More than half of the UK’s care home beds are in homes rated poor or inadequate. That’s the damning conclusion of a new report published by Which?.
In total, nearly a third of local authority areas have one in three beds or more in poor-quality care homes.
Alex Hayman, Which? managing director of public markets, said: “Having to choose a poor care home isn’t really making a choice at all, and it’s disturbing to know that so many people across the country are already in care homes that are clearly not good enough.”
Those comments were echoed by Caroline Abrahams, Age UK's charity director, who said: “It is completely unacceptable that many older people with significant health and care needs have no real choice but to live in ‘poor’ or ‘inadequate’ care homes because that's all that's available in their area.
“Older people and their families who find themselves in this position are entitled to feel outraged and very badly let down.
“What's worse, we fear this situation is more likely to get worse than better because the funding gap facing social care is already big and projected to keep on growing.”
However, some people argue that care homes are simply not the right answer for our growing elderly population.
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The cost of care
Certainly the question of who should pay for elderly care is a deeply divisive and contentious one.
Back in the summer, the Government came under fire for its social care policy, widely dubbed the ‘dementia tax’.
Under that policy, people would self-fund their care home or at-home care until they had a maximum of £100,000 left in assets. Theresa May had appeared to U-turn on the policy manifesto after it played out so badly on the doorsteps in the last general election.
She insisted that there would be an upper limit on the amount that people would be expected to pay for their care.
However, the question is still not settled, it wasn’t even mentioned in the Budget speech, and the elderly population of the country is continually growing.
Phrases like ‘ticking time bomb’ are probably overused, but on this occasion that is exactly what this is. Older people clearly need and deserve support as or if they become more frail but no one seems to know what the fairest way to pay for that is.
So what’s the answer?
Pete Dowds, founder of social care provider Elder, makes the bold claim that Britain does not need care homes and that they only exist because they evolved from Victorian workhouses.
He argues that, of the 450,000 people in care homes in the UK, 100,000 are with just six operators and that those operators are loaded with debt.
What’s more, Dowds argues that care homes are not as comforting to the elderly as their original family home. He says: “In a care home, even with the best care in the world it is still just a Premier Inn. It’s a hotel forever, not a home. I don’t understand why you have to move.”
To an extent, it’s understandable that he’s making this argument when you remember that this former corporate lawyer is one of the founders of Elder along with former trader Tom Brooks. It’s a company that helps people source live-in care for their elderly loved-ones.
However, the passion in his voice as he talks of searching for care for his own grandparents shows that it’s not just business, it’s personal.
“The minute you move into a care home you sign up to their routine, that’s your life now. Whereas with a carer your old life just carries on. You spend decades of your life building your own life and you often have children, and the family home is a real hub.
“My family home is a magnet for me and my siblings. But then they have to leave that. Why does someone have to leave their home when they need to be cared for?”
Even if care homes were the answer, Dowds says the current situation is unsustainable.
After all, there are 40,000 new people coming into care each year but some 85% of care homes are more than 50 years old.
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Systemic problems
Even if you believe there is no looming crisis within our country’s care homes, there are undeniably issues with funding.
A survey carried out earlier this year by the charity Independent Age showed that nine out of 10 MPs say the current social care system us not fit for purpose.
Janet Morrison, chief executive of Independent Age, said: “Confidence that the social care system can deal with the UK’s ageing population has virtually evaporated among parliamentarians.
“The crisis in social care was front and centre in the election earlier this year, and it is clear from this poll that there is an overwhelming desire from politicians on all sides for the Government to work towards a cross-party consensus on a solution.
She says the problem cannot be solved by simply pumping more money into the current system because it is not fit for purpose.
“To meet current and future demand, we need to take a radically different approach, recognising the status quo has failed. The Government has promised a consultation on social care, but to work this must set out a long-term vision for health and care that has support from across the political divide.
“It must also lead to a lasting settlement that better integrates health and social care services and is sustainable over the years to come.”
So what can we do?
If the current system is broken and even more money can’t fix it, what are the alternatives?
It’s a question facing all of us, since we’re all likely to be on the receiving end of care at some point in our lives.
Some, like Dowds, suggest a new model based around at-home care is best, but there remain affordability challenges there too.
Others believe that a greater onus must be placed on family members to provide a greater level of support to people who stay at home.
Whatever the answer is, it’s clear we need one. Fortunately, the Government has agreed to publish its Social Care Green Paper by summer 2018. Let’s hope it has some answers.
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