Well no shocks there, Sherlock – it’s been going on for years!
John Bingham, Social Affairs Editor of the Telegraph, writes that the elderly are being denied access to the care system.And it’s getting more and more intense. We’ve been looking after older people for over 200 years and have seen many changes, but not the brick wall we suddenly ran into about ten years ago. Suddenly, it seemed, our homes were accumulating vacant rooms. We knew it wasn’t about our quality of care, because it’s something our homes are renowned for.
We did some research and found that it was down to the Government diverting funding for frail elderly in care homes, and putting it instead into ‘domiciliary care’, that is, providing care in people’s own homes. To help the switch, local authorities were receiving financial incentives. Even people with complex care needs were being only offered domiciliary care in some cases.
It’s easy to see that domiciliary care costs less than residential care. Also, thinking about it, doesn’t domiciliary care sound better, anyway? After all, who wouldn’t prefer to be cared for in their own home?
Domiciliary care is great for low level needs. The fact is, though, that as people age and become frailer they need more care, and it’s arguable whether that can be given properly by a carer on a 15 minute schedule. It’s also very isolating. For many people, the only person they see day after day is the carer from the Agency. It may not even be the same person: recent reports show that there can be as many as 50 carers in a six month period.
Now even funding for people for this type of care is being restricted to those with high level needs. Six months ago the President of the Directors of Adult Social Services, (DASS), warned that Councils might soon no longer be able to guarantee the safety of elderly and disabled in their care. And Age UK warned that 800,000 older people were ‘facing catastrophe’ because they couldn’t get care.
In July, John Bingham also reported[i] on a confidential survey of budget chiefs in 144 councils in England that showed a drop of £266million on adult social care in the current financial year – a two per cent fall on 2013. Even so, Councils were collectively spending £13.8 billion this year on adult social care. It’s the squeeze between a rock and a hard place – shrinking budgets and a sharp rise in the number of people needing care.
Care chiefs said they had to effectively find savings of 26 per cent or the equivalent of £3.53 billion. Also, most senior officials accepted that the cuts they are making this year could force the private care homes or agencies they rely on out of business and attract more and more legal challenges from people denied care. And half acknowledged privately that slashing budgets mean fewer people can receive care, which will directly increase pressure on the NHS.’
We’ve seen fees paid by local authorities drop to below the real cost of care. If we weren’t a charity, with faithful supporters, we wouldn’t be able to cover our costs.
Care now takes up 35 per cent of councils’ overall budgets, up from 30 per cent four years ago, and the proportion is predicted to continue growing. It also shows that half the money being transferred from the NHS to social care as part of a plan to integrate the two more closely (the Better Care Programme) is now being used simply to prop up the system. The hope is that it will help to reduce the number of elderly taken to A&E and admitted to hospital. Frail, older people would say ‘Amen’ to that. They don’t want to be there any more than the NHS.
Today’s discovery comes from the National Office of Statistics, from a survey that showed that the number of people in care homes over the last ten years rose by only 0.3 percent, whereas the number of over 65s rose by 11 percent – thirty seven times faster. In several regions in England and Wales the number of care home residents actually fell – despite double digit growth in the overall elderly populations in the same areas. And in areas where the number of care home residents did increase, the rise was dwarfed by that in the elderly population as a whole.[ii]
And – significantly, in the same ten year period the number of people caring, unpaid, for loved ones jumped by 600,000 to more than six million. Many people give up their jobs to care family members, which usually puts pressure on their finances. Not to mention lost tax revenue for the exchequer.
In the meantime, people who can afford to pay for their own care are doing so. And many care home providers have decided that they will only take ‘self funders’. But we’re a charity with a ministry to older people, and we believe in Matthew 25:40, where Jesus said, ‘Truly, I say to you, as you did it to one of the least of these my brothers, you did it to me.’ (ESV)
When I visit our care homes I am struck by the frailty of many residents. Some can barely lift a spoon to their mouths, in fact, quite a few have to be fed. They often can’t walk, or stand unaided. Many have dementia. Years ago, before the divide between social care and medical care, they would have been classified as needing nursing care.
About nine years ago there was a move towards extra care housing (ECH), that is, retirement complexes with individual apartments where people lived autonomously but could be cared for in their own homes by an onsite care team. (Apartments for rent or for leasehold purchase.) It has many advantages. A good ECH eliminates loneliness; lets people live in their familiar homes, and in the case of couples where one becomes very frail, keeps them together to the end. In our ECH in Yorkshire a few months ago I met a man whose wife had died recently. He told me that they’d chosen to come in, knowing that she had a terminal illness. The care she’d received had been wonderful. And he added, ‘What I hadn’t counted on was the support I received from every else living here. It’s made all the difference in the world to me.’