Last reviewed 28 July 2020

A report by the Association of Directors of Adult Social Services in England (ADASS) has recommended that more care is provided to people in their own homes and has called for a move away from long-term support in care homes. The report said reform must be underpinned by a "Home First” principle, with a much stronger emphasis on existing types of care and support that are housing based, such as "supported living" and "extra care housing", as well as new and innovative forms of care.

According to the report, this could mean a shift away from existing types of residential care with, for example, a lesser reliance on long stay, larger scale care homes "although they may continue to play a key role in reablement and short-term care". ADASS has called for a two-year funding settlement in 2020 to ensure the short-term sustainability and continuity of care, and to create the space for a national conversation to shape a new person-centred vision for adult social care.

The public conversation about adult social care reform is one of the nine recommendations made in the ADASS report. It also calls for locally-determined integrated care with local authorities coordinating care and support, and a complete review of how care markets operate and the suitability, sufficiency, sustainability, social value and quality of provision, with a consideration of regulation.

The report also recommends addressing current system inequalities that adversely impact people with learning disabilities, mental health and substance misuse issues, older people, women, BAME communities and those at end of their lives; it calls for housing to become central to care; a workforce strategy offering fair national care wages, training and career progression and greater support for informal carers; prioritisation of access to technological solutions; a cross-government strategy to enable people with care needs to live a good life; and a funded, managed transition from current care system to the new system to ensure service continuity for people with care needs.

ADASS President James Bullion stated in the report: "We have the opportunity to be radical, to be person-centred and to be transformative. We must seize this opportunity with both hands".

Adult Social Care – Shaping a Better Future is available at