A damning report has revealed how structural weaknesses and neglect left social care exposed to the worst effects of the Covid pandemic.

The research by the Nuffield Trust and the London School of Economics, which focuses on the initial four months of the pandemic (February-May 2020), says lack of visibility of the sector, unclear accountability, insecure funding and poor workforce pay and conditions impacted the sector’s ability to implement protective measures in a timely way.

Natasha Curry, deputy director of policy at the Nuffield Trust, said: “What happened to social care at the start of the pandemic represents the consequences of letting one of our most important public services languish in constant crisis for years. Those early months exposed an array of weaknesses within social care that impacted the shape, speed and effectiveness of the response. Many of these difficult challenges could have been eased had warnings been heeded.

“Governments of all hues have failed to make social care and those who need it a priority. Despite the pain endured during the pandemic, we now have the ominous sight of reforms being yet again delayed. As the Covid-19 Public Inquiry begins to reflect on the tragedies we saw, I hope one positive legacy might be that we will realise how much we need strong, healthy social care services, and act accordingly.”

The report finds the fragmented nature of the system and a shortage of civil servants working on social care contributed to confusion over who was responsible for decisions and implementation in the Covid response, which, for example, undermined the effective distribution of PPE and testing for care staff.

Key findings include:

• The exclusion of the sector from pandemic planning exercises and failure to take action to address problems identified where the sector was included
• No director general for social care in the DHSC since 2016 and no sector representative on the SAGE advisory group in the first few weeks of the pandemic
• Lack of access to Covid testing and sick pay for staff when self-isolation policies were in place, especially for those on zero hours contracts
• Many providers of care, often small businesses, entering the pandemic with little or no cash reserves due to a lack of long-term funding support
• Delays in emergency funding reaching the front line with extensions frequently announced with only weeks, days or in one case hours before the end of the scheme
• A lack of data and information about who uses and provides adult social care services and how to communicate with them
• Small organisations that make up much of the sector lacked the back office capacity to interpret continually updated guidance and outdated care home buildings struggled to isolate or group together infected residents and to accommodate wider infection control measures.

The report noted some positive progress in learning from these issues with the DHSC bolstering its social care capacity and expertise and the appointment of a director general and chief social care nurse. Progress was made on planning for ongoing outbreaks following the initial months with the establishment of the social care taskforce in June 2020 and the decision to continue to provide PPE purchased centrally and the smoother subsequent rollout of vaccinations.

Cathie Williams, joint chief executive of the Association of Directors of Adult Social Services, said: “There are many lessons to learn, but the biggest one is that we cannot procrastinate any longer. Just last week social care leaders said we’d run out of road to keep patching things up. We need serious, long-term investment and transformation of social care in England. ADASS published a Roadmap called Time to Act to show how we can make it happen. What we need now is the political will and the funding to do it.”

Minister for care, Helen Whately, said: “The social care workforce, care providers, charities and local authorities worked incredibly hard throughout the pandemic to care for people under the most challenging circumstances. I can’t thank them enough for the work they have done and continue to do.

“During the pandemic we supported social care with £2.9 billion in specific Covid funding, sent out more than 230 million Covid tests to care homes and prioritised social care for Covid vaccinations.

“We are committed to learning lessons from the pandemic and are investing up to £7.5 billion over the next two years to put social care on a stronger financial footing, help reduce waiting lists and alleviate workforce pressures.”