Almost 400,000 people are on social care ‘waiting lists’, care bosses estimate, as they warn of a “rapidly deteriorating” situation for older and disabled people this winter.

An estimated 204,241 people are waiting to have their social care needs assessed – a “very significant” rise from September, according to the Association of Directors of Adult Social Services (Adass).

There are also 25,468 people thought to be waiting for care or a direct payment so they can organise their care, and 166,136 people waiting for an overdue review of their care plan.

Of those waiting for an initial assessment, more than 40,000 have been waiting longer than half a year, the survey of 85 social care bosses suggests.

The report states: “This is not just an inconvenience. It means that people’s needs are not being met.

“It is likely to mean that their wellbeing and mental and physical health deteriorates or worse.”

The Government must urgently stabilise the sector with emergency funds, Adass says.

Its snap survey between November 2 and 18 was responded to by more than half of directors in England.

Their responses on demand and provision in their area were averaged and extrapolated to give a national estimate.

It found that there has been a further significant increase in the number of hours of care provided to people at home from August to October – up 15% from May to July.

However, this record growth is not keeping up with demand or the complexity of need.

More than 1.5 million hours of commissioned home care could not be provided between August and October due to a lack of capacity, Adass estimates.

This level of unmet need is almost three times that recorded for May to July, and more than five times that for February to April.

It also found that almost half (48%) of councils reported care home closures or providers going out of business in the past six months.

This is up from 35% in the summer, and 25% before the pandemic.

Adass president Stephen Chandler said: “This survey confirms our worst fears. Red lights are flashing right across our dashboard.

“Despite magnificent efforts by the committed, courageous and compassionate people working in social care who are delivering extraordinary amounts of care and support, services are failing to meet everyone’s needs and older and disabled people are suffering.

“The Government must now acknowledge the scale of the crisis and step in with emergency funding and measures to ensure we can get through the winter ahead.”

Adass is calling for the Government to commit to a £1,000 retention bonus to stem the tide of carers quitting to work in sectors with better pay and hours.

It also wants to see £1.5 billion invested immediately to prevent the further collapse of services, and the equivalent amount to support unpaid carers.

Dr Rhidian Hughes, chief executive of the Voluntary Organisations Disability Group (VODG), said that staff are quitting “every day” to work in sectors such as retail and hospitality, with managers stepping in because they cannot fill rotas

The “skeletal staffing” of services is taking away the essential support that disabled people need to maintain control over their lives and will end up placing further pressure on the NHS, he added.

He said: “The erosion of support for people who draw on social care services is happening locally, in people’s homes and out of sight.

“There is no headline grabbing ‘crash’ but the realities of Government’s under-funding of social care is having profound consequences on the quality of life for disabled people.”

He added that the Government must provide emergency funding so care providers can get through winter and “to stem the rising levels of unmet need”.

Councillor David Fothergill, chairman of the Local Government Association’s community wellbeing board, said: “As we head into another difficult winter, these figures are a stark reminder of the immense scale of the challenge facing people in need or in receipt of adult social care and those who work with them.”

Unison general secretary Christina McAnea said the report was “another deafening alarm bell about staffing shortages in the care sector” and demanded a pay rise for care workers.