Last reviewed 6 April 2021

A National Audit Office (NAO) report has described the Government’s “short-termist” adult social care policy as starving the sector of investment and hampering councils’ ability to plan for the future.

This comes amid unmet need, high levels of unpaid care and growing demand. The public spending watchdog found government oversight over the adult social care sector ineffective.

It said the Department of Health and Social Care (DHSC) was unable to assess the quality of services and council commissioning because current accountability and oversight arrangements did not work. This meant it was incapable of assessing the quality of council commissioning, return on investment or future resource needs.

The report found the impact of short-term funding settlements for councils, typically for one year, led to a lack of investment and an inability on councils’ part to plan.

It said: “Uncertainty over the long-term sustainability of funding has made it difficult for local authorities to plan how much care, and at what price, they will be able to purchase beyond the current financial year, constraining innovation and investment.”

Funding uncertainty, together with “no coordinated, long-term vision across government about how to fund or incentivise the market through mechanisms such as fee rates, housing benefit, grant funding or loans”, were making providers reluctant to invest in accommodation for adults with care needs. It said the Government’s short-termism also hampered investment in workforce development.

Nuffield Trust Deputy Director of Policy Natasha Curry responded to the report saying it illustrated the pre-Covid fragility of social care services that had been exacerbated by the pandemic. She said: “Organisations providing care are too often paid at or below cost for council-funded clients, with the result that they either turn down council contracts, collapse, or charge people paying for their own care higher fees.”

She added: “The impact of this unstable system inevitably falls on care workers and the people receiving care, many of whom struggle to access the essential and high quality services they deserve.”

The report, The Adult Social Care Market in England, is available at: