High-cost care for young adults surges as directors warn of “impossible choices”

High-cost social care packages for young adults have risen by almost a third in just one year, according to new figures from the Association of Directors of Adult Social Services (ADASS). Directors across England reported a 30% increase in the number of 18–24-year-olds whose weekly care costs exceed £7,000, reflecting rising complexity of need, financial strain on councils and inadequate arrangements for transferring support from health services.

Councils are supporting young people with profound physical disabilities, significant learning disabilities, severe neurodivergence and high-risk mental health conditions. Among those affected is 24-year-old Freya Viles, who has cerebral palsy and requires hoisted transfers to and from her power chair. She works part-time and is active in her community but said that the lack of funding for a direct payment has left her reliant on a succession of live-in carers. “It’s frustrating because cost is deciding what my adulthood looks like instead of me,” she said. “I want to highlight the importance of the right support to allow everyone live the life they want.”

The ADASS Autumn Survey paints a wider picture of rising demand, increasing complexity and deepening financial pressures. Councils are projecting a £623m overspend for 2025/26 — the highest at this point in the year since Covid — and expect to make £869m in savings in 2026/27. A third of Directors (34%) report very little or no influence over Integrated Care System structures, while half say they lack agreements with health partners on funding, training or competency for delegated healthcare tasks.

Jess McGregor, ADASS President and Executive Director Adults and Health at Camden Council, said: “Councils overspending on adult social care isn’t about abstract numbers — it’s about the unmet needs of real people. The underfunding of adult social care is forcing councils to make impossible choices – trying to balance financial sustainability with doing the right thing for those who rely on us.”

The survey is published ahead of the National Children and Adult Services Conference and the Autumn Budget. ADASS has urged the Treasury and DHSC to invest in preparation for adulthood, provide stabilisation funding for care markets, support workforce retention as international recruitment is phased out, and fully fund the Fair Pay Agreement and Employment Rights Bill costs.

BASW England’s Adult Thematic Group welcomed what they called the survey’s “comprehensive and balanced approach”. Co-chairs Margaret Young and Carmen Colomina emphasised that social workers are “central to delivering the three shifts proposed by government,” highlighting their role in prevention, coordination and relationship-based practice. “Their skills, knowledge, values, and capabilities are indispensable within multi-disciplinary teams and in shaping the future of Adult Social Care,” they said.

Cllr Dr Wendy Taylor MBE, Chair of the LGA’s Health and Wellbeing Committee, said the findings “strongly reinforce the hard work of councils” but also demonstrate the “huge financial pressure councils are under.” She added: “The rise in the number of requests for high-cost care for younger working age people is a message to us all, that social care is about everyone and effects all of us, directly or indirectly.”

“This important annual survey strongly reinforces the hard work of councils doing all they can to ensure everyone who draws on care and support can live independent lives.
“But the overspend is also another reminder of the huge financial pressure councils are under, and the incredibly difficult decisions they are having to make about care, just to ensure they are meeting their statutory responsibilities.

“We desperately need the sector to be put on a sustainable financial footing to ensure that people do not suffer and everyone who draws on care and support can access what they need.”

Recent figures also show a small overall decline in the number of children looked after (CLA). On 31 March, the number of CLA fell by 2% — a decrease of 1,760 children — to 81,770. This includes a 1% drop in non-UASC CLA and a 12% fall among unaccompanied asylum-seeking children. The rate of CLA per 10,000 children has reduced from 69 to 67, down from a peak of 70 in 2022 and 2023. Fewer children started to be looked after during the year, while more ceased, including increases in both special guardianship orders (up 6%) and adoptions (up 1%).