Social care in the United Kingdom

Social care in the United Kingdom is the job of local government. The Department of Health and Social Care manages the system in England. The Care Quality Commission visits organizations which provide it.
In the past social care was largely a family affair. Not many people survived to live long with severe health problems. People who were born disabled or with learning difficulty were often put in long stay hospitals for life. People with mental illness often lived in big hospitals for years. These institutions have mostly closed and now more people get help in their own homes or in group homes. They may pay for it, or it may be supplied by the local council. People who pay themselves pay a lot more than what the council pays. More people need social care as more people live to be old and people survive with conditions which in earlier times would have meant an early death. The 1948 National Assistance Act set up old people's homes, run by local government in England, and geriatric wards in hospitals. Conditions in the geriatric wards were often poor. Many were in former workhouses. They were closed and now people end up in nursing homes which are private and they may have to pay. Some are small firms, with a single care home, some are part of huge chains backed by venture capital. HC-One is Britain's biggest, with about 20,000 staff and 321 homes. About 400,000 people are in residential institutions and about the same number get care in their own homes.
There have a been a lot of reports about social care. They all recommended major changes in funding and provision but very little has changed since 1990. There have been proposals for a National Care Service like the NHS, but people who have more than PS23,250 (or PS24,000 in Wales) have to pay, so people are forced to sell their houses. The Health Foundation says that extra money - somewhere between PS6.1 and PS14.4 billion a year - will be needed to meet future demand in social care by 2030.
Social care is not just for old people. About a third of people needing it are disabled adults.
In a year, more than 4.3 million people in the UK become unpaid carers. 4 million people stop their unpaid caring roles every year. The unpaid care work in the UK was recently valued at PS59.5 billion a year. The 2021 United Kingdom census found an increase in the number of people who said they were caring for more than 20 hours a week compared to 2011, but fewer people caring for less than that.
Social workers are employed to make decisions about the help people need if the government is paying. The people who are paid to actually do this work may be called care workers. They are mostly women and the pay is low. People often leave for better paid work in retail. According to Skills for Care there were 165,000 unfilled jobs in England in 2021/22 - 52% more than the year before. There are about 988,000 paid care workers in the United Kingdom. Many of these workers are immigrants. 58,000 came to the UK in the year to March 2023 -- mostly from India and Nigeria. The trade union Unison reported in 2023 that many pay a lot of money to people in their home countries who find them work. They are then vulnerable to exploitation and cannot complain.
Social care is often needed when people have been in hospital. Pressure on hospitals caused by the COVID-19 pandemic has also put pressure on social care. Lack of social care is is a big cause of people getting stuck in hospital.
The Care Quality Commission said in October 2022 that health and social care in England was " gridlocked and unable to operate effectively." Only 2 in 5 people were able to leave hospital when they are ready to do so. They said it needed planning and investment.
According to Skills for Care there were 165,000 unfilled jobs in England in 2021/22 - 52% more than the year before. There are about 988,000 care workers in the United Kingdom.
There were 12,280 registered care homes in England at the end of 2022, but by May 31 there were only 12,224. The numbers of care homes have been falling for some years, as costs, especially for mortgages, have risen. There has been a shift away from care homes to care at home. In 2023 there were 6,600 more home care agencies in England than in 2010.
In November 2022 the Department of Health and Social Care put up an extra PS500 million. This was intended to help to lower the number of people stuck in hospitals because they couldnt get social care.