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Adult social care in England: overview

1. Social care (‘care’) comprises personal care and practical support for adults with physical disabilities, learning disabilities, or physical or mental illnesses, as well as support for their carers. The government’s objectives are to enhance adults’ quality of life, delay and reduce the need for care, ensure positive care experiences, and safeguard adults from harm
2. Publicly funded care makes up only a minority of the total value of care, and this proportion is decreasing. Most care and support is provided unpaid by family, friends and neighbours (informal care), while many adults pay for some or all of their formal care services. Local authorities provide a range of universal and preventative services, many of which are available without assessment of need. Local authorities typically only pay for individual packages of care for adults assessed as having high needs and limited means. They commission most care from the private and voluntary sectors, with home care and care homes the most common services.

3. Legislative and other changes are increasing adults’ role in shaping their own care and support, diversifying the types of care available and changing how adults access it. In 2012, the Department of Health announced new legislation, the Care Bill. The Department designed the bill to rationalise local authorities’ obligations, to introduce new duties based on individual wellbeing and to mitigate pressures on self-funders and carers. From April 2015, the bill will change how local authorities assess and fund adults’ care needs. From April 2016, it will introduce a limit on an individual’s contributions to meeting their eligible care needs. The government wants to continue reducing public spending while maintaining spending on care and support, and improving outcomes for adults, as need for care rises.

4. Adults’ care needs are often multiple and interrelated with other needs. Adult social care is therefore part of a complex system of related public services and forms of support (Figure 1 overleaf). How well services meet adults’ needs depends on all parts of the system working together. For example, good medical management of long‑term conditions can prevent a person developing care needs, and welfare benefits can maintain independent living.

5. This report, the first in a series on adult care, describes the care system. It highlights the main risks and challenges as the system is changed radically, some of which will be covered in more detail in future years. We provide a glossary of care‑related terms, used throughout this report, in Appendix Three.