‘The care system is crumbling’
By Tony Watts - Editor - 02/07/2009
Charities and campaigners are warning of a meltdown in care provision for older people unless decisive action is taken soon.
The Government is publishing a Green Paper this month which will look at who should provide and fund care in the coming years, amid widespread concerns that not enough money is currently being allocated to meet the needs of a growing older population. However, campaigners are doubtful that the proposals will go far enough, or be put in place fast enough, to make up the current shortfalls.
Already, some councils are restricting care at home support to those with critical needs. New research by Age Concern and Help the Aged shows that almost two thirds of local councils rated as providing ‘excellent’ care at home are failing to provide any care at all to many older people who cannot carry out basic daily tasks‚ such as getting out of bed‚ using the toilet and washing themselves.
“This is just one example of how the crumbling care system is failing our older people,” says Michelle Mitchell‚ the Charity’s Director. “By restricting home care to those who only meet the highest criteria, local councils continue to deny many older people the care they need to live dignified and independent lives. Despite their needs being classed as ‘low’ or ‘moderate’ many of these older people are nonetheless disabled and housebound.” The charity is calling for the forthcoming Green Paper to reverse creeping eligibility restrictions and end the postcode lottery of service provision.
Councils are also imposing strict limits on what they will pay to residential and nursing homes - down to a level which, say the homes, does not allow them to provide a proper level of care, and leading to the closure of many smaller homes. The Registered Nursing Home Association (RNHA) say that the low levels of pay that homes now pay means they have to take on low skill staff. “Nursing and residential homes often compete for staff in the same marketplace as supermarkets but, at present, are unable to offer the same terms and conditions,” says their Chief Excutive Frank Ursell.
According to national charity Counsel and Care, older people, their families and carers are facing a “massive care crisis as the care gap widens”. Stephen Burke, Chief Executive of Counsel and Care, said: “There are growing numbers of older people but fewer people are getting care and support. Older people, their families and carers are struggling to get the quality care and support they urgently need.
Many have to sell their homes or use their lifetime savings to pay for the ever-increasing costs of a care home place. Now is the time for radical reform in order to create a care system that is simpler, fairer, consistent, transparent and flexible – for everyone who needs care and support.
“The forthcoming green paper on care and support must spark wide public debate about what we want the future of care funding to look like and, what our collective rights and responsibilities are in society as a whole to ensure that greater priority is placed on good quality of life in older age.
“However, the debate about the future must not delay the urgent changes we need to see now. Practical action must happen, including a review of capital limits and the pitiful personal expenses allowance for care home residents, help with deferred payments, a review of increasing home care charges, and better financial support for carers.”
Age Concern and Help the Aged are calling for an additional £1 billion to shore up the care system – which would have the added benefit of creating 50,000 new jobs in the care system.
A MT reader responds
The Care system is crumbling (Mature Times July) and has been for years.
Before I retired as a Camden social worker in 1992, we were able to provide homecare free of charge to all who needed it. I thought it was the thin end of the wedge when the new system came in categorising people into urgent, critical, substantial, moderate, and low. The plan was that social services would provide for whichever categories Councils could afford. In other words - rationing.
At first, they provided for urgent critical, substantial, and moderate categories. If clients were not offered a service because of the category they were put in, they could appeal and hope it would be reconsidered.
Then the moderate category was cut, then the critical and now it is just those people who have urgent needs who get a service. In addition, they are now means tested and offered the choice to choose a carer and pay the carer themselves. All this is difficult for older people.
Many clients have refused the help because they were afraid of paying for a service, which had been free. The service used to be provide by the council, then it was privatised, into what seems a much worse unreliable system.
Therefore, we are left with many people having no service, relying on friends and family (who are often elderly themselves), or paying for a private service, if they have the means.
It is no longer a social service- it is a social assessment service.
D. Forsyth