 60 in the UK than there are under 18, leading to the significant increase in demand for adult social care.

*House of Commons, UK Parliament Website

Population Projections

We have already seen that the population at present provides a huge demand for adult social care, especially in the over 65-year-olds. This is projected to continue as our ageing population increases. By 2030 there are projected to be 51% more people aged 65 and over and 65% more people aged 85 or over in the UK compared to 2010*.

*ONS, Ageing Projections

Looking ahead at the population of three age groups over the next thirty years it is projected that by 2035 the number of people aged 65 and over will rise to over 16 million (23.6% of the population). The population over 75 is projected to double in the next thirty years, while the number of people aged over 85 in the UK is predicted to more than double within twenty years, to a figure of 3.4 million.

Over the last decade the number of centenarians living in the UK has risen by 72%, and it is estimated that one in five people currently in the UK will live to see their 100th birthday. This includes 29% of people born in 2011.

An ever-increasing ageing population will see more demand from people for social care, as shown by the earlier projected forecast increases in individuals requiring care.

Current Shortcomings in Care Delivery

Many traditional care providers are unable to meet clients’ needs for care visits. Dame Denise Platt, the Previous Chair of the Quality Care Commission (CQC) notes that:

“Failure to listen to what people really need and respond to, results in missed opportunities to promote independence and to help people live full and rewarding lives.”

The average length of care visits is a noted shortcoming of care providers. In January 2016 UNISON reported that 74% of councils in England commissioned domiciliary care visits that lasted fifteen minutes or less. A UKHCA 2013 Report had a similar note on lengths of visit, noting that a survey from LaingBuisson showed just over half of local authority funded visits lasted thirty minutes, while 16% of visits were of fifteen minutes. This survey also noted that 19% of a homecare workers time was spent travelling, a notable time that could be spent with clients if they were less rushed.

These short care visits are detrimental to the care of such a vulnerable part of the population, where high quality care is critical to their well-being. Regarding those individuals with dementia, the national dementia strategy states:

“Specifying tasks rather than outcomes, not having the time or continuity to develop relationships between individuals and care workers, and care workers being rushed and only visiting for short (15-minute) periods are all particular problems for people with dementia”

A more tailored approach to home visits, primarily ensuring a longer length of time is spent with a client, is obviously more beneficial to their care. As Stephen Burke, former Chief Executive at Counsel and Care puts it.

“Clearly the public want better care for our ageing population”

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Adult Social Care Market

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