According to Watkins et al. (2017), in the last decades, numerous reports and consultations have been developed about the challenges facing social care providers in England and Wales. However, little concerning funding has been achieved. The issue has widely been politicized and for policymakers, they have opted to do nothing like the most reasonable reason. In England and Wales, adult social care entails the provision of care as well as support for those in need of it due to illness, age, disability or other socio-economic situations that disadvantages them. The care varies from providing them with essential day to day activities like cleaning to being an active participant in all their life’s aspects. In general, social care can be given in the individual’s homes to ensure that they live independent lives. It is projected that about 8 per cent or 5.4 million people in England and Wales provide social support and care as informal carers, which entails family and friends (Cromarty, 2017). Allowances and savings are a vital source of funding for these carers. On the other hand, in England, local authorities are required to cater for the needs of the other population which is broad. Local authorities have the obligation of promoting well-being for the affected individuals, and due to the pressure of funding most people are left out even though they qualify for assistance.

Based on Charlesworth, Thorlby, Roberts, and Gershlick (2017), the scale of challenges that social care providers continue to face demonstrates that an urgent solution is needed. The growing ageing population, socio-economic pressure, health challenges and a system that is almost falling demonstrates the necessity for an urgent solution.  Wenzel, Bennett, Bottery, Murray, and Sahib (2018), argues that rather than focusing on the funding issues, full reform to the entire adult social care system is the best solution given that the system is flawed completely. Social care needs remain unmet, which is undisputed. In that, the providers are unable to enact their roles as required for the lack of adequate resources and the growing demographic pressure. It is estimated that about 1.4 million individuals qualify for social care support, but the majority of them receive close to no assistance as local authorities continue to struggle with funding (Pickard, 2015).

Pickard (2015) posits that it has become widespread that their adult social care is in major crisis across England and Wales. In England, the last one or so decade has been marked by a substantial fall in public services spending following the implementation of the austerity Programme as a measure to guard the economy after the last global economic crisis. Unfortunately, the reduction in funding has significantly affected the healthcare and social care of the ageing population. Respectively, between 2009 and 2010 and 2015 and 2016, public funding of social care for older individuals above 65 years reduced by 21 per cent in England (Harding, 2017). The funding reduction has resulted in millions of individuals missing out on care and the number will potentially grow in the next couple of years. In today’s society, it is without a doubt that the number of the ageing population continues to rise hence creating more need for care services. There has been an intensifying concern on the impact of funding reductions on social care outcomes which include the potential of its secondary effects on major public services such as overwhelming the National Health Service (NHS).

The study by Goddard et al. (2016), carried out at the local level in England established that the reduction of social care services has resulted in an increase in home care beds. The lack of adequate funding has resulted in delayed discharges as the burden of care appears to have been left solely to local authorities. The local system is getting overwhelmed by the growing numbers of individuals in need of care as the demand for their services outweighs the existing resources as a whole. Due to the nature of the overwhelmed local authorities in general the length of hospital stay is about 30 per cent longer for older adults, given that the quality of care has significantly reduced due to the lack of adequate funding.

Adult Social Care in England and Wales

Watkins et al., (2017) found that, adult social care is inclusive of an extensive variety of non-medical care services that significantly support people with physical or mental illnesses that affect their ability to attend to their day to day activities like movement and cleaning. With this regard depending on the severity of the condition, care is likely to be permanent or temporary. According to Harding (2017), between 2014 and 2015, it is only 26 per cent of the population of individuals aged 65 and above across England that received some kind of social care particularly those living outside care home settings.

Watkins et al., (2017), established that public care is mainly funded and organized at the local level. In other words, in England, the responsibility lies in 152 local governments. In the financial year, 2015/2016 local governments spend more than £16.8 billion on social care (Harding, 2017). The budget is particularly high considering that the authorities are responsible for offering other services to the local communities. With the need to allocate funds to all the services, the local authorities have resulted in setting prioritizes which has significantly affected service delivery on certain levels.

Based on Wenzel, Bennett, Bottery, Murray, and Sahib (2018), the extent of social care differs considerably per every local authority. The variation is a result of three factors which include differences in older adult care needs, revenue differences, and prioritization decisions among local authorities. Care differences result in different spending habits as regions with a high number of older and sicker people leads to larger spending on social care in general. In other words, the area in which an individual life is likely to determine the level of care that they receive in respect. Following the government reforms that took place in 2014, the introduction of the eligibility criteria alongside the standardized processes in the assessment of care has significantly eliminated a considerable number of beneficiaries (Cromarty, 2017). While local authorities are allowed to use their own set of criteria, they can additionally enjoy the flexibility of setting their guidelines.

Local revenue levels have dramatically declined in recent years as the government has been focusing on cautioning the economy against the financial crisis. Grants from central government to local authorities reduced by 38 per cent by 2017 (Papanicolas, Mossialos, Gundersen, Woskie and Jha, 2019). Since local authorities depend heavily on these grants to support their operations, their spending habits have dropped significantly as well which explains the rationale behind the struggling social care system. The significant spending differences in social care among local authorities are reflective of the rapidly changing needs, revenue reduction, and spending decisions made by local administration (Cromarty, 2017). While to some extent the changes are justified, the ageing population continues to suffer due to reduced social care funding based on their vulnerability to social and health-based struggles coupled with the growing cost of living in contemporary society.

Adult Social Care Needs

In England and Wales, adult social care needs involve providing support and care services to improve the quality of life among older adults in light of the fact that needing it because of sickness, age, disability or other financial constrains that weaknesses them. The consideration changes from giving them basic everyday exercises like cleaning to being a functioning member in for their entire life's viewpoints. By and large, social care can be given in the person's homes to guarantee that they carry on with their lives as normal as possible. The role is not only limited to social needs as health related care is additionally provided to the adult population based on their extensive vulnerability to chronic illnesses such as dementia, diabetes and hypertension which in severe cases hinders their mobility and ability to attend to their day to day needs (Charlesworth and Johnson, 2018). Individual saving, allowances and family top-ups serve as essential funding options for social care.

For older adult’s care can either is provided informally by friends, family, or neighbours or formally by trained professionals. However, due to the reduced funding of professional social care, in both England and Wales care is mostly provided informally (Wenzel, Bennett, Bottery, Murray, and Sahib, 2018) Formal care is not as common today with the growing population of individuals in need of care as it is mainly targeted on individuals with severe social and health needs. Between 2014 and 2015 it is only 9 per cent of the non-institutionalized older population of 65 and above that acquired formal care (Harding, 2017). Social care funding originates from either public or private funding in England and Wales. Most of the formal care funding is funded by the government. Formal care under public funding is only available to individuals who have attained a level of care needs and limited economic capabilities.

Social Care Funding Crisis

Crawford, Stoye, and Zaranko (2018) found that the fact that Social care is in major crisis has widely been emphasized in recent years. The social care system is almost collapsing because people are enjoying a prolonged life expectancy which comes with its own share of challenges. With the growing number of the ageing population, the challenges are numerous and the reduced spending is not only an issue that is limited to England alone as it is widespread. The majority of the ageing not only suffer from severe medical needs due to illnesses like dementia and diabetes but they also live in low and middle-income areas which further intensifies their need for care (Charlesworth and Johnson, 2018). In England and Wales, as the populations continue to benefit from extended life expectancy, the issue of care provision remains one of the most pressing social, legal as well as political problems.

According to Watkins et al., (2017), the immediate source of the on-going social care crisis in England is attributable to the lack of adequate funding in support of social care. The issue is mainly fuelled by the implementation of austerity which limits the amount of spending on public services. Underfunding is without a doubt a major contributor to the progressing social care issue but it cannot be blamed as the sole cause since several other factors must be addressed to solve the funding issue (Papanicolas, Mossialos, Gundersen, Woskie and Jha, 2019). Based on the nature of governance and the need to protect the economy from the financial crisis, it is evident that higher spending on social care is not likely to take place. Social care is suffering from a systemic problem that requires the integration of innovative solutions to solve the issue by addressing all the possible causes while prioritizing the needs of the population.

The funding issue has resulted in worrying rates of unmet care needs for older adults. The problem has mainly been caused by the interlocking policies and social norms as they have significantly altered the privatisation of care for the vulnerable population (Cromarty, 2017). The denationalized nature of social care in Wales and England has created a rather unfair system characterised by major limitations which hinder individuals from accessing care which they desperately require by creating rather complex inclusion criteria. In turn, the system has lost accountability with regard to the provision of quality care and patients’ safety by being the leading contributor to neglect and abuse of the recipients. Undeniably, ageing people have a set of vulnerabilities that can either be social, economic, or medical. The majority of them however rely on the government for social support and in most cases, they are denied it based on the perception that their needs are not severe (Wenzel, Bennett, Bottery, Murray and Sahib, 2018). Consequently, this has resulted in the cases of the rise of chronic illnesses as the vulnerable population continues to suffer from neglect. Public funding is a necessity is supporting social care for both medical and non-medical needs. The burden has been transferred to the already overwhelmed local authorities who are unable to provide the level of quality that older people deserve to live meaningful lives.

There is a mixed and complex state of the social care system today in England and Wales. The reprivatisation of the care responsibility to families and the private sector has without a doubt allowed the government to protect the economy from collapsing but at the expense of the well-being of the ageing population (Charlesworth and Johnson, 2018). For the majority of those that are in need of social care, it is without a doubt that they are unable to receive the services simply because their families cannot afford them or the inclusion criteria assumes that they are in less need for assistance. More than 10 million individuals in need of social care support due to the inability to attend to their day to day needs as a result of health-related issues in England and Wales based on 2010 reports. However, it is only less than a million individuals that received care on a long-term basis while slightly over two hundred thousand acquiring short term care support as a way of enhancing their long-term independence (Cylus et al., 2018). While the number of informal care providers has continued to increase due to the coverage gap, formal care continues to decrease rather significantly an aspect that is worrying since the ageing population continues to grow significantly. For the carers, this situation is challenging as they are additionally required to meet the health and financial needs of the population in the face of the high cost of living.

With respect to the statistics of the informal care which is growing rather rapidly in England and Wales, this highlights the changing trends in the system and rationality of such changes. While the focus has been to understand the issue as a public funding issue, but there is a need to also understand the contribution of the changing social as well as economic practices in the growth of the crisis (Cylus et al., 2018). The number of people that require help in attending to their day to day activities will continue to increase and the limited funding is likely to severely affect formal care delivery to this population.

Funding, Privatization, and Unfairness in the Social Care system

One of the leading forces in the on-going social care crisis is related to the predominantly privatized social care. Since the establishment of the NHS as well as the Community Care act of 1990, it is undeniable that the social care system has experienced a significant number of changes. The system has become open to different market forces apparently intended at creating more alternatives for the recipients while introducing competition in the industry with the aim of lowering the cost of care (Charlesworth and Johnson, 2018). The overall implications of the marketization and privatisation of social care have transferred the provision of social care services from the public service sector to a more public industry promoting the profit maximization needs of private institutions. While local authorities retain some form of control, the limited funding affects their decision making as their priorities mainly lies on providing care to individuals with severe needs. The exclusion for most of the ageing population has created exploitative opportunities for the private sector based on the growing demand for the care services. The situation is responsible for burdening recipients and their families based on the need to spend more on care and medical services. While in the late 20th century, more than 90 per cent of care services were provided by local authorities under the public service system, from 2010, most of these services are provided by private institutions and informal carers (Cylus et al., 2018). The change has provided a significant revenue gain for the private sector while subjecting recipients to further suffering particularly those that cannot afford the services offered by private entities.

Most private firms that are involved in the provision of public services generate significant revenue even though there have been rising cases of care home bankruptcy in recent years. It is worth noting that while most of the enterprises run a number of branches, maximization of profit in the care industry is not easy, since the business is rather complex and it requires an integration of different operational strategies in addition to subsidies from the government. For example, the close of the Southern Cross Healthcare came as a surprise to most individuals despite the fact that the enterprise was operating in more than seven hundred and fifty care homes across the country. The insolvency of the company came as a result of an ineffective business strategy as the brand was mainly focused on the maximisation of profit in the care sector hence failing to account for the special needs in the industry that requires a rather strategic response. The issues regarding to the quality of care that the private sector provides has been a major contributor to the failure among the providers. Possibly, the industry is one that requires focusing on the provision of high quality and safe care rather than maximising profit.

Failures of social care providers are currently controlled under the Care Act of 2014, which provides a legal responsibility to the Care Quality commission for monitoring the market.  The market regulatory responsibility is significantly supported by the local authorities’ roles in meeting the needs of older adults receiving care from the care providers that have failed in their duty. According to Taylor-Gooby (2017), the new regulatory regime seems to undergoing a test since more private care providers are leaving the market as a result of financial issues due to high staffing cost, retention and recruitment challenges linked to minimized profit ranges and Brexit. The challenges relating to payment and working conditions for care providers have resulted in higher staffing costs. Close to 50 per cent of all there care providers leave their workplaces within a year as they lack work security and a significant number of them are not given the minimum wage which further demotivates them. As the Brexit process continues to making the recruitment and retention of care providers challenging, there is no doubt that quality is most likely to depreciate and adversely affect the ability of the institutions to maximize profits (Taylor-Gooby, 2017).

Harding (2017) established that, the financial challenge with respect to social care which is an outcome of the overall privatization of the industry does not just affect care providers. Over the last couple of years, local authorities have experienced a significant cut in social care funding from the central government by at least 37 per cent between 2010 and 2017(Harding, 2017). Besides dealing with the rising cost of care provision linked to the rising demand as the outcome of the ageing population and an increase in minimum wage, social care expenditure suffers from a significant cut in the last couple of years.  The combined implications of cost pressures and funding gap means that most of the local authorities are forced to cut down on the amount of their spending on care workers. Consequently, care workers end up receiving less payment than the actual cost of providing care and individuals or self-funders are in turn required to incur higher costs for the services. Under the local authorities, the underpayment of care workers means that they receive approximately £2.24 every hour to receive residential care while 96 per cent of self-funders pay 43 per cent higher than those under covered by the state funds while living in the same homes or settings (Harding, 2017). In this context, care providers often rely on self-funders as a way of overcoming the challenges of subsidized care offered by local authority funded services’ users.

According to Allen et al. (2017), the current funding system for social care in England and Wales for older adults particularly those with dementia is arguably the most unjust. It is not only that individuals are not able to predict about the likely future in care provision and also plan responsibly, but is worth noting that those that require higher care needs as a result of old age are punished twice. First, they are required to pay for their own care services to the point when capital reaches the top level to acquire the support of local authority and while they are doing all these, they assist in subsidizing the care offered to the recipients of state funded care. The existing gap amid local authority cost and care cost also implies that in the case that self-funders exhaust their assets in state contributions for the care costs, their families might be required to offer third party fee as a way of meeting additional cost for the ideal accommodation and this puts them at the risk of being put in cheaper care homes (Dixon, Laing, and Valentine, 2020). Third party  top ups might additionally be required in the case that the residents funded by local authorities select a residential placement that charges their services above the set rates by the local authority. It is worth noting however, that while to up fees are vital in ensuring that care recipients receive the highest quality of care, they are generally complex and regulated poorly and as a result, the families of the residents might be required to play part in subsidizing care even though their loved ones are subjected to poor quality services, which further puts them at risk or major health complications (Harding, 2017).

For a while now, the spending on healthcare has been limited in England and with the low growth of spending occurs despite the growing demand for care as the population continues to age. While in recent years, the population of older individuals over the age of 80 has increased by more than 340,000, the spending on care for this population has been cut. While the spending in social care has reduced by about 1 per cent, the actual public spending on adult social care has declined by 6.4 per cent (Harding, 2017). Due to the intense financial pressure that the health care system is facing, there have been some significant efforts to improve the overall efficiency of the system through the provision or reduction reimbursement rates, freezing of staff and cutting down on prescription and administrative expenses. While the healthcare sector in England has recorded the highest growth in the recent than any other industry, but staffing gap, insufficient pay, poor care services and patient safety are some of the issues that have highlighted a worrying trend as a result of reduced funding on public and adult social care (Brimblecombe, Pickard, King and Knapp, 2017).

England and Wales are not the only healthcare sectors that have been struggling with meeting the care needs from the growing older population while at the same time trying to reduce the cost of care. However, based on the findings of a number of recent studies, it is unfortunate that the systems have been focused on reducing their spending on a population that needs them the most in the face of the rising chronic illnesses and cost of care (Keaver, Pérez-Ferrer, Jaccard and Webber, 2020). While the authorities might have succeeded in securing the economy from social care expenses, the older adults continue to suffer from the lack of quality care, which ultimately affects their safety and hurt their well-being.

Regulatory Complexity in Social Care 

Harding (2017) notes that, the implementation of the Care Act in 2014 changed completely the regulation of care across England by consolidating a disorganized patchwork with respect to regulation that had been developed since the approval of the National Assistance Act in 1948 (Allen et al., 2017). However, even after adhering to this legislative framework there is still a significant deal of complication that exists in the system which further affects the provision of social care to the adult population.  The legislative framework that covers social care serves as the perfect example of the effects of a decentralized regulation system. A decentralized system when it comes to the provision of care is characterized by complexity, interdependence, fragmentation and an intense level of permeability amid public and private institutions.

Within the fragmented regulatory system, it is normally assumed that there is no single company that has the required knowledge for solving diverse, complex as well as dynamic issues. In fact, there is not a single player that has a comprehensive overview that is needed in the application of proper instruments for making the regulatory system effective. In this case, the regulatory fragmentation and complication are responsible for the on-going care crisis in England and Wales, which are mainly dominant in three different areas care (Keaver, Pérez-Ferrer, Jaccard and Webber, 2020). First, the challenges are seen via the challenges that people in need of care and their families encounters while navigating through the system. Second, this is dominant through the unfair application of human rights norms and laws and lastly, through the absence of a clear and comprehensive model for acquiring compensation for those that are hurt by poor quality care. The system is flawed as it is mainly focused on the regulation of cost while at the same time ignoring the need to protect the safety of the care recipients through the provision of high quality services.

The challenges of crossing the social care systems originate from the presence of several well-established private care providers within the private marketplace (Challis, 2020). The stratified system with regard to care provision within the system has ultimately been created as a respected response towards the existing government pushes surrounding choices and competition between firms implies that it is particularly challenging for the individuals responsible for funding care (Harding, 2017). In this case, this covers a significant number of older persons and those suffering from dementia which affects their overall ability to participate in day to day activities and are therefore required to navigate through the system through the use of professional assistance as well as support.

The privatization of care has also created major issues and complications with regard to the utilization of human rights for care providers. While, in the NHS healthcare is always covered under the Human Rights Act of 1998, the social care stand remains unclear in this system (Allen et al., 2017). The privatization of the sector is one that has allowed private institutions to maximize on their overall gains at the expense of the overall well-being of the care recipients and their families. Self-funders are required to pay more to receive similar services as those funded by local authorities and the state while the quality of care is not satisfactory due to staffing gap. In return, care workers suffer from underpayment as the funders constantly try to minimize their overall expenses.

Older population receives differential care levels which depend on the payment methods. Those paying for their care have minimal options to seek compensation if they acquire poor services. The dominance of regulatory complexity as well as the unequal application of human rights model to care recipients and the lack of awareness on how to seek for compensation has all contributed to the adult social care crisis as a result of funding gap (Challis, 2020). If the system continues to operate as such while focusing on funding reduction, the system will further subject care recipients to more suffering and major health challenges in the next couple of years and the quality of care continues to depreciate.

Solving to the Social Care Spending Gap

Most of the problems in today’s adult social care are as a result of underfunding despite the rising number of the ageing population. The funding issue has created in major challenges and complexities which continue to counter the effectiveness of the system in general. Therefore, to effectively address the crisis more funding is necessary. Based on rationality, it is evident that the policy selection with regard to cutting down on funding and privatizing the social care sector are disproportionate which makes it difficult to regulate the system while accounting for the rights of care recipients and care workers. In return, the challenges have produced the current social care crisis which affects patient safety and services quality (Goddard et al., 2016). Not only is the system infringing on the rights of social care workers by subjecting them to poor working conditions where they are overworked and yet they receive minimal payment, but also, this has adverse effects on the safety of the care recipients.

More funding is required to protect self-funders from exploitation from the private institution while at the same time ensuring that the services are subsidized to ensure the survival of the private care providers. The responsibility lies in the government in protecting its people without requiring recipients to take full responsibility of their care needed (Challis, 2020). Care is vital and for low status recipients the pressure between receiving poor services and receiving care needs to be resolved by developing a more responsive funding system.

Theoretical Framework

System theory was be used in developing a theoretical framework that guided the research. The theory was useful in demonstrating how the problem of funding crisis might be resolved to enhance the efficiency of the adult social care system and ensure its sustainability in the future. The theory is grounded on the principle that an effective system is the one that is based on the needs of individuals, expectations, and rewards of the parties within the system. Systems theory refers to the study of society’s complex systems which includes, individuals existing beliefs and their relationship in general.  Based on the provision of the study, the main stakeholders in social care are communities, government, private investors and families. As a result of reduced funding on social care in both the U.K and Wales, it is evident that families are mainly responsible for the provision of care.