High-cost care packages for young adults surge by almost a third in a year

A sharp increase in high-cost social care for young adults has been revealed in a new survey published today by the Association of Directors of Adult Social Services (ADASS).

It is driven by the growing complexity of care and support needs, the transfer of support from health to local government care without associated funding, pressures on local government finances, and workforce challenges.

Directors across England report a 30% increase in the number of 18-24 year olds whose care package costs more than £7,000 per week.  

Councils support young people with the most-complex needs including profound physical disabilities, significant learning disabilities, severe neurodivergence, and enduring or high-risk mental health conditions such as complex trauma.

Freya Viles, 24, has cerebral palsy and needs a hoist to move into and out of her power chair.

She is an active member of her community, working part time at the Wiltshire Centre for Independent Living two days per week, and managing a local hospice shop on Sundays.

Councils overspending on adult social care isn’t about abstract numbers — it’s about the unmet needs of real people

She said: “I want to live the way other young people do – leading a normal busy life, and choosing who I have around me.

“Having a direct payment to employ PAs would give me choice and control, but I’ve been told it costs too much. Instead, I have live-in support and have now had more than 30 different carers from three agencies, meaning I really struggle to build relationships of trust.

“It’s frustrating because cost is deciding what my adulthood looks like instead of me.

“I often must balance my lifestyle and the carers. I want to highlight the importance of the right support to allow everyone live the life they want.”

The ADASS Autumn Survey report also finds:

• Directors are estimating the largest overspend at this point of the year in the post-COVID-19 era, with a projected £623m overspend for 2025/26
• Significant savings will be required from next year’s adult social care budgets totalling £869m savings in 2026/27
• The Government move to neighbourhood health means adult social care needs a strong voice, yet a third of directors (34%) say they have very little, or no, influence over Integrated Care System structures
• In terms of healthcare tasks being delegated to adult social care staff, half of directors said they do not have an agreement in place with health partners on funding, training or competency frameworks for staff

Jess McGregor, ADASS president and executive director for adults and health at Camden Council, said: “Councils overspending on adult social care isn’t about abstract numbers — it’s about the unmet needs of real people.

The underfunding of adult social care is forcing councils to make impossible choices – trying to balance financial sustainability with doing the right thing for those who rely on us

“Nowhere is this more evident than for young adults with complex needs, like Freya, whose care and support ensures they can live full and independent lives.

“The underfunding of adult social care is forcing councils to make impossible choices – trying to balance financial sustainability with doing the right thing for those who rely on us.”  

The ADASS survey is launched the day before the National Children and Adult Services Conference opens in Bournemouth tomorrow.
It is also published ahead of the Autumn Budget and ADASS has submitted recommendations to the Treasury ahead of the announcement, calling for:

• Investment in preparation for adulthood, including aligned statutory guidance across DHSC, DfE and MHCLG, and a national set of standards developed with young people and families
• Stabilisation funding for care markets and support for workforce retention as the Government phases out international recruitment
• Full funding for the Fair Pay Agreement implementation and other cost pressures arising from the Employment Rights Bill so that funding pay increases does not fall to councils which are already under strain

The Autumn Survey findings also reinforce the importance of the Casey Commission on Adult Social Care.

ADASS’ president has given evidence to the commission encouraging support for children, young people, working-age adults, and older people to be more coherent, sustainable, and fair.