Approach and methods

We analysed national government policies on adult social care in England related to COVID-19 between 1 June 2020 and 28 February 2021. Our analysis also includes a small number of policy developments that took place after February 2021, if we thought this was needed to understand or reflect the policies we reviewed. We also refer to key social care policies introduced during the first stage of the pandemic response – between 31 January 2020 and 31 May 2020 – which are described and assessed in more detail in our previous analysis.

We focused on policies introduced by central government directly related to social care. We did not review guidance or policies affecting social care from national organisations outside government, such as the Local Government Association or major social care charities. We also excluded policies or approaches of individual local authority areas or care providers. Nor did we analyse the wider support that may have been available for care providers through government loans, tax holidays, and other interventions to support businesses. As a result, our analysis only focuses on a limited part of the policy response to support social care.

Our analysis is based on publicly available data and evidence. To identify and understand relevant policies, we reviewed government policy documents, press releases, ministerial speeches, letters, guidance documents, web pages, and other sources. Much of these data are compiled in our COVID-19 policy tracker – covering national policy developments in England in 2020. We used this database as a starting point, before searching government and other websites for additional information. Some policy documents were retrospectively removed from government websites or updated on the same webpage without clear descriptions of what had changed, so we used the Wayback Machine digital archive and other sources to help understand how policy changed over time. To understand how these policies have been implemented, we drew on government announcements, select committee sessions, official statistics, statements from social care organisations or leaders, and other sources. These data are limited and therefore our analysis provides an incomplete picture.

Finally, to understand the impacts of the pandemic on adult social care users and staff, we synthesised findings from relevant studies and analysed publicly available data from official sources, including the Office for National Statistics (ONS) and Care Quality Commission (CQC), as well as surveys from ADASS, Carers UK, and others. We held a workshop discussion with 11 social care experts and sector leaders in March 2021 to test the findings from our analysis of the national policy response.

Box 1: The structure of adult social care in England

Adult social care is the care and support provided to people who need it because of disability, illness, or other life circumstances. The kind of support that people receive varies widely depending on their needs – from help washing and dressing, to transport services, day centres, and help with employment or volunteering opportunities.

People might receive social care in a mix of settings, including:

  • care homes (including residential or nursing care homes)
  • domiciliary care (supporting an individual living in their own home)
  • day care or community care (such as community outreach and support for carers).

Care services are provided by around 18,200 organisations working in 38,000 locations.

Around 842,000 adults received long-term support from local authorities in England in 2018–19. 35% were younger adults (aged 18–64) and 65% were older people (aged 65 and older). About one-third were supported in nursing and residential homes, but most people received care in the community (including in their own homes). Others go without care, privately purchase their care, or turn to family and friends for unpaid support.

The NHS and social care are commissioned and funded separately. Publicly funded social care is commissioned by 151 local authorities, who receive a grant from central government. National policy responsibility for social care rests with the Department of Health and Social Care. Responsibility for local authority finances and other issues sit with the Ministry of Housing, Communities and Local Government. The Care Act 2014 defines local authorities' responsibilities to assess people’s care needs and eligibility for publicly funded support – and describes the core purpose of adult social care as promoting individual wellbeing. The CQC regulates social care providers and agencies.

An estimated 1.5 million people undertake paid roles in adult social care in England. There are chronic workforce problems in the sector, and terms and conditions are poor. Pay is low (for example, the mean annual pay for care workers in the independent sector is £16,900 per year), turnover is high (around 430,000 leave their job each year), and a quarter of staff are on a zero-hours contract. An estimated 13.6 million adults provide unpaid care in the UK (4.5 million of whom started caring as a result of the pandemic).

Analysis code is available via GitHub (

Previous Next