Delivering Quality Care on a Shoestring: The Impact of Budget Cuts on Social Care Services
For over a decade, the social care sector in the UK has faced relentless financial strain. With budgets being reduced year after year, care providers find themselves under immense pressure to deliver high-quality care to a growing number of individuals—all while grappling with limited resources. It’s a dilemma that affects not just those of us in the sector but the very people we support whose lives, health, and well-being hang in the balance.
Recent reports paint a stark picture: millions have been cut from social care budgets, forcing providers to make impossible choices. Yet, despite the financial hurdles, the demand for quality care continues to rise. So, how do we continue to support the most vulnerable among us with dignity and respect? To answer this, we must first confront the reality of what’s happening on the ground.
The Reality of Budget Cuts:
Across the country, care providers are being asked to do more with less. The reality? Staffing levels have plummeted, training opportunities have dried up, and essential resources are becoming increasingly scarce. Let me share an example that might resonate with you: one individual we support—someone who only had core hours in her care package—recently requested an additional hour per day. She simply wanted someone to accompany her on her daily walks because she felt unsafe walking alone. Her request was declined, with no explanation and no meeting to explore the benefits. This is the harsh reality for many: individuals whose needs are dismissed due to budget constraints, without consideration of how these small changes could drastically improve their quality of life.
In some cases, local authorities have even resorted to tactics that undermine the very principles of person-centred care. Providers are being told to reduce care packages by up to 50%, with the threat that individuals will be moved to different placements if cuts are not made. Imagine the anxiety and uncertainty this creates for someone who has called a place home for years. It’s a disturbing shift from assessing quality to prioritising the cheapest option available. When authorities focus solely on cost-cutting, placements break down, and we find ourselves receiving the same referrals again six months later. This cycle of instability helps no one.
The Challenge of Maintaining Quality:
How do you maintain the quality of care when the resources simply aren’t there? This is the question care providers face daily. When a person’s needs change—whether due to new behaviours, a decline in mobility, or the need for specialist assessments—referrals often go in circles. There simply aren’t enough Positive Behaviour Support professionals, occupational therapists, or physiotherapists to meet demand. The result? Delays in assessments, worsening health conditions, and ultimately, higher long-term costs for everyone involved.
Another layer of complexity is ensuring our teams are trained. Take the mandatory Oliver McGowan training for staff supporting autistic adults—an essential program. While we advocate for this, many local authorities cannot afford to provide the face-to-face training component, leaving care providers to absorb the costs. It’s another burden on providers who are already financially stretched thin, and yet, we’re still expected to maintain the same standards of care.
Staff salaries, for example, were increased by 10% in April 2024—a change we welcomed and have long fought for. Yet, many local authorities are not providing the necessary inflationary uplifts to cover these rising costs. Some authorities have offered a meagre 2% increase, forcing providers to do more with even less. These gaps in funding are pushing care providers to the brink, and ultimately, it’s the individuals we support who pay the price.
The most concerning part of all this? The threat of regression to institutional practices. Due to staffing shortages and budget cuts, we are seeing a return to practices that should have been left behind long ago: individuals going out in groups instead of on their own terms, everyone eating at the same time, and even going to bed at set hours—not because it suits them but because that’s what the staffing levels dictate. This is not person-centred care; this is care driven by crisis management.
Impact on the People We Support:
For those relying on social care services, the consequences of these budget cuts are immediate and profound. Reduced care hours and diminished services mean that even basic needs often go unmet. Take the example of an individual who once had regular access to physiotherapy for a mobility issue. Due to cuts, she now faces significant delays in receiving the treatment she needs, leading to a deterioration in her physical health. This is not an isolated incident; it’s happening to many individuals across the country.
Families, too, are feeling the strain. A recent survey of families in our services revealed their top concerns: the cutting of care packages, the lack of allocated social workers, and the unavailability of specialist services like OT and physiotherapy under the NHS. These fears are real, and they underscore a growing crisis in social care that demands our immediate attention.
Innovative Solutions and Adaptations:
In the face of these challenges, care providers are doing everything they can to innovate and adapt. Technology has offered some relief, with digital tools helping to streamline care delivery and provide virtual support to those who need it. Community partnerships are also playing an increasingly important role, as providers collaborate to share resources and implement creative solutions that maximise the limited funds available.
Local authorities, too, have adapted in certain ways, reducing management structures and embracing hybrid working. Emails and Microsoft Teams are now used more effectively, reducing postage, stationery, and travel costs, and allowing for more meetings to be held than before. However, while these internal savings are beneficial, they do not address the core issue: the chronic underfunding of social care services.
Call to Action:
The time for action is now. We must unite—care providers, policymakers, community leaders, and local authorities—to advocate for sustainable funding in social care. We must push beyond reactive measures and focus on preventive strategies that maintain the dignity and well-being of those we support. This means working together to develop more effective assessment processes that focus on the quality of care, ensuring fair wages for care workers, and reinstating essential specialist services that have been lost.
Collaboration is key. By pooling resources, sharing best practices, and leveraging community partnerships, we can build a more resilient care system that works for everyone. The future of care depends on our collective ability to push for change, to fight for the rights of those who need us most, and to demand that their needs are met—not just as a matter of policy, but as a matter of humanity.
The funding crisis in social care is not just a financial issue—it’s a moral one. As budgets continue to erode the foundations of care services, we are faced with a choice: do we continue down this path of cost-cutting and compromise, or do we stand up for the people we support and fight for a system that honours their dignity and worth?
Now is the time to act. We must recognise the value of social care and preserve the services that are the backbone of our communities. Together, we can ensure that every individual receives the support they deserve, no matter the financial constraints. Let us stand united, speak out, and fight for the future of care.
Useful Links:
Statistics and Reports: King’s Fund – The NHS and Social Care: Social Care In A Nutshell | The King's Fund (kingsfund.org.uk)
National Audit Office (NAO) Social Care Report: Reforming adult social care in England (nao.org.uk)
Government Guidelines on Oliver McGowan Training: Oliver McGowan draft code of practice - GOV.UK (www.gov.uk)
4. Advocacy and Action Groups: Care and Support Alliance
5. Letter - The Impact of Budget Cuts on Social Care Services