A new CAA report proposes pooling the financial risk of an ageing population nationally, rather than leaving it with 153 individual councils.
The core of the model: ring-fenced national funding shared on a needs-based formula, a national tariff for care, and an independent body to keep it honest.
Individuals keep a means-tested contribution, but with a lifetime cap and a raised capital threshold, so no one faces unlimited costs or has to sell their home.
Councils keep assessment, planning, safeguarding and oversight, but are relieved of carrying a national demographic risk on a local budget.
Backed by the Rt Hon Damian Green, Chair of the Social Care Foundation and former Deputy Prime Minister responsible for social care policy.
The Care Association Alliance (CAA) has published a proposal for how England should fund adult social care for older people. Its report, Adult Social Care Funding Reform, describes a national funding settlement built on a straightforward idea: the cost of growing old and needing care is a national risk, and it should be met nationally, while care itself continues to be arranged and delivered locally.
At present, primary responsibility for adult social care sits with 153 local authorities under the Care Act 2014. They assess need, commission services and manage local provider markets. They also carry the full financial weight of demographic change, a pressure that is national in scale and rising quickly. The number of people aged 85 and over is projected to double within twenty years, and the Office for Budget Responsibility estimates that simply maintaining today’s system will require public spending on social care to grow by 3.1 per cent a year over the next decade, compared with the 0.7 per cent average delivered between 2009/10 and 2022/23.
That pressure shows up directly in the price of care. On average, councils pay £24.10 an hour for home care, while the Homecare Association puts the minimum sustainable rate at £32.14. The National Audit Office found in 2021 that authorities were commissioning care at below the sustainable cost of care, and the King’s Fund reports that in 2025/26, council fee increases of around 5 per cent were outpaced by provider cost increases of 8 to 10 per cent. This is not a matter of councils choosing to underpay. It is what happens when local budgets are asked to absorb a national cost. Providers take the strain through thinner margins and deferred investment, and families often meet it through the higher fees paid by those who fund their own care, on average 41 per cent more than the council-funded rate.
The CAA argues that these are symptoms of a single structural mismatch, and that they need to be fixed together. Its proposed national funding settlement rests on three principles: pooling the financial risk of demographic change nationally, a statutory entitlement to support triggered by assessed need, and continued local delivery within a national framework.
In practice, the settlement has five main components:
A ring-fenced national care grant, distributed to councils on a needs-adjusted formula, so that funding follows need rather than local fiscal capacity.
A reformed means test, with a raised capital threshold, frozen at £23,250 since 2010/11, and a lifetime cap on what any individual can be asked to pay.
A national tariff for residential and home care, set at the independently assessed cost of sustainable provision, which councils commission at or above.
A bundled funding model for residential care, with assessed packages that are portable when people move.
A reformed Deferred Payment Agreement scheme, so that no one is required to sell their home to pay for residential care.
Underpinning the settlement is an independent National Care Assessment Body, sitting outside both the NHS and local government, which would verify the cost evidence, review the tariff and report where provision falls short. Local authorities retain their role as commissioners and delivery leaders, close to their communities and provider markets, but are relieved of being the sole bearer of national financial risk.
The report is explicit about what it does not propose. This is not a free care service on the model of the NHS, and it does not absorb social care into the health service. Individuals who can contribute to the cost of their care will continue to do so, within a reformed means test and a lifetime cap. The word national describes the funding architecture, not the way care is provided.
The proposal is offered as a contribution to the Casey Commission, which is beginning to test public views on who should receive care, what the state should guarantee and what individuals should contribute. The CAA says funding reform is the necessary first step, and Adult Social Care Funding Reform is the first in a programme of papers it will publish over the coming months.
Melanie Weatherley MBE, Co-Chair of the Care Association Alliance, said:
“No family should receive worse care because of where they happen to live, and no provider should have to choose between keeping a contract and delivering care safely. These are not failings of the people running the system. They are what happens when a national risk is carried on local budgets. If we fund care nationally, price it honestly through a national tariff, and ask an independent body to keep it that way, we can give families certainty, providers stability, and councils the resources to do the job they are asked to do.
“This paper is not a criticism of local authorities, who are doing a demanding job under real pressure. It is a practical plan to put the whole system on a sustainable footing, and we hope it is useful to Baroness Casey’s commission as it begins its work.”
The Rt Hon Damian Green, Chair of the Social Care Foundation and former Deputy Prime Minister responsible for social care, said:
“The case for reform is widely accepted. What has been missing is a workable, affordable plan that a government of any colour could adopt. This paper offers exactly that, and a cross-party route to deliver it.”
