Social care spending: home care

In 2010, the Government published spending plans that reduced central government grants to local authorities (who are responsible for funding social care) by 26% in real terms between 2011-12 and 2014-15. Local government spending overall, which includes income from Council Tax and other charges, was projected to fall by 14% in real terms. In June 2013, the Government followed this with a further 10% reduction in grants for 2015-16. (For more information, see our report, Focus on: Social care for older people.

Personal Social Services: Expenditure and Unit Costs covers information about the money spent on adult social care by the social services departments of Councils with Adult Social Services Responsibilities (CASSRs) in England. Gross current expenditure by CASSRs on adult social care in England in 2014-15 was £17.1bn. This represents a reduction of 1% in cash terms from £17.2bn in 2013-14, which is the equivalent of a 3% decrease in real terms and an 8% real-terms decrease from 2009-10.

How has gross expenditure on adult social services changed?

Gross current expenditure by Councils with Adult Social Services Responsibilities on adult social care was £17bn in 2015-16. There was a 26% increase in expenditure in cash terms between 2004-05 and 2014-15, but since 2010-11 expenditure in cash terms has remained relatively steady. Between 2004-05 and 2015-16 expediture in real terms peaked at £18.5bn in 2009-10 and then declined to £17bn.

Of gross current expenditure in 2014-15, 76% (£13bn) was spent on long-term support, 4% (£0.6bn) on short-term support and the remaining 20% (£3.4bn) on other social services expenditure.

How has the proportion and amount spent on home care changed?

It is important that people remain as independent as possible and this often involves providing care at home. This care can include help getting to bed, dressing or bathing. Here we look at the proportion of adult social care expenditure that was spent to support people living in their own homes. We can see that the proportion of money spent by councils for home care has been fairly steady since 1994-95, with a yearly average of 17.6%. However there has been some variation since 1994-95: it dipped to a low of 15.9% in 2002-03 and climbed to a high of 19.0% in 2010-11. Since then it has been decreasing.

How does the amount spent on home care vary by client type?

We can see that by far the largest amount spent on home care is for the over 65s - in 2013-14 it was just over £1.8bn. This has however been decreasing since 2010-11, where it was at a high of £2.1bn. The amount spent on home care for adults under 65 with learning disabilities has seen the biggest rise and has been increasing since 1994-95; it was £0.7bn in 2013-14. Adults under 65 with physical disability or sensory impairment, also generally increased to a high in 2010-11 of £0.3bn, and stayed steady in the following years. Home care expenditure on adults under 65 with mental health needs was the smallest amount, around £0.07bn in 2013-14.

How does the proportion spent on home care vary within each client group budget?

Overall, older people have the highest proportion spent on home care - in 2013-14 this was 21%. This had been fairly steady, at around 23%, from 1996-97 to 2010-11, after which it decreased to 21% in 2013-14. For adults under 65 with a physical or sensory disability, the proportion spent on home care initially increased to a high of 23% in 2001-02, from where it decreased to 19% in 2013-14. For adults under 65 with learning disabilities, the proportion has generally increased, from 2% in 1994-95 to a high of 14% in 2010-11. It decreased slightly to 13% in 2013-14. Adults under 65 with mental health needs have the lowest proportion spent on home care overall. This has been fairly steady at around 5-6%, but it increased slightly from 2009-10 to 7% in 2013-14.

How does the expenditure on long-term support differ by setting and age?

40% (£5.2bn) of expenditure on long-term support is spent on residential care: £2.1bn on those aged 18-64 and the remaining £3bn on people aged 65+. For those aged 65+, 20% of the total long-term support expenditure is spent on each of community home care and nursing. For those aged 18-64, more money is spent on support living (£1.1bn) and via direct payments (£944m).

This is quite an abstract measure and gives no indication of need or resultant outcomes in the local population.

About this data

In 2014-15 the collection method for this data changed from the Personal Social Services Expenditure and Unit Costs Return (PSSEX1) collection to the new Adult Social Care – Finance Return, resulting in significant changes to the data collected, including the introduction of new Primary Support Reasons.

Long term support (i.e. any service or support which is provided with the intention of maintaining quality of life for an individual on an ongoing basis) and short term support (time-limited episodes of support) have been detailed separately.

For more information on this data prior to 2013-14, please see the NHS Digital

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