Guest Blog – Four things you never knew about social care ?

 This guest blog was contributed by Richard Humphries, Senior Fellow at The King’s Fund. Richard joined The King’s Fund in March 2009 to lead on social care. His professional background is social work, having worked in a variety of roles including Director of Social Services and Health Authority Chief Executive (the first combined post in England).

Age UK’s new report – Care in Crisis 2012– is the latest clarion call to sort out a care system which even Government ministers accept is broken. The report sets

Richard Humphries

out in stark detail just how many people are going without the care they need. Public spending on care for older people is actually going down even though numbers are going up – especially frail very old people who need the most care. England is no different from all advanced countries in the world that need to devote a bigger share of the national wealth to an ageing population – itself a sign of social and economic success. Yet we are finding it remarkably difficult to rise to the challenge.

Here are four things you may not know about England’s social care system. It has its origins in the 1948 National Assistance Act when the world was a different place, with much lower standards of living, health and wealth. 64 years on, the care system must be the only public service that has never been fundamentally reformed to keep up with changing times (although it has been frequently reorganized, which is not the same thing). We wouldn’t dream of running any other major service as though we were still in the 1940s. The system has suffered from years of policy tinkering instead of sensible long term reform.

Second, if you have savings or assets of more than £23,250, you will be entirely responsible for the full cost of residential care, a cliff-edge so steep it makes Beachy Head look like a gentle slope. Many people do not realize this until it is too late. Some think , wrongly, that the NHS will pick up the bill.

Third, that even if you are relatively poor, it is unlikely that your local authority will help you. 82% of councils limit the help they provide to those with ‘substantial’ or ‘critical’ needs i.e. you will need to have become very dependent indeed before you can get help. England must be unique in simultaneously restricting help to those with the highest needs and the lowest means.

And finally, that your chance of needing care and support in later life is much higher than you think – one third of men and a half of all women will have a significant care need at some point in their retirement. So we all have a stake in seeing a better system fit for the 21st century.

The King’s Fund has been arguing the case for change, alongside many other charities, since our major review by Sir Derek Wanless in 2006. Since then White Papers and Green Papers have passed like ships in the night. The Government pledged to set up an independent commission to look at how care is funded. It delivered on that commitment and the commission headed by eminent economist Andrew Dilnot has produced proposals that command almost universal support from organisations involved in older people’s care. We agree that they offer a sensible framework in which the costs of care can be met. But reform of funding must go hand in hand with reform of how care is delivered.

The Age UK report sets out seven major building blocks for change including quality, safety and dignity in care. The Government will soon set out its stall in a White Paper and accompanying response to the Dilnot report – its authors could do worse than make sure Care in Crisis 2012 is top of their preparatory reading list.

Age UK are calling on the Government to reform the adult social care system. Find out more about Age UK’s Care in Crisis campaign and how to sign up to our petition.

Read Care in Crisis 2012

9 responses to “Guest Blog – Four things you never knew about social care ?

  1. These are good points that so few people realise until they need to implement care, either for themselves or their family.
    The Care in Crisis report is a good report and I agree that the care system is in crisis, but it uses the spend on care as a key measure and I think there is a huge danger in using the amount of money spent on care by local authorities as a yardstick for measuring this.
    Although the preventative workstream of Putting People First was not seen as the main focus for most local authorities, the majority of them have now got reablement services, telecare services and improved equipment services of some sort in place and all of these have had an impact on the level of spend on care, as they are having a positive impact on helping people to live independent lives with reduced levels of care need.
    I’m not denying that much more needs to be done, just commenting that simply looking at level of expenditure as one of the key measures distorts the picture.

  2. mrs maureen clarke

    I Think people should be aware that when they take out lasting power of attorney for their loved one they should make sure it also covers health.I made the mistake of not doing this and as my mother is in a care home Ihave no say in for example rails on the bed or the use of crash MATS with the bed 18inches high.she had a serious accident falling onto a crash mat and i was refused bed rais with bumpers and have no say in this if my solicitor had signed not just financial affairs but also health i would be able to have a say in this safeguarding matter

  3. I am suprised that the care of the elderly is so very poor. I am eighty five, and am thankful that I do not need any , or very little, help at this time,
    Of course that can change very quickly, a fall, flu, etc. can quickly change the life style of us oldies.
    Having spent a life time look after our older people, I do agree that they must be given dignity, Please don’t call us , lovey, or ducks, give us our name, and do listen, being old does not mean we are stupid, just think of the knowledge that person has acquired in all those years.
    Elizabeth.

  4. Hilary Greenleaf

    My father fell from a nursing home bed onto an upturned plug when he was frail and terminally ill and died the next day. I had requested rails be fitted but staff were reluctant due to health and safety assessments needing to be done first, they offered I crash mat which implies that they would be happy to let him fall, but they failed to put even this in place. When I investigated the recommended assessment form listed by MHRA all the check points seem to relate to the dimensions and standards of the beds rather than the assessment of the patient. My point to them is therefore that if all beds conformed to a safe standard, these undertrained staff would feel happier in authorising their use. Whe you are paying £800+ a week I think that you should have the right to a bed that is suitable if rails if required. The case of my father need not have happened!

  5. mrs maureen clarke

    My own experience is similar.My mother aged 92, in the later stages of Dementia fell from a nursing home bed and badly bruised her face.I was outraged that there was no rall on her bed and a crash mat on the floor did not cover the radiator on which she banged her face.I also questioned how low her bed was when wound down ..It was 18inches from the crash mat. This ridiculous health and safety rule and care workers not winding beds down low must cause serious injury to many vulnerable old people.Ifelt thatthis was a safeguarding issue so contacted my local safeguarding officer who agreed with me but was not prepared to do anything about it.I have instructed a solicitor to sue for damages as I was not involved in the initial assessment and feel that my mother was put at unnessessary risk.This was particularly upsetting as I had had to move her from a Bupa home where someone had forcefully stolen her wedding ringfrom her finger and I was thinking if they can do that how can Itrust them?THE cQC were notified but seem useless.It makes you despair .

  6. Hilary Greenleaf

    Maureen, I saw the case of your mother in the paper and have contacted the Daily Mail concerning the case of my father. The situation is ridiculous and I am currently collecting statistics of bed falls and bed falls onto mats to present some sort of case to the minister of health. I agree that the CQC are a complete quango, a waste of space with no powers. They have merely told me that they will continue to monitor the home.

  7. catherine schmidt

    I agree with everything what has been said my mother is in a home where it is not clean atall. you never see the tables getting properly wiped down clothes get swapped & changed from other people so tell me how are they looking after the Elderley not good atall makes me sick. to think is this our society .no love is in a residential home its just a money thing for people that own residential homes. in the office smells lovely go to the people where they sit like birds on a perch (it smells horrible) not nice is it

  8. Janice Chissick

    I am reading these accounts here and I despair. Every day I am encountering lower and lower standards in my mothers nursing home and I really don’t know what course to take. Social workers are useless, thenCQC is not fit for purpose. How do we fight for the basic dignity our elderly deserve. Most of the relatives fear retribution and are too scared to do anything. Is there a lobby group I can join to try and do something with all this energy I am using up.

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