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Further cuts to care services in England will be needed in the coming year, council chiefs are warning.
Local authorities plan to spend £22.5bn in 2019-20 on services for older people and younger adults with disabilities.
That represented a rise of £400m on last year but was not enough to keep up with demand and inflation, the Association of Directors of Adult Social Services (ADASS) said.
It warned services were “fragile and failing”, after surveying 151 councils.
The government said it would be looking to publish plans to overhaul the system “at the earliest opportunity”.
The Green Paper is now nearly two years behind schedule.
‘We are being penalised’
One couple caught up in the squeeze is Pauline and Roger Wellman.
Roger, 74, has had cancer and now struggles with dementia and a severe skin condition.
He is cared for by Pauline, 72, who says they had to fight for support from their local council and still make contributions towards the help they now receive.
“We’ve worked all our lives,” Pauline says.
“It seems to me we are penalised – because if we didn’t have anything, we would get everything.
“Don’t you think sometimes that is a little unfair?”
One of their care workers, Lauren Counsell, says even when people such as the Wellmans do receive support, it is often insufficient.
“A lot of people you go to see don’t have the hours they need,” she says.
“But the council has a criteria – and they have to stick with it.”
How bad will things become?
The charity Age UK estimates 1.4 million older people are not being given the help they need.
The ADASS said councils had had to make £7bn of cuts to care budgets since 2010.
And the group is predicting another £700m of savings will be needed in the coming year.
Some of that could be made through more efficient ways of working.
But the ADASS said social care directors would have to focus services on those with the highest needs to make ends meet.
And its survey of councils suggests over the past six months more than 7,000 people have been affected by the closure of care services run by private agencies working on behalf councils.
ADASS president Julie Ogley said there was a desperate lack of money in the system and over a third of the anticipated spend for 2019-20 would come from charges to the public and separate one-off grants.
“We are having to make incredibly difficult decisions based on dwindling resources, which should not be allowed to happen in a modern, compassionate society,” she said.
Alzheimer’s Society director of policy Sally Copley said: “How much more evidence do we need that social care is on its knees?
“By failing to take action, the government is betraying hundreds of thousands of people who depend on social care for support.”