The Conservatives’ record on adult social care: spending, policies and outcomes in England, May 2015 to pre-COVID 2020

This paper uses the Social Policies and Distributional Outcomes framework to evaluate developments in adult social care policies in England during the period between 2015 and the eve of COVID-19 pandemic in February 2020. The paper explores adult social care policies and goals, along with public spending, and their impact on inputs (such as workforce), outputs (such as number of people receiving adult social care support) and outcomes. It finds that despite an increase in pooled health and social care funding over the period and improvements in pay for the lowest paid care workers, there has been a further fall in the number of older people receiving community-based services and the intensification of care provided by unpaid carers has increased. Ethnic inequalities in satisfaction with care services, and both the scale of, and steep social gradient in, unmet need are troubling signs of inequities in the social care system. The paper concludes with reflections on the strengths and weaknesses of the social care systems on the eve of the COVID-19 pandemic and identifies four policy challenges for the 2020s: recognition (for paid and unpaid carers), coordination (within social care and between social care and health), adequacy (of resources and quality) and equity (especially by age, ethnicity, and socio-economic status).