Casey review finds fragmented social care system

Baroness Louise Casey’s commission has published research describing adult social care in England as fragmented, with responsibilities spread across government and no single point of overall stewardship. Casey called for a new settlement for care, while the commission’s final recommendations are expected next summer.

The research was commissioned by Casey’s review and carried out by the Nuffield Trust and the Institute for Government. It says responsibilities are divided among central government departments, national and local bodies, and non-public providers, leaving no single authority with overall oversight. The report says the system still lacks a coherent sense of direction.

The report estimates that more than 1.5 million people work in social care across around 19,000 employers. It says England is the only UK nation without a mandatory register of care workers. Private providers dominate a sector whose structure, the report says, developed in a largely uncontrolled and unintended way.

People paying for their own care are charged, on average, 40% more for the same service than people whose care is arranged by a council, according to the research. Unlike NHS care, social care...