Dangerous Care Cuts: What’s Really Happening to Learning Disabled Adults in Supported Living?

You may have noticed it’s been a little quiet on our blog recently. This is because we have been working hard behind the scenes developing Dr MJS Harmony Haven and making steady progress towards opening our service (Perhaps sooner than expected 👀)

As a doctor working in the South East and developing a supported living service in Ashford, I am increasingly worried about what I am seeing across adult social care in England. Learning disabled and autistic adults are having their support cut in ways that feel not only unsafe, but in some cases potentially unlawful. This is not an abstract policy problem; it is about real people losing the help they need to live safely and with dignity.

The Surrey story and why it matters for all of us

In February 2026, an investigation by ITV News highlighted what was happening to a group of learning disabled and autistic adults supported by a provider in Surrey. 27 adults had their care packages reviewed and were facing average cuts of almost half of their support hours. Some individuals were reportedly facing reductions of around two thirds of their support.

Families and the care provider raised serious concerns about how these decisions were made.

They described assessments being carried out:

• Without families present

• Without meaningful involvement from the staff who know the person best

• In almost all of the 27 cases, without any clear, decision specific mental capacity assessment having been done

A mental capacity assessment is not a bureaucratic extra. Under the Mental Capacity Act 2005, professionals must start from a presumption of capacity, assuming that a person can make their own decisions unless there is a reasonable cause to doubt this. When there is doubt about whether someone can understand, retain, weigh up and communicate a decision about their care, a proper, decision specific capacity assessment should be carried out, and if they are found to lack capacity for that decision, any change to their care must then be made in their best interests.

Making major changes to care where there are clear reasons to question someone’s capacity, for example significant learning disability, communication difficulties or cognitive impairment, without doing that kind of assessment is a serious concern in terms of compliance with the Mental Capacity Act.

The provider’s chairman described the Surrey process as “flawed”, “negligent” and “illegal”, and pointed out that many of the adults affected had no involved family at all, exactly the people the system should protect most. Surrey County Council denied wrongdoing and said assessments were carried out by qualified professionals in line with legal duties, but their own documents showed planned savings in supported living for people with learning disabilities and autism that year.

This is not just one council with a problem

Although that particular story came from Surrey, it would be naive to think this is an isolated incident. Local authorities across England are under intense financial pressure, and adult social care is one of the biggest areas of spend in their budgets.

Recent national analysis has shown that:

• Adult social care providers saw significant operating cost increases in 2025 and 2026, driven by wage rises and inflation.

• The adult social care system in England faces a projected multi billion-pound funding gap by the end of the decade just to maintain current levels of service.

• Councils and sector leaders have warned of a potential “total collapse” in parts of the special needs and social care system without further funding.

When you put this alongside savings targets in learning disability services, it becomes easier to understand why we are seeing aggressive reassessments and cuts. None of this makes it acceptable, but it does make it predictable.

The risk is that people’s lives are being quietly reshaped to fit spreadsheet targets, rather than support being shaped around what individuals actually need.

The bigger picture, hospital and premature death

The consequences of poor community support show up very clearly in national data.

NHS England’s most recent statistics on people with a learning disability and autistic people in mental health hospitals show that just over 2,000 people are in inpatient settings in England at any one time. Around 70 per cent of this group are autistic, compared with around 38 per cent in 2015, a dramatic shift in the inpatient population. There are around 200 under 18s in these units, and the vast majority of them are autistic. The average length of stay is close to five years, and the vast majority of detentions are under the Mental Health Act.

The latest Learning from Lives and Deaths (LeDeR) annual report, republished in early 2026, shows that around 40 per cent of deaths of people with a learning disability in 2023 were classed as avoidable, nearly double the avoidable death rate in the general population. The average age of death for a person with a learning disability sits at about 63, compared with around 82 for the general population, a gap of almost 20 years that has not narrowed.

These statistics tell us what many families already know. When support in the community is fragile or cut back, people are more likely to become unwell, be admitted to hospital, and die far younger than they should.

What the law says about assessments and cuts to care

While all of this is happening at national level, individual families are dealing with very immediate questions about care packages and reassessments.

The Care Act 2014 sets out clear duties for local authorities:

• If it appears that an adult may need care and support, the local authority must carry out a needs assessment, regardless of their finances.

• The assessment should involve the person themselves, and anyone else they want to be involved, usually family members or carers.

• Where someone has substantial difficulty engaging with the process and has no appropriate person to support them, an independent advocate should be provided.

• Any decisions about eligibility and support should promote the person’s wellbeing and consider the outcomes that matter to them.

Alongside this, the Mental Capacity Act 2005 requires that when there is doubt about a person’s ability to make a specific decision, for example about changing their care, a proper mental capacity assessment is completed. If they are found to lack capacity for that decision, any decision made on their behalf must be in their best interests.

So if a council is cutting someone’s care without:

• A transparent, holistic assessment

• Genuine involvement of the person and those who know them well

• A decision specific mental capacity assessment in situations where there is clear reason to question their capacity

Then there is a strong argument that the process is not compliant with the law.

If you are facing cuts to care, practical steps

If you are being told that your own or a loved one’s support will be reduced, here are some practical steps you can take:

1. Ask for the assessment in writing

   
   

   Request a copy of the full needs assessment and any supporting documents, and check whether they reflect the person you know.

2. Ask about mental capacity

   
   

   If your relative has a learning disability or autism and you think there may be issues with understanding or decision making, ask whether a decision specific mental capacity assessment was completed in relation to the change in care. If not, challenge this and ask for one.

3. Insist on involvement

   
   

   You have a right to be involved as a carer or family member. If you were excluded from discussions, raise this in writing and request a fresh assessment with you present.

4. Seek specialist advice

   
   

   Independent advocacy services, disability charities, and specialist solicitors can help you understand whether the council has followed the proper process and what your options are.

5. Use the complaints and appeal routes

   
   

   Every local authority has a formal complaints process, and concerns can be escalated to the Local Government and Social Care Ombudsman if necessary.

I know that doing all of this is exhausting, especially when you are already providing a lot of unpaid care. But in the current climate, formal challenge is sometimes the only way to protect essential support.

#Supported by Skill, Surrounded by Heart