Louise Casey, the head of the social care commission, will warn that successive governments have been 'asleep at the wheel' over adult social care in England, leaving a chaotic patchwork with 'no one in charge' of the system.
At the annual national children and adult services conference, Casey is expected to call for a 'new settlement' built on 'decency, contribution and a duty to care for our neighbours, our loved ones and ourselves'. She will say England has no clear 'system stewardship'. People's experiences of care vary depending on where they live, with different standards, waiting times and assessment processes; the private care sector has grown dominant, and regulation of services has often been ineffectual.
The prime minister has embraced the review, accelerating its completion to next year, 12 months quicker than envisaged by the Starmer government, with the expectation that a national care service plan will be in Labour's next election manifesto. He has announced he would use savings from scrapping the state pension triple lock to target investment in a national care service based on Scotland's free personal care approach.
Casey will also say she agrees with the findings of the Covid-19 inquiry on social care. The inquiry's chair, Heather Hallett, described the adult care sector during the pandemic as 'something of an afterthought'. More than 43,000 people died from Covid-19 in UK care homes between March 2020 and July 2022. She is expected to describe this as a 'national shame'.
Casey has drawn on research by the Nuffield Trust and the Institute for Government, which warns that successful reform depends on political will and warns against disruptive structural changes that lack a clear purpose.
Analysis
Why This Matters
- The review is expected to shape Labour's next election manifesto, directly influencing the future of care for millions.
- It exposes deep systemic failures in funding, regulation and oversight that have persisted across successive governments.
- The proposed trade-off of scrapping the pension triple lock to fund a National Care Service highlights the difficult fiscal choices ahead.
Background
Adult social care in England has faced decades of underfunding and patchwork reform attempts. The Covid-19 pandemic starkly exposed the sector's vulnerabilities, with over 43,000 care home deaths, leading to a public inquiry that heavily criticised the government's approach.
Key Perspectives
Louise Casey: argues the system is a chaotic patchwork with no clear oversight, and calls for a new 'settlement' rooted in decency and duty of care.
Nuffield Trust and Institute for Government: warn that reform requires lasting political will, and that structural reorganisation without a clear purpose risks failure.
What to Watch
- The accelerated completion of the Casey review over the next year.
- Whether the government formally commits to a National Care Service in its manifesto.
- The political reaction to funding a care overhaul by cutting the pension triple lock.
Checked
12 claims in this story checked against 1 source: 11 supported.
Show each claim
- SupportedThe headline says Casey will describe England’s social care system as a chaotic patchwork with “no one in charge”.World news | The Guardian: “Lady Casey ... will say the result is that in effect “no one is in charge” of a system ... People’s experiences of care have varied depending on where they live ... while the private care sector has grown dominant”
- SupportedCasey is expected to say the system faces a “moment of reckoning”.World news | The Guardian: “Casey’s latest robust critique of adult social care, together with her view that the system faces a “moment of reckoning””
- SupportedCasey is expected to call for a “new settlement” based on decency, contribution and a duty to care for others.World news | The Guardian: “Casey is expected to call for a “new settlement” for care, “one based on values I still believe this country shares: decency, contribution and a duty to care for our neighbours, our loved ones and ourselves””
- SupportedCasey will warn that successive governments have been “asleep at the wheel” over adult social care in England.World news | The Guardian: “Successive governments in England have been “asleep at the wheel” on social care”
- SupportedPeople’s experiences vary by location, while standards, assessment processes and waiting times differ; the private care sector has grown dominant and regulation has often been ineffectual.World news | The Guardian: “People’s experiences of care have varied depending on where they live, with different standards, assessment processes and waiting times, while the private care sector has grown dominant and regulation of services has often been ineffectual”
- SupportedThe prime minister accelerated the review’s completion to next year, 12 months sooner than envisaged by the Starmer government.World news | The Guardian: “The prime minister has embraced the Casey review, accelerating its completion to next year – 12 months quicker than envisaged by the Starmer government”
- Partly supportedThe prime minister said he would use savings from scrapping the state pension triple lock to invest in a care service based on Scotland’s free personal care approach.World news | The Guardian: “He has already announced he would use savings from scrapping the state pension triple lock, starting in the next parliament, to target investment into a care service based on the Scottish approach of free personal care”
- SupportedA national care service plan is expected to be in Labour’s next election manifesto.World news | The Guardian: “with the expectation that a national care service plan will be in Labour’s next election manifesto”
- SupportedCasey will say she agrees with the Covid-19 inquiry’s findings on social care.World news | The Guardian: “Casey will also say she has written to the Covid-19 inquiry agreeing with its findings on social care.”
- SupportedHeather Hallett described the adult care sector during the pandemic as “something of an afterthought”.World news | The Guardian: “The Covid-19 inquiry chair, Heather Hallett, last month described the adult care sector during the pandemic as “something of an afterthought””
- SupportedMore than 43,000 people died from Covid-19 in UK care homes between March 2020 and July 2022.World news | The Guardian: “More than 43,000 people died from Covid-19 in UK care homes between March 2020 and July 2022.”
- SupportedCasey is expected to describe the care-home deaths and related events as a “national shame”.World news | The Guardian: ““It is a national shame that this was allowed to happen. It should never happen again.””