Early findings from LGA engagement
Adult social care reform in England has been on the national agenda for years, yet meaningful change has remained difficult to achieve.
Pressures have continued to grow, with more people needing care, ongoing workforce shortages, provider markets remaining fragile, and funding challenges continuing to impact on people who draw on care and support.
The Independent Commission on Adult Social Care, chaired by Baroness Casey, offers a renewed opportunity to take stock and reset the direction of travel.
As Baroness Casey outlines her early thinking, the LGA’s ‘Care where we live’ engagement series has been a timely opportunity to hear from councils in England, as well as partners, people who draw on care and unpaid carers, about local government’s future role – and several themes have emerged.
There is strong consensus that adult social care should remain rooted in local government. Councils are uniquely placed to connect care with the wider determinants of wellbeing – housing, public health, transport, community safety and leisure services.
This convening role enables councils to work effectively with the NHS, the voluntary and community sector, and other partners to build the ‘ecosystem’ of support that enables people to live well.
Just as importantly, councils provide democratic accountability. Visible and accountable leadership structures enable decisions about care and support that shape people’s lives.
Many contributors see reform as an opportunity to deepen integration across health, care and housing. In some areas, local government reorganisation could offer a route to align strategic planning with health systems, while retaining strong community connections.
Recurrently, the system is described as one that too often responds when people reach crisis, rather than supporting them to stay independent. There is a clear need to rebalance towards prevention.
Good social care is not a set of services, but the ability to live well, where there is easier access to advice, that adapts to changing needs, and where one can stay living at home and maintain relationships and routines.
Closer alignment with NHS prevention programmes and investment in community connection approaches are seen as important. Trusted relationships also matter – continuity of care workers and professionals who listen and understand individual needs are consistently highlighted as central to a positive care experience.
At present, many councils are managing, rather than actively shaping, local care provision. Fragmented markets, variable quality and workforce pressures point to the need for a stronger stewardship role.
Councils need stronger powers to develop sustainable local care markets. This includes moving beyond traditional market position statements towards a more proactive approach – fairer pay and better conditions for care workers, strengthening commissioning capability, and strategic oversight.
The workforce is widely recognised as the heart of the system and the ‘critical infrastructure’ of adult social care.
There is ongoing debate about the balance between national frameworks and local delivery. There is support for a national care Service, provided it focuses on setting clear national standards, consistent rights and better shared infrastructure, including data sharing, financial assessments, and technology and equipment.
Views expressed as part of ‘Care where we live’ were that delivery should remain locally led, so services reflect the needs, assets and priorities of individual communities. Strengthening local partnerships will be critical. There is particular interest in enhancing the statutory role of health and wellbeing boards, with oversight of integrated health and care planning, and a focus on improving people’s care experiences.
Whether the focus is prevention, funding or governance, the shared ambition is the same: a system that enables people to live the dignified and independent lives they choose, supported by strong communities and coordinated services.
These key themes are a useful indication of how the sector, and the public, are beginning to envisage the future of adult social care. While all councils continue to strive for improved performance and quality of social care delivery, these findings underline the vital role they will continue to play in shaping that future.
This is our moment to ensure local government has its voice heard clearly: the system must feel human, responsive and be centred on people’s lives, not organisational boundaries.
The next steps are for the LGA to analyse all engagement and views and form a collective view on behalf of the sector to share with Baroness Casey – who will be speaking at the LGA’s annual conference in July.
Smith Square debate – the money question
The LGA’s ‘Care where we live’ engagement with the sector culminated in a Smith Square Debate confronting the defining question for adult social care: what kind of system do we want, and how do we build it before the current one collapses under its own weight?
Among the debate’s panel members, one consensus emerged – adult social care is no longer just a public service crisis; it has become a national question about identity, infrastructure and the future country we want to be.
Dr Clenton Farquharson CBE, Associate Director of the national partnership Think Local Act Personal, reminded the debate that good care starts with humanity, not budgets. Most people want a home that feels like theirs, with the people they love around them, with peace, purpose and a life that feels like their own. That isn’t a luxury, it’s just life.
Challenging long-held assumptions that social care is about organising and managing people, Dr Farquharson argued that it should be about backing people, and supporting work, community, rest, family and connection.
Across the discussion, a recurring theme surfaced – that adult social care reform has repeatedly started with the money, and not with a shared vision of what care should do.
Richard Humphries, a Senior Policy Advisor at the Health Foundation, argued that the country must decide whether it wants a universal system that supports people to live well or a basic emergency service that steps in only when people hit crisis.
Former First Secretary of State Damian Green described the current funding model as unsustainable, stating that council tax cannot carry the weight. Proposing a national funding settlement, underpinned by a national assessment of need, he said local government should act as the glue holding together local delivery, commissioning and market shaping.
Urging the sector to build public support for social care as a priority, Mr Green warned that without a stronger national voice reform will always be politically fragile.
Dame Patricia Hewitt, drawing on her experience as a former Secretary of State for Health, argued that far too little is spent on social care. Describing how many older people occupying hospital beds would be better supported at home, she argued that the system will continue to fail individuals and the taxpayer without redirecting investment upstream.