Newton - Preparing for Adult Social Care Reform

This report, developed by the County Councils Network (CCN) and Newton, assesses the financial and operational implications of the government’s planned adult social care charging reforms.

These reforms - including the £86,000 care cap, a more generous means test, a fair cost of care duty, and the right for all individuals to ask councils to arrange their care - represent the most significant change to adult social care in a generation.

This report highlights that while the reforms aim to make the system fairer and protect individuals from catastrophic care costs, they will create substantial cost pressures and workforce demands for councils.

These must be addressed if the reforms are to be implemented successfully. It finds that county areas are particularly vulnerable: councils are facing increasing demand, workforce shortages, and market fragility.

The report argues that without full funding, phased implementation, and strong national support, councils will face severe operational strain that risks undermining the reforms’ intentions.

An analysis of the reforms in the report reveals that:

• The cost of the care reforms, including the cap and means-test for over 65s, new ‘fair cost of care’ and administrative overheads in England could cost a minimum of £25.5bn over the next decade.
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• This compares to the government estimate of £15.6bn for the same elements of the reforms.
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• There is a significant regional variation in the costs of implementing the reforms, with councils in county and rural areas disproportionately impacted.
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• Councils in England’s counties account for 57% (£14.3bn) of the total estimated minimum costs of the reforms over the next decade.
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• This is compared to 19% (£4.9bn) in urban metropolitan borough councils in the North and West Midlands.  An additional 4,300 social work staff will be required to carry out the additional Care Act assessments, reviews, and case management, on top of a current vacancy rate of 1,782.  
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• Unless the government provides more funding and changes the way it allocates resources between councils, county and rural areas could face a minimum funding deficit of £7.6bn.
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• Some 3,000 additional new social workers and financial assessors will be required in these areas, 60% of all new recruitment.  
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• In order to properly fund these reforms, the government could potentially need to spend half of the Health and Social Care Levy by 2032 on these proposals alone, irrespective of other social care pressures in the system.  

Recommendations to government included:

• Provide full national funding to meet the true cost of reform.
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• Launch a national workforce strategy to address acute staffing needs.
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• Phase implementation to allow systems adequate preparation time.
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• Strengthen national implementation support, including IT, programme management and guidance.
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• Ensure funding distribution is aligned with regional need.
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• Support councils and providers to manage fair cost of care and market sustainability.