‘We’re being impoverished’: how English councils have cut care during the pandemic

Lee Mangar’s voice trembles with exhaustion and indignation. She has been looking after her increasingly frail father throughout the pandemic without any payments to cover her caring responsibilities.

Tom Wall www.theguardian.com 

“I am going to cry now … I just need everyone to know the absolute shoddy position Suffolk is putting vulnerable people like my dad in,” she says from her home in Ipswich. “I’m just lucky that I’ve got the determination to keep fighting, because there are a lot of people out there who can’t stand up for themselves.”

Her father, Harold, sold his house to fund a move into a specially adapted extension on Mangar’s house. But Suffolk county council stopped paying Mangar £844 a month to care for her father, who has Lewy body dementia, following the move.

Under the Care Act, people in need of care can use direct payments from their local authority to pay carers, including family members, to help them carry out everyday tasks. Mangar was being paid to help Harold with his personal care and meals – now she has to do it without any financial support.

“They deemed him to be a self-payer. But there is no money,” says Mangar, who gave up her job in a nursery to look after her dad. “We are living off my dad’s pension and borrowing from my mum, who’s in sheltered accommodation. We’re being impoverished.”

Mangar can barely afford to buy the essentials she needs to clean him – let alone treats such as his favourite takeaway meals or new clothes for herself. She says her father needs specialist wipes which cost £4.75 a pack. “I’ve run out and at the moment I haven’t got enough money to go and buy them. So today I had to use kitchen roll, which is no good.”

Their plight is far from unique. Freedom of information requests by the Guardian to 19 English councils facing a high demand for social care, reveal that more than 3,700 working-age adults with physical or learning disabilities and almost 8,500 people aged over 65 have had the monetary value of their care package reduced since March.

The responses also show that just over 1,200 working-age adults with disabilities and nearly 3,500 over-65s have had the number of hours of support provided by local authority-funded carers reduced. And among new applicants for support, less than half of the 255,000 requests for social care were accepted, with only 41% given funded care packages in the 19 authorities between March and September.

“The pandemic seems to be making a bad situation worse,” says Caroline Abrahams, charity director at Age UK. “There’s no reason to suppose that these people’s needs have diminished during this health emergency, rather the reverse if anything, so in most cases they are being left to manage without all the care they require.”

The largest cuts were in bigger, more rural local authorities. Devon county council reduced the monetary value of 655 care packages for working-age adults and nearly 2,000 care packages for over-65s between March and September, more than any other council. Suffolk county council cut support for 571 working-age adults and 1,779 older people.

Staffordshire county council turned down the highest proportion of social care requests, with just under two-thirds of 16,443 people approaching the council for care assessments during the pandemic initially offered only advice, occupational therapy or directed to community groups. Northamptonshire county council – which declared itself effectively bankrupt in 2018 – had the next highest rate of rejection, with more than one-third of families and individuals refused long-term care packages, which can cover help with everyday tasks such as washing and cooking to trips to day centres.

Metropolitan authorities also rejected a large proportion of care requests and cut back on support throughout the pandemic. Liverpool turned down 31% of the near 3,500 requests for social care, while reducing the hours carers spend with 194 working-age adults and 223 elderly people in the city. Birmingham turned down a quarter of its 18,500 requests for social care and Solihull rejected 27%.

The pandemic has increased demands on already overloaded local social care services, which have been struggling to meet the growing needs of ageing populations. Requests for care have soared by over 100,000 since 2015. But austerity since 2010 has shrunk social care budgets by 10% and total real terms spending on social care is below 2009 levels.

Edel Harris, Mencap’s chief executive, says cash-strapped local authorities are clawing back vulnerable people’s support packages at a time when they need it most. “Many people with a learning disability have spent the pandemic trapped at home, losing vital life skills and suffering from increasing mental health problems,” she says. “Unpaid family carers have been left to pick up the pieces, but they are exhausted, stressed and in some cases completely broken.”

A survey in November by the Association of Directors of Adult Social Services (Adass) found that nearly a quarter of English adult social care directors have no confidence in their budgets being sufficient to meet all of their statutory duties, with several councils warning that they could follow Northamptonshire’s footsteps without more government support. Stoke-on-Trent city council this month proposed cuts of £412,000 to disabled and older people’s day services as well as more than £1m worth of savings from adult social care services.

Covid-19 is accelerating these cuts. Minha Chaudhary (not her real name) was told in December that her council was reviewing the care package for her 25-year-old disabled daughter, Zahra, who needs round-the-clock support.

Until now, the funding enabled Zahra to take part in activities such as swimming, cycling and reflexology. Chaudhary, who lives in north-west England, fears the council’s review of Zahra’s care package will lead to cuts to her daughter’s support. “[The support planner] was really antagonistic,” says Chaudhary. “She was recommending that she would take some of the package away from us because we’ve not used it all. But we are in a pandemic and everywhere is shut.”

Chaudhary, who works part-time while her husband looks after their daughter, is taking legal advice. “I’m worried sick,” she says.

Belinda Schwehr, chief executive of specialist legal advice service CASCAIDr, which is supporting Chaudhary, says “This is the endgame for social care. We are getting to the point where anyone able to feed themselves will not get social care.”

In November, the chancellor Rishi Sunak announced new funding for the beleaguered social care sector, including an additional grant of £300m. Sunak also allowed councils to levy a 3% adult social care precept, which could, along with the grant, generate up to £1bn. But this still falls short of what many experts and charities say is needed to keep up with demand next year, let alone the additional costs generated by the pandemic.

“Once again, local authorities are faced with trying to meet the care needs of their populations with inadequate government funding, but it’s older and disabled people who are ultimately paying the price, as these FoI responses demonstrate,” says Abrahams.

Suffolk county council says it has increased the value of more packages than it has reduced since March. “Every authority has continued to adjust the number of care packages it provides to eligible residents throughout 2020, as we continue to react to a range of social changes including the effects of the coronavirus on our communities,” says Beccy Hopfensperger, Suffolk’s cabinet member for adult care.

Devon county council says care packages had been changed rather than cut, with the high numbers reflecting the size of the authority: “Between March and September, there have been changes to people’s care packages in response to coronavirus, and many have sought alternative ways to meet their care needs. The fall in value then is a reflection of such changes,” says a spokesperson. Solihull council says it responds to all requests but some people may not accept social care services, or may not be eligible.

Staffordshire county council insists a range of support is available in communities, with the council funding those most in need. It adds it carries out care assessments at first contact when support is less likely to be needed. Northamptonshire county council says it had not turned down anyone who is eligible for social care support. Liverpool city council says people are assessed for services according to need rather than budget. While Birmingham city council says it is not turning down requests and points out there are many reasons referrals do not result in social care provision.

The Department of Health says it has made £4.6bn available to councils to address pressures on local services, including social care: “We are committed to sustainable improvement of the adult social care system and will bring forward proposals this year.”

This cannot come soon enough for dedicated but burned-out carers like Mangar. She has little to look forward to this year: “There is no money for me to plan anything. I can’t have a break. My life is just getting up in the morning and caring for my dad … we have been treated very, very unjustly.”