Costs to councils for providing care and support for working age adults could grow to reach £17bn by end of the decade: CCN

The cost of providing care for working age adults and life-long disabled people requiring social care is now “far outpacing” social care to the over 65s, analysis by County Councils Network (CCN) has found.

The CCN research found that two-thirds of adult social care commissioning budgets are now dedicated to working age and lifelong disabled adults,

The organisation warned however that historically, there has been less of a national focus on younger individuals who require adult social care support to maximise their independence, compared to older adults with declining physical health, frailty, or dementia.

The report calls for a “significant increase” in funding for councils to meet rising costs, and a number of reforms to the system to focus more on prevention.

The analysis reveals that rising costs are primarily driven by the increasing complexity and needs of individuals, resulting in a “dramatic increase” in the costs of care placements – up 32% on average – particularly amongst those with the most acute learning disability needs.

The report notes that “inappropriate and insufficient” housing was highlighted in the study as a key issue preventing optimal outcomes being achieved for working age and lifelong disabled adults.

In particular, the lack of suitable local authority housing was cited as leading to a greater use of supported living, reducing independence and driving up cost.

Councils reported often being reliant on limited 24-hour residential and nursing placements due to a lack of alternative housing options.

In addition, some councils said they are exposed to needing to use more expensive out of area placements to meet local needs, leaving them “at the mercy” of the provider market.

Other key findings included:

• The costs of providing care and support for working age adults and those with a lifelong disabled condition is now the largest area of adult social care expenditure in England. In 2023/24, 63% of all adult social care commissioned support, such as residential and home-based care, was on working age adults, despite these individuals making up just 40% of all adult social care service users.
• Councils have witnessed a dramatic rise in the costs of these services over the past five years, up by a third.
• The average level of weekly expenditure per individual has increased by 31% for working age and lifelong disabled adults between 2019 and 2024, from £565 to £735.
• Care packages for working age adults with the most complex learning disabilities have witnessed the most acute rise in placements costs. Individuals in this cohort typically receive a care package with an average weekly cost of £3,316 per person. This has increased by an average £1,299 in the last year.
• Without reform, councils’ costs to provide care and support for working age adults will grow to reach £17bn by the end of the decade.

Calling for “better links” between working age adult social care and housing, the report recommends more specific local authority housing suitable for the working age adults cohort alongside new requirements for the greater provision of supporting housing options within the government’s planning reforms and local housing targets.

It also recommends “closer alignment” with national and local education and employment sectors to open up education and job opportunities.

Speaking at the CCN Annual Conference 2024 yesterday (11 November), CCN Adult Social Care Spokesperson Cllr Martin Tett said: “Caring for working age and lifelong disabled adults is one of the most important and rewarding responsibilities councils carry out. But too often in the debate on adult social care their needs and challenges are forgotten.

“Our research reveals that far too many working age and lifelong disabled adults are placed in expensive and sometimes inappropriate residential placements. This is bad for councils and even worse for care users who see their independence drastically reduced.

“For individuals and councils, the National Care Service risks being an empty slogan unless it is backed with a renewed focus on working age adults, and significant increase in funding for councils to meet rising costs and ensure the quality and safety of support is maintained.”

Responding to the report, Cllr David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board said: “Adult social care is often seen primarily as a service for older people, but many who access on it are younger, working-age adults with disabilities. While their aspirations—such as independence, relationships, and hobbies—may align with those of older generations, supporting them effectively requires a distinct approach. This report highlights the urgent need for focused attention on this group as we address funding and reform.

“The projections are concerning for those needing care, amid widespread unmet needs and the overwhelming majority of councils expected to overspend on adult social services next year. Without immediate investment and a long-term funding strategy, the situation will only deteriorate. Ensuring adequate resources to support working-age adults equally must be a government priority."

Lottie Winson