Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the impact of employer National Insurance contributions on the financial sustainability of regulated adult social care providers.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government took the cost pressures facing adult social care, including changes to employer National Insurance Contributions and increases to the National Living Wage, into account as part of the wider consideration of local government spending within the 2024 Autumn Budget process.
To enable local authorities to deliver key services such as adult social care, the Government has made available up to £3.7 billion of additional funding for social care authorities in 2025/26.
In addition, the Spending Review 2025 allows for an increase of over £4 billion of funding available for adult social care in 2028/29 compared to 2025/26.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many local authorities have been found to be non-compliant with the outcomes-based commissioning requirements set out in the care and support statutory guidance in each year since 2020, and what enforcement action has been taken against those local authorities.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets to meet the diverse needs of all local people. The Care and Support Statutory Guidance is the accompanying statutory guidance for local authorities and partner agencies, which sets out the principles that should underpin market shaping and commissioning activity, including a focus on outcomes and wellbeing.
The Care Quality Commission (CQC) assesses how well local authorities are delivering their duties under Part 1 of the Care Act 2014, including those related to market shaping and commissioning. To date, the CQC has published over 60 assessment reports, which are publicly available on the CQC’s website. To date, none have yet been found to be failing in its market shaping duty. If the CQC identifies that a local authority has failed to deliver one or more of its Care Act duties, the Secretary of State for Health and Social Care (Wes Streeting MP) has legal powers to intervene.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of local authority compliance with outcomes-based commissioning requirements set out in the care and support statutory guidance.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Under the Care Act 2014, local authorities are tasked with the duty to shape their care markets to meet the diverse needs of all local people. The Care and Support Statutory Guidance is the accompanying statutory guidance for local authorities and partner agencies, which sets out the principles that should underpin market shaping and commissioning activity, including a focus on outcomes and wellbeing.
The Care Quality Commission (CQC) assesses how well local authorities are delivering their duties under Part 1 of the Care Act 2014, including those related to market shaping and commissioning. To date, the CQC has published over 60 assessment reports, which are publicly available on the CQC’s website. To date, none have yet been found to be failing in its market shaping duty. If the CQC identifies that a local authority has failed to deliver one or more of its Care Act duties, the Secretary of State for Health and Social Care (Wes Streeting MP) has legal powers to intervene.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of care provider closures in each local authority area since January 2024.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Under the Care Act 2014, local authorities are required to shape their local markets, and ensure that people have a range of high-quality, sustainable and person-centred adult social care and support options available to them, and that they can access the services that best meet their needs. Care providers entering and exiting is a normal part of a functioning market, and local authorities should have appropriate contingency plans in place depending on the services being provided.
The Care Quality Commission’s (CQC) Market Oversight Scheme monitors the financial health of typically the largest and potentially most difficult-to-replace providers in the adult social care sector. The CQC will notify local authorities if they consider it likely that any provider’s services will be disrupted because of business failure. Since January 2024, there have been no such notifications.
The number of adult social care providers deregistered by the CQC from 1 January 2024, broken down by local authority, is shown in the attached table.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many self-employed care workers operate in England, and what assessment they have made of how many of those workers meet the criteria for self-employment.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
There is no available estimate of the number of care workers who are self-employed. The only available data on self-employment within the adult social care sector is for personal assistants who are employed by direct payment recipients.
Skills for Care estimates that in 2024/25, there were 100,000 personal assistants (PAs) working for direct payment recipients, and of these, 10% were self-employed. There is no equivalent data available on self-employed PAs who are working for individuals funding their own care.
The Department has not made an assessment of how many of these workers meet the criteria for self-employment.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of introducing standard national terms and conditions for contracting adult social care services to ensure appropriate fees are paid by public bodies to allow providers to meet their legal obligations for care regulations and employment, including pay for all working time, including travel, and mandatory training.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Local authorities are best placed to understand and plan for the needs of their population, which is why, under the Care Act 2014, they are tasked with the duty to shape their care market to meet the diverse needs of all people. In meeting this duty, local authorities must consider ways of promoting a workforce with the appropriate skills and working conditions. Local authorities should work with care providers on an ongoing basis to arrive at a shared understanding of what it costs to run high quality and sustainable care provision, taking into account local circumstances.
We expect local authorities to pay sustainable fee rates that meet the costs of delivering care, which is why the Market Sustainability and Improvement Fund will provide over £1 billion for adult social care to local authorities over 2025/26. This can be used to target increasing fee rates paid to adult social care.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of (1) the number of postcodes in England where private care agencies refuse to provide services, and (2) the level of deprivation in such postcodes.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
A limited amount of information on care packages handed back by home care agencies has been collected by the Department since September 2022. We have recently reviewed how this information is gathered and are starting to gather more detailed information. However, we are unable to publish the data as the majority is supplied on a voluntary basis, and is therefore not representative.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the number of care packages handed back by care agencies in each of the past three years which have been distributed (1) privately, and (2) by public authorities, broken down by region.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
A limited amount of information on care packages handed back by home care agencies has been collected by the Department since September 2022. We have recently reviewed how this information is gathered and are starting to gather more detailed information. However, we are unable to publish the data as the majority is supplied on a voluntary basis, and is therefore not representative.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what their estimate is of the percentage of total care packages funded by public authorities that have handed back in each of the past three years, broken down by region.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
A limited amount of information on care packages handed back by home care agencies has been collected by the Department since September 2022. We have recently reviewed how this information is gathered and are starting to gather more detailed information. However, we are unable to publish the data as the majority is supplied on a voluntary basis, and is therefore not representative.
Asked by: Lord Wills (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what their estimate is of the percentage of total care packages funded privately that have handed back in each of the past three years, broken down by region.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
A limited amount of information on care packages handed back by home care agencies has been collected by the Department since September 2022. We have recently reviewed how this information is gathered and are starting to gather more detailed information. However, we are unable to publish the data as the majority is supplied on a voluntary basis, and is therefore not representative.