'Client contributions' to social care - adults with learning disabilities

With recent campaigning about drastically increasing charges for people drawing on adult social care, I thought I'd have a quick look at what the NHS Digital statistics say about the scale of 'client contributions' to adult social care in England. I've only looked at figures for adults labelled as having a primary care need of learning disabilities (the same analyses could be done for other groups of people), and I've looked at figures from 2016/17 to 2019/20. This is obviously before COVID-19 really hit, but it might give a bit of a picture of how things were going before the pandemic.

I last did a blogpost about this 6 years ago (the way the statistics are collected has changed since then, so the figures aren't directly comparable), and this blogpost on social care statistics and adults with learning disabilities might be useful for context.

Two graphs.

This graph below shows the amount that local authorities received in 'client contributions' to social care services for adults with learning disabilities aged 18-64. A few things:

• In 2019/20, client contributions totalled £369 million for adults with learning disabilities aged 18-64, 6.8% of the total gross expenditure of local authorities on social care for this group. This equates to an average of £2,265 per year per person getting long term social care.
• From 2016/17 to 2019/20, the total amount of client contributions has increased by 6.4% per year (Compound Annual Growth Rate), compared to 3.8% per year for local authority spending (minus client contributions). It's important to say that these figures aren't adjusted for inflation.
• The greatest client contributions were in the categories of Fairer Charging Income (£137.2 million) and residential care (£123.8 million). 
• While client contributions to residential care are reducing over time (in line with residential care services reducing over time), client contributions to Fairer Charging (10.8% per year) and many other types of support have increased rapidly from 2016/17 to 2019/20.

The second graph below is in the same format, and shows the amount that local authorities received in 'client contributions' to social care services for adults with learning disabilities aged 65+:

• In 2019/20, client contributions totalled £78.4 million for adults with learning disabilities aged 65+, 11.1% of the total gross expenditure of local authorities on social care for this group. This equates to an average of £3,703 per year per person getting long term social care.
• From 2016/17 to 2019/20, the total amount of client contributions has increased by 6.1% per year (Compound Annual Growth Rate), compared to 7.2% per year for local authority spending (minus client contributions). Again, it's important to say that these figures aren't adjusted for inflation.
• The greatest client contributions were in the categories of residential care (£35.4 million) and Fairer Charging Income (£25 million). 
• While client contributions to residential care are fluctuating over time, client contributions to Fairer Charging (15.8% per year) and many other types of support have increased rapidly from 2016/17 to 2019/20.

Local authorities have generally tried to preserve spending on social care services for adults with learning disabilities up to the start of the pandemic, although this is not keeping pace with the number of adults with learning disabilities who could do with some social care support. Austerity for local authorities is also, of course, austerity in the lives of many people with learning disabilities and their families and friends, and these statistics show that people and families are being required to make rapidly increasing contributions that many can ill afford. And of course, these statistics only record formal 'client contributions', when we know that many families are making substantial contributions that would not show up in these statistics.

Finally, all these statistics are before the impact of the COVID-19 pandemic, when we know that people with learning disabilities have faced huge cuts to their social care support and there is real anxiety about rapidly increasing charges. Are we really building back better?