Responding to the resignation of Sir Keir Starmer as Prime Minister and the prospect of Andy Burnham succeeding him as Labour leader, the Care Association Alliance (CAA), the national voice of local care provision in England, has called on whoever forms the next government to make the reform of adult social care funding an immediate priority. It has also called on Andy Burnham to honour the commitments he has made to the sector. As Mayor of Greater Manchester, and again in recent weeks, Burnham has said he would overhaul England's failing adult social care system within his first year in office. The CAA today urges him to stand by those words: to bring forward the timetable of the Independent Commission on Adult Social Care, chaired by Baroness Casey, and to commit to a fundamental overhaul of how care is funded, starting with the introduction of a national funding settlement. That settlement is set out in the CAA's forthcoming policy paper, Adult Social Care Funding Reform: The Case for a National Funding Settlement, which will be published shortly. 2028 is too late The Casey Commission's first phase is due to report this year, but its final recommendations are not expected until 2028. That timetable makes meaningful legislative reform unlikely before the next general election. The sector, the people who draw on care, and the families who support them cannot wait that long. A change of leadership is the moment to match the scale of the crisis with the pace of the response. National Funding Settlement The CAA's forthcoming paper sets out why the current model is neither fair nor sustainable. The financial burden of a national demographic challenge falls on local authority budgets that vary enormously across the country. The result is a postcode lottery in which access to care is shaped by geography as much as by need. Providers are commissioned at rates that do not cover their costs. The average domiciliary care fee of £24.10 an hour falls nearly £8 below the recognised minimum sustainable rate. Families face costs that are unpredictable and bear little relationship to what others pay elsewhere, and the means-test capital threshold has been frozen at £23,250 since 2010. In place of this, the CAA proposes a national funding settlement built on three principles: national pooling of financial risk, a statutory entitlement triggered by assessed need, and local delivery within a national framework. Its recommendations include a ring-fenced, needs-adjusted national care grant; a national eligibility threshold set in statute; a national tariff for publicly commissioned care; a lifetime cap on individual contributions alongside a substantially raised capital threshold; and an independent National Care Assessment Body to oversee eligibility, pricing and long-term demand. Commenting, Melanie Weatherley MBE, Co-Chair of the Care Association Alliance, said: "Social care has been left on the 'too difficult' pile by successive governments for far too long. A change of leadership cannot become another excuse for delay. It must be the moment the country finally grips this. "Andy Burnham has said he would overhaul adult social care within his first year in office. We welcome that ambition, and today we ask him to stand by it. That means refusing to let the people who need care wait until 2028 for answers, bringing forward the work of the Casey Commission, and committing now to the reform that everything else depends on: a sustainable, national settlement for how care is funded. "We will set out in a forthcoming series of papers what a genuine National Care Service should look like in practice. The case for a national funding settlement is the foundation. Whoever leads the next government, the frontline providers we represent stand ready to help build it. But the time for reviews and timetables stretching into the next decade is over. The time to act is now."

The Settlement - Edition 1 The monthly campaign brief from the Care Association Alliance

Responding to reports that the Government is no longer considering a standalone arm’s-length body to oversee adult social care reform, the Care Association Alliance has warned that the focus must remain on how care is funded, not on the structures sitting above it, and that the sector must not be overlooked once again. Melanie Weatherley MBE, Co-Chair of the Care Association Alliance, said: “Social care does not need its own version of the NHS. An arm’s-length body sitting above the system is not what we have been calling for, and it is not what determines whether people receive good care. A national framework is essential, but it can be built within the structures we already have. What worries me is the risk that dropping the idea of a new body quietly becomes an excuse to drop social care altogether, and the sector is overlooked once again, as it has been so many times before.  The point we keep making is a simple one. What matters is not the structure sitting above the system, but the funding settlement sitting beneath it. Access to care is still shaped by geography as much as by need, providers are paid rates that do not cover their costs, and families face bills they cannot predict. None of that changes by creating or removing an organisation. It changes only with a national funding settlement, and that is the work Ministers cannot afford to leave until 2028.”

When William Beveridge set out his vision for the modern welfare state in 1942, he did so with remarkable clarity and ambition. His aim was nothing less than to defeat the five giants standing in the way of social progress: Want, Disease, Ignorance, Squalor and Idleness. It was a founding act of national purpose, and one that produced, among its greatest achievements, the National Health Service, defining Britain's sense of itself for almost eighty years. But the settlement that gave us the NHS left another challenge unfinished. People in the UK are living longer than ever before but not healthier for longer. Healthy life expectancy has stagnated and, in some communities, declined. Around one in two people will develop cancer in their lifetime. Around one in eleven people aged 65 and over are living with dementia. More than half will develop a cardiovascular condition. One in six men and one in five women will experience a stroke. Want and Disease have not been defeated. They have been relocated into a fragmented care system that obscures its true costs and was never designed to manage the scale or complexity of the challenge it now faces. That failure does not stay confined to social care. It reaches directly into the NHS itself. Delayed discharges now cost the health service over two billion pounds a year, and the picture is worsening. Behind that figure lies a more complicated reality than is often acknowledged. The problem is often not a shortage of care home beds or home care providers, capacity exists across much of the country. What the system too often lacks is the coordination to use it. Occupied beds mean longer waits in A&E, delayed ambulance handovers, and slower emergency responses elsewhere. This is a single system, and when one part blocks, the effects spread. The reasons for those delays are more systemic than they first appear. Discharge planning begins too late, assessment processes create their own bottlenecks, and providers are too often brought in at the last moment rather than treated as partners in a shared process. A system better designed around collaboration would move faster. But the deeper prize lies further upstream. Care providers who are genuinely embedded in their local health and care communities, responding early and managing complexity before it becomes crisis, can prevent admissions from happening at all. That capacity exists. Realising it consistently requires the kind of sustained investment and system-wide commitment it has never quite received. The conversation about fixing the NHS cannot therefore be separated from the conversation about social care. Yet too often, it is. In social care, Want is visible in financial insecurity. Individuals and families face catastrophic and unpredictable costs shaped as much by geography as by need. A self-funder in a care home can pay close to four hundred pounds more per week than a local-authority-funded resident in the same setting for the same service, while the system relies heavily on unpaid family care to mask the true extent of its underfunding. At the same time, we are failing to organise care around the realities of modern illness. Today's challenge is not acute conditions treated and discharged in days. It is the long-term management of dementia, frailty and multiple co-morbidities. Yet our institutions remain structured around a rigid divide between health and care, and between national and local responsibility for funding. The result is a system that spends considerable time and energy arguing over who should pay rather than how best to care. At the Care Association Alliance, we work with providers on the frontline of care every day, and it is from that vantage point that we have been developing a programme of reform. Over the coming months we will set out, paper by paper, what a genuine National Care Service should look like in practice, starting with the case for a nationally coherent funding framework and extending to commissioning, workforce and the relationship between health and care. The renewed focus on a National Care Service reflects that the status quo is not sustainable. But we should be equally clear about what it is not. It cannot simply be layered onto a structurally flawed system, nor should it be understood as an extension of the NHS. Social care differs fundamentally in both function and funding. Importing the NHS model wholesale would risk importing its operational pressures while undermining the diverse provider base on which care depends. Good care is, by its nature, local. It depends on relationships, on knowledge of place, and on providers who understand the people they serve. Any National Care Service worth the name must strengthen, not displace, that local infrastructure. Reforming this system must start with funding. Britain's social care system is not failing because of a lack of dedicated people or willing providers. It is failing because it was never given a funding model equal to the demands placed on it. Today, the financial burden of caring for an ageing population falls largely on local authorities whose budgets vary enormously from one part of the country to the next. The result is a system where providers accept rates that do not cover their costs and where individuals pay vastly different amounts for the same level of need depending on where they happen to live. That is not a sustainable foundation. Beveridge's ambition wasn't just in producing a report but shaping institutions that have changed this country permanently and for the better. That is the scale of ambition social care now requires. Not reorganisation at the margins, but a renewed national settlement built for the realities of longer lives and more complex need.  Melanie Weatherley MBE Co-Chair of the Care Association Alliance

The National Minimum Wage – it’s more than just a pay rate 24 July 2025 Following a meeting between the Care Association Alliance and His Majesty’s Revenue and Customs, we would like to share HMRC’s advice with members on staying compliant with National Minimum Wage legislation. In 2024/25 HMRC identified over half a million pounds of arrears for over 2,000 workers in the social care sector. Mistakes are easy to make when you are calculating wage payments; this can happen even when you’re paying your staff an hourly rate that is above the minimum wage. Here’s some examples of common mistakes that can lead to underpayments, particularly in the social care sector: Unpaid working time – underpayments can happen when extra hours are worked but not paid, for example time spent travelling if it’s in connection with the worker’s job, such as travelling between clients or waiting time. This also includes time spent awake and working during sleep-in shifts, being on standby at or near the workplace, or carrying out mandatory training on site or at home. Deductions and expenses – if workers incur expenses or have deductions from pay for items connected with the job (including the costs of uniforms, mandatory training or safety clothing), this could bring their wages down to below the NMW. Deductions for services provided by the employer such as meals, admin costs for attachment of earnings, transport, or excessive deductions for accommodation can also result in underpayments. Underpaying workers – mistakes can also happen when an employer pays a worker the incorrect rate. This is usually because of a failure to implement annual rate increases correctly, for example, missed birthdays as workers move from one age band to another or errors in applying the apprentice rates. Type of worker – If an employer applies the incorrect work type to the NMW calculation, it can lead to underpayments. There are four different types of worker for NMW purposes: salaried, time, output and unmeasured. The hours you must pay a worker the NMW for depends on the type of work they do. The rules and calculation of hours apply differently for each type of work that the worker does. You can find more information on calculating NMW on the gov.uk website . Including certain payments or premium payments when calculating a worker’s pay for National Minimum Wage purposes – Some employers may think they are paying above NMW because they are including things like shift allowances, on-call allowances, sleep-in allowances and higher rates for weekend or evening work in the calculation. However, dependant on the type of worker, these should not be included in the calculation. When these are taken out of the calculation, the worker could be being paid below NMW. Accommodation – If you deduct payments for accommodation from a worker's pay, or charge for accommodation, it can lead to underpayments. The rules allow a notional daily amount called the accommodation offset to count towards NMW. If an amount is charged or deducted over the level of the offset, the difference will reduce the worker's pay for minimum wage purposes. Status of workers – Incorrectly treating workers as volunteers, interns or self-employed can lead to underpayments of NMW. An individual’s NMW entitlement depends on whether they are a worker for NMW purposes. Generally, with limited exceptions, if an individual gets something of value in return for their work and are not genuinely self-employed, they are likely to be entitled to NMW. Salary sacrifice schemes – If a worker gives up their contractual entitlement to a portion of their salary in exchange for some form of benefit, this can lead to underpayments of NMW. These benefits can include company cars, additional pension contributions and cycle-to-work schemes. Where a salary sacrifice is in place, the worker no longer has entitlement to that portion of salary and therefore their pay for minimum wage purposes is reduced accordingly. Compliance and Enforcement Ensuring workers are paid fairly and in line with the current and appropriate NMW rate is a legal requirement for all employers. HMRC officers have the right to carry out checks at any time and ask to see payment records. They can also investigate employers if a worker complains to them. Employers who do not follow minimum wage legislation, and underpay their staff as a result, are subject to enforcement action by HMRC. If HMRC finds that an employer has underpaid their workers, any arrears must be paid back immediately. There will also be a fine of 200%, and offenders might be publicly named by the Government. Opportunity to Correct Mistakes However, there is an opportunity to put things right before a HMRC compliance check is opened. There are no penalties or naming if employers repay arrears before HMRC opens a compliance check. Putting things right If you identify an issue after reading this, here’s how to put things right: change working practices going forward calculate the arrears due to workers using the current rates pay arrears back to workers make reasonable attempts to contact any affected ex-workers If, as a result of a self-review, you have identified and paid arrears for underpayment of minimum wage, then there is an option to inform HMRC. To request a copy of the form to be used for making a voluntary declaration email voluntarydeclaration.nmw@hmrc.gov.uk . There are no public naming or financial penalties associated with any paid arrears that are declared to and accepted by HMRC using the voluntary declaration process. Further information can be found at: Calculating the minimum wage Summary of National Minimum Wage and accommodation rates Guidance on whether a person is a worker Guidance on who is and is not entitled to the minimum wage The current minimum wage rates  If you prefer to speak to someone you can call ACAS for advice on 0300 123 1100.

Comment re: NHS 10 Year Plan 3 July 2025 The government has today launched the NHS 10 Year Plan. This is expected to be a fundamental reset for NHS, putting people back where they belong at the heart of the care that they receive. We welcome this ambitious plan and its aims. The Care Association Alliance is pleased to have been part of the NHS Change engagement programme and to have had an input to the plan, but we’re disappointed there is no plan for social care either within or alongside the NHS 10 Year Plan. One part of the plan is to improve people’s access to the NHS and to shift care out of hospitals and into the community through the Neighbourhood Health Service. We welcome the move to a community-focused approach and look forward to working with our colleagues in the NHS to make it a reality. We believe that neighbourhood health services will only reach their full potential for frail elderly people and working age adults who use social care services if neighbourhood working includes social care as well as health. It is crucial that social care be regarded as a key part of Neighbourhood Teams delivery from the outset. Another aim in the plan is the switch from analogue to digital. We welcome this aim, which will streamline communication and make it much simpler for us all to interact with NHS. However, technology and information sharing needs to embrace social care to make the most of the single patient record and technology-enabled care and improve outcomes for people. As an integral part of the health and care system, it is essential that social care play its part in the changes envisaged in the NHS 10 Year Plan from the outset. We cannot wait until Baroness Casey completes her work and try to catch up. For social care to play its part, funding must follow the work so that care providers can work with NHS colleagues to provide the care and support needed by each individual. ends The 10 Year Health Plan is part of the government’s health mission to build a health service fit for the future. · Publication: Fit for the Future: The 10 Year Health Plan for England https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future · Easy read version: https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future-easy-read · Announcement - Neighbourhood Health: https://www.gov.uk/government/news/pm-launches-new-era-for-nhs-with-easier-care-in-neighbourhoods

Save the Date! CAA Resilience Webinar: Monday 16 th June 2025 at 2pm When to seek financial advice as a care provider? The care sector faces growing challenges, however with the right support at the right time, care providers can navigate these pressures, protect their operations, and unlock long-term values. Join us on 16 th June when we will hear from Leon Goddard, Senior Adviser - Markets and Commissioning at the Local Government Association and industry expert Johnny Abraham, Managing Director at J9 Advisory, specialist business advisory services. Further details and booking information to follow shortly

The government’s increase in the rate of employer National Insurance Contributions (NICs) from 13.8% to 15% came into effect at the weekend. As a result, the care sector, like many others, is facing detrimental financial pressures in trying to provide a high-quality care service. Our overall staff costs are projected to rise by at least 9%, thanks to the number of part-time staff we have and the low level of pay in the sector. We provide a regulated service based very heavily on personal interaction, so we can’t simply reduce staffing levels. Many care workers are at or close to minimum wage, so there’s no way to mitigate the increases by negotiating a lower pay rise. Providers would love the opportunity to pay their staff more, as they deserve it, but it simply cannot be budgeted for. These cost increases impact both self-funders and services contracted by local authorities or the NHS. For those paying for their own care this is leading to higher than normal price increases of 8% to 10%. This may be an unmanageable burden for some. Where the local authority or the NHS is the customer, we have no control over prices and the vast majority are unwilling or unable to cover the increased costs. The UK government has chosen not to provide local authorities with sufficient funds to cover the NIC increases for care that they commission – although they have where the care is provided in house. As a result, care providers who deliver care to the most vulnerable on behalf of local authorities are facing potentially existential challenges. The Care Association Alliance is urging the government to fix these funding shortfalls so that local authorities can properly support care providers. We urge HM Treasury to redress the unfairness and ensure that local authorities are able to support providers, and we call on the Department for Health and Social Care and the Ministry for Housing, Communities and Local Government ensure that this funding is passed on.

We at the Care Association Alliance are deeply disappointed by the actions of Labour MPs in the House of Commons yesterday (19 th March). A Liberal Democrat amendment to exempt health and care providers from a rise in National insurance Contributions was defeated by 307 votes to 182. As a result, on 6th April hard-pressed social care providers will be hit with increased bills they can’t afford. This vote is another damaging blow to our sector which could well leave many people without the care and support services they rely on, as it will push many care providers over the brink. The government has dismantled the core principles and ethos of the Care Act 2014 and abandoned millions of vulnerable people who depend on the care sector. The impact will also be felt by the NHS, which will experience even more difficulties in discharging patients from hospital. This is a dark day for adult social care, and we call on the Chancellor Rachel Reeves to think again and exempt health and care providers from this NIC increase. In the meantime care associations are ready to work with local authorities, care providers and NHS colleagues to do the best we can for those who rely on care and support in what will be very difficult times. Melanie Weatherley MBE, C0-Chair of the Care Association Alliance For media information please contact: Jez Ashberry Director Shooting Star jez@weareshootingstar.co.uk 01522 528540 / 07780 735071