Charities providing specialist care to thousands of vulnerable adults with learning disabilities and severe autism are having to “evict” residents to avoid insolvency because of tax and wage rises and local authority funding cuts.
Non-profit providers say their work is in a “state of acute precarity” with many preparing to cut services, close doors to new residents and effectively evict tenants because the fees councils pay no longer meet the cost of care.
The warning comes as concerns grow that the government, which announced a three-year review of social care headed by Lady Casey a fortnight ago, is not moving swiftly enough to avert a worsening crisis in the sector.
The annual Sector Pulse Check survey of more than 200 social care providers, both private and charitable, says many are on the brink as they struggle to remain viable in the face of cash-strapped councils’ refusal or inability to meet the rising cost of services.
It says charities increasingly have to threaten to walk away from contracts – effectively evicting individuals in residential care – to force councils to pay the full cost of specialist services. More than half of charity care providers handed back contracts last year.
One charity described how the 80-something mother of one of its residents with complex learning disabilities and autism was in floods of tears and suffered weeks of stress because council cuts meant the “home for life” for her 60-something son – who had lived with the charity for 47 years – was at risk.
“In the end we didn’t evict. It cost us but we are a decent organisation,” said Stephen Veevers, the chief executive of the specialist care provider HFT. “It would have been devastating and would have been life changing for those involved. This kind of thing will be going on up and down the country, day in day out.”
Sean Timbrell, the chief executive of Stroud Court community trust in Gloucestershire, a charity that provides specialist residential care for autistic adults, accused some councils of passing the buck and failing to meet their legal responsibilities.
“The impact on residents is devastating,” he said. “We can no longer subsidise personalised activities, and as residents have just £30 per week for personal expenses, many lose opportunities for joy and growth.”
Many specialist adult social care charities were set up in the 1950s, 60s and 70s by parents of severely autistic children and those with learning disablilities because they were frustrated that outdated institutional services were not meeting their care and support needs.
Veevers said he was concerned the charity model of care was under threat. “The risk is it fails, and we goes back to the ‘warehousing’ approach of the 1950s. You will see an increase in big for-profit, private equity-backed providers gobbling up contracts because they will be the only people left in the game.”
The Sector Pulse Check survey says specialist social care charities are far more likely than private for-profits to face financial difficulties because of their almost total reliance on council funding. “The liquidity of not-for-profit providers in particular is becoming so difficult that service delivery is being substantially impacted,” it says.
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Many charities were blindsided by the chancellor’s decision to raise employer national insurance contributions (NICs) from April, a move estimated to add £2.8bn to costs for the UK’s 18,000 social care providers. This came on top of extra costs incurred by increases to the “national living wage”.
Social care provider charities are seeking exemption from the NIC rises, arguing that like voluntary hospices, which have been offered financial support by the government, and the NHS, which is exempt, they are effectively public services.
Keir Starmer wrote to charities last week saying he was “proud of the way we have worked in partnership with civil society over the last six months and everything you have helped us to achieve”, and promising a closer partnership with the voluntary sector to deliver Labour’s missions.
Charity leaders have received the prime minister’s letter coolly, noting the gulf between the government’s rhetorical support and its failure to fund social care properly. One charity boss said they were “spitting feathers” after reading the letter.
A Department of Health and Social Care spokesperson said: “The Casey commission will work to build consensus around the future of adult social care that is fair and affordable. The first report will be published next year and set out the immediate action this government should take to lay the foundations of a National Care Service.”