Baroness Casey says social care is held together by “sticking plasters and glue”

Too many families are navigating an underfunded, ‘cobbled together’ social care system that lacks ownership and accountability, according to Baroness Casey, chair of the Government’s social care commission.

In a speech at the Nuffield Trust Summit, she called for a national reckoning equivalent to Beveridge’s reforms in 1948, as social care has never had its own creation moment, when the nation decided what it was for, what people should expect, who should pay, and how.

She said that the system was shaped for a very different age and was held together with “add-ons and workarounds, sticking plasters and glue”.

Baroness Casey added: “More people identify as disabled. A staggering 16.1 million people identified as disabled in 2022, and staring us in the face is the fact that the number of older people has increased more rapidly than the number of working-age people. This means more people to care for, with fewer people to care for them. So we all know the characteristics of our society have fundamentally changed.”

What is the Casey Commission on Social Care

The commission plans to set out a vision for adult social care, with recommended measures and a roadmap for delivery. The aim will be to create a National Care Service underpinned by national standards, delivering consistency of care across the country.

The first phase, which will be reported in mid-2026, will identify the critical issues facing adult social care and recommend medium-term reforms and improvements. The second phase, which will be reported by 2028, will make longer-term recommendations for transforming adult social care.

In her speech, Baroness Casey said that social care is too reliant on low-paid care workers, and there is a deep divide between health and social care.

She also confirmed she has written to the Secretary of State for Health and Social Care, urging the Government to take six urgent actions on dementia, motor neurone disease, and adult safeguarding due to the urgency of the reform needed in these areas.

Scale of the challenge of social care

The Social Care Institute for Excellence (SCIE) said that the speech brought welcome clarity to the scale of the challenge facing social care. Her framing of the sector’s pressures—demographic change, the growing complexity of needs, and a system built on ‘add-ons and workarounds’—will resonate with many across the sector.

Gerard Crofton-Martin, Interim Chief Executive of SCIE, added: “The Commission’s extensive engagement with organisations, practitioners and people with lived experience is encouraging, and we look forward to working with Baroness Casey and the Commission as this important work progresses.

“Her call for a moment of reckoning and renewal is an important one. Social care has never had the kind of design moment that shaped other parts of the welfare state. If we are serious about reform, we need to be honest about the pressures created by demographic change and rising complexity of need, and clear with the public about what a future system of care and support should provide.”

The Commission has so far hosted evidence sessions with people working across adult social care, including unpaid carers, frontline practitioners, providers, local authorities, NHS workers, and sector representative organisations.

There is also an online evidence portal where anyone can submit their insights, experiences and ideas for change directly to the team.

Alison Bloomer

Alison Bloomer is Editor of Learning Disability Today.

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