Posts Tagged ‘elderly care’

Council cuts making social care unsustainable

Thursday, September 18th, 2014

An article from the BBC recently brought to light the fact that 89% of councils now only offer care services to adults with needs classed as substantial or critical. The research from the Association of Directors of Adult Social Services (ADASS) shows that this figure has increased from 72% since 2010-11, neglecting those whose needs are deemed low to moderate.  As a result, thousands of people are struggling along without help

It is clear that the system has been affected by cuts that have ravaged social care budgets across the UK. ADASS estimates that over the past three years more than £3.5 billion has been wiped from social care spending, reducing the amount of care councils are able to offer to vulnerable individuals. While the government claims to have provided local councils with an extra £1.1 billion to help with the cost of social care, the fact remains that this figure alone does not make up the shortfall left in social care budgets by such hefty cutbacks.

As a result of these cuts many councils have had to make drastic changes to their social care budgets. Gloucestershire  County Council, for example, has recently announced its need to make an additional saving of £75 million on top of the £114 million savings it has made since 2011. Derbyshire County Council has also recently announced that it intends to cut its social care budget by £11 million this year alone, by raising its threshold for those who qualify for care and introducing means testing.

Ultimately these cuts will have the biggest impact on vulnerable individuals whose needs aren’t deemed serious enough to warrant council-funded care. Not only can this lead to financial trouble for those in need of care as costs continue to increase, but it can also lead to vulnerable individuals having their support taken away.

A previous Prestige blog examined the impact that council cuts have had on the number of elderly receiving care at home who are forced instead to attend A&E. It is clear that council cuts are damaging to the individuals who require assistance, place added pressure on GPs and A&E – who are ill-equipped to handle this – and ultimately end up costing more as those who fail to receive support at home have no choice but to go into residential care. Providing more funding for support at home would act as a preventative measure, postponing the time when permanent care is required.

Falling confidence in the care sector

Wednesday, September 3rd, 2014

A recent article from The Telegraph highlights growing concern in the care industry as only one in four voters believe they will receive proper care in their old age. New research involving 75 charities and voluntary organisations concludes that the care crisis could prove a decisive issue in next year’s general election, with the issue coming only second in priority to health.

It is interesting that old age care has become a top priority for voters and the public after what feels like many years of apathy. The issue has undoubtedly been brought to the forefront of people’s minds following devastating reports and investigations from the likes of Panorama into care home abuses. Combined with years of council cuts – 26% off care budgets in just four years – and tightened restrictions on those who qualify for care, this has left many unsupported and excluded, signalling the need for drastic reform and extra funding.

Previous Prestige blogs have examined various ways to address challenges facing the care sector, ranging from more robust monitoring and tougher inspections from trade bodies, improving the image and pay of nurses to increase retention and counter the growing nursing shortage while also considering the role those typically outside the sphere can play. An article in the Guardian inspired another Prestige blog which looked into the way that communities could help reduce loneliness and provide basic level support.

Community support is one way in which residential care can be postponed by providing basic needs early on. Another is home care. This offers a cheaper alternative to residential care – for which the average basic annual cost across the UK is now approaching £29,000 – while also allowing individuals to remain in the comfort of their own homes for longer. In doing so, it still provides an element of support and comfort, delaying the need for permanent care.

The recent overhaul of the care system – allowing people to defer paying care bills to avoid having to sell their homes and the introduction of the care cap – may be a case of too little, too late. Already senior care chiefs are warning that they may lack the ability to guarantee the safety of those in their care because of the financial squeeze. It is clear that more needs to be done, and quickly, to address the growing concerns and lack of confidence in the sector.

Care workers are underpaid and undervalued

Friday, August 29th, 2014

An article in The Guardian recently highlighted the lack of recognition offered to care workers for their commitment to caring for the elderly and unwell. Workers support care home residents in a multitude of ways, from helping with day to day basics right through to round the clock care, yet seldom get the recognition they deserve for their tireless work. Recent stories of neglect and abuse in nursing homes have dominated the headlines – as they rightly should – but the thousands of top quality care workers who have devoted their lives to helping the most vulnerable get little to no recognition.

Being a care worker is a physically and mentally draining job yet there is distinct lack of fair pay. Currently 78% of staff earn an average of £6.45 per hour, just 14p more than the minimum wage – an embarrassingly low sum for such an invaluable service. It is therefore not surprising that the number of care homes with low morale and high staff turnover continues to increase.

As a result, the Commission on Residential Care has recommended that residential care should become a living wage sector. This move would allow for better pay as well as encourage training and career progression – highlighting two key factors that would vastly improve retention within the profession. Moreover, establishing a minimum level of training would allow for a carers licence to be created. The implementation of a licence would serve to monitor skill, quality and achievement.

Previous Prestige blogs have also called for recruitment challenges to be addressed, at the heart of which lies – as mentioned above – pay and attitudes to the profession. If attitudes towards nursing and care workers as a profession were to change, this would encourage more people to work in the sector and start to fill the shortages.

Better pay and training along with the emphasis on career progression would see more people viewing this as a valued and long term career – encouraging greater retention. Benefits such as flexible working could also help in this regard while at the same time making care a viable career for those with fewer hours available.

Cost of a care home rises 54% more than pensioner incomes.

Wednesday, August 20th, 2014

As recent articles in The Daily Telegraph and The Daily Express highlight, new research from Prestige Nursing + Care has found the gap between pensioner income and care home costs has widened by 54% over the previous year. The annual fees for a room in a care home now average £28,666 across the UK, more than double the average pensioners’ income of £13,993. It leaves a shortfall of £14,666, placing untold pressure on individuals concerned about how they will cover this cost.

Even in the North East where care is cheapest, there remains a shortfall of more than £10,000 while in the South East this increases significantly to £17,526. The mismatch between incomes and costs leaves many with little choice but to sell their homes to cover this shortfall.

Previous Prestige Nursing + Care blogs have commented on the impact that council cuts have had on care funding over the last few years, having drastically reduced the number who are eligible for financial support. Liz Kendall, the shadow care minister, also expressed her concern on this matter during a speech in Ilford last week where she stated how cuts to social care are piling pressure on NHS hospitals and putting vulnerable people at risk.

Care at home can offer a viable alternative to residential care and can be used to assist elderly or disabled people with day to day tasks. Without this sort of support and assistance it could result in individuals having to move into a care home sooner. In essence, support at home can act as a preventative or delaying measure.

Limited access to GP surgeries impacts elderly care

Thursday, July 31st, 2014

Articles in The Independent and The Times this week suggest that over the next year millions of people will be shut out or turned away from their GPs. It is an alarming thought and one that has serious implications for the quality of care provided to the elderly and vulnerable in particular. One in nine people reported being unable to book an appointment at their GP surgery, which adds up to patients being turned away more than 40 million times this year.

This is indicative of endemic failings across the system, and is something that will only accentuate existing problems. As more people are turned away – or have to wait excessive amounts of time – this inevitably impacts the numbers forced to go to A&E instead. With reported waiting times of up to a month it is clear that the system is in crisis, exacerbated by what Chris Smythe calls a “rising population of older and sicker patients.” One danger of this is that patients may give up trying to make appointments, particularly those who are older, frailer and require that much more effort to go to the doctor.

As soon as the care provided by GPs enter into the debate people are far too quick to dwell on the issue of their salaries, which we believe is not what lies at the heart of the matter. The benefits of a 24 hour service or greater availability of appointments at the weekend would quell the problem to some extent. But ultimately – despite numbers being at a record high – there are not enough GPs to accommodate the population and dried up investment means existing resources are overstretched.

There is currently a distinct lack of alternative options to provide the elderly or frail with care outside of hospitals. If this could be addressed it would reduce the burden on the NHS and significantly reduce costs across the UK. Previous Prestige Nursing + Care blogs have considered the role that community care could play. With greater emphasis on this and more encouragement from the government it is a viable way in which the cost and burden on GPs, the NHS and unpaid carers could all be reduced.

Critical to the success of this ambition is an adjustment in attitude among many in the UK towards providing care. By accepting that it is a logical and sustainable solution to a growing challenge of supporting our ageing population, policies designed to bolster community care could really make a difference.

Pension reform clarity still lacking for long term care

Friday, July 25th, 2014

The explanation from George Osborne earlier this week on his Budget’s pension reforms gave greater clarity about the increased flexibility pensioners will receive by easing access to pension savings, lifting tax restrictions, and offering improved competition. However, it failed to address the implications for long term care.

All in all, we agree that the reforms – first announced in March – are a step towards greater independence for those in retirement, but greater clarity in the context of funding long term care is still required.

The Telegraph highlights that the reforms could play a significant role in helping people to pay for care later in life. Under the new regulations, individuals will be able to withdraw their savings – which may otherwise have been tied up in a fixed income that allowed no access for emergencies or unforeseen events – should they need to pay for care services. In previous years, many people requiring residential care have been forced to sell their homes in order to cover the cost, and the Chancellor has previously said the new reforms will not result in more people having to do this.

Despite expanding on how the changes will work, however, he is yet to address concerns that the reforms could result in people having to pay more towards social care. Under the new Care Act, the means-tested threshold for care costs will rise to £118,000 for people with property assets, and £27,000 for those without – anyone below these limits will be exempt from care costs.

Analysis of official wealth and assets data by Prestige Nursing + Care suggests that, under the new rules, more than one in ten (11%) of the 6.05 million people aged 55-64 in England could lose their exemption from care costs by withdrawing the average £25,000 net pension, which might push them over the threshold.

As of today, funds tied up in pensions or annuities are not included in the assessment of how much one has to pay towards care, whereas cash assets and property are. There is little indication about whether savings withdrawn under the new regulations will be counted as cash assets towards means testing for care. This is something the government must address. What is clear is that efficient forward-planning will be needed to ensure that individuals do not find themselves liable for huge care costs later in life as a result of liberating their pension savings

The sustainability of long term care.

Tuesday, July 15th, 2014

The Association of Directors of Adult Social Services (ADASS) has recently issued a dire warning that the care sector is close to breaking point and no longer able to absorb the pressures being placed upon it. This is heightened by ‘extreme public concern’ about the quality of care for older or disabled people in the wake of a series of care scandals.

The Telegraph goes on to highlight a study published last week which shows that 26% of local authorities’ care budgets have been wiped out in just four years putting standards under scrutiny and questioning the sustainability of the care sector. The ageing population, nursing shortages and severe cuts to funding are all negatively impacting long term care for the future.

We have already witnessed massive gaps in the standards and availability of services provided. This directly increases pressure on the NHS and existing staff, who can ill afford it, and leaves huge numbers of vulnerable people without the support they need.

Spending on social care has plummeted by 12% since 2010, according to The Telegraph, with councils and social care departments forced to slash budgets by over a quarter. Previous Prestige research also found that there are significant regional differences in council funding, with the North particularly badly hit by cuts.

A confidential survey of budget chiefs also found that total spending on adult care dropped by a further £266million in the current financial year (a 2% fall on last year). The study showed that many officials accept that cuts they are implementing could force private care homes or agencies out of business, which begs the question of where and how care would be provided.

Despite a realignment of funding from NHS to social care as part of a plan to integrate the two, this is simply propping up the system and (in its current form) is not a long term solution. One idea being floated is that of increasing volunteers to do the jobs currently being done by professionals. While we welcome increased community involved and support to families providing care, it is vital that adequate training is provided to ensure this does not result in any decline in standards.

Ending care home abuse

Wednesday, July 2nd, 2014


Following the Panorama exposé in May a great deal was written – including  a couple of Prestige Nursing + Care blogs – about  the importance of, and ways to improve, standards of care in order to address the issue,.

During this time the Sunday Express has also launched its Care with Kindness campaign. This gained backing from the government as Heath Secretary Jeremy Hunt announced a crackdown on poor quality care in order to better improve standards for the 500,000 residents in care homes in Britain. It stresses that several steps will be taken to protect care home residents from abuse, such as tougher inspections and NHS whistleblowing helplines. Changes had to take place after the Care with Kindness campaign found that complaints of abuse in care homes have increased by 20 per cent in the past year.

While tougher inspections and consequences are a welcome change to tackle abuse, as this case shows low wages and staff shortages are also a key factor in unsatisfactory staff being recruited. This is part of what really needs to be addressed in order to end care home abuse.

To reiterate a point from a previous Prestige blog: the government needs to do more to address cuts to funding so that nurses and care workers have access to better training and higher pay. Improvements in both these areas would change the way that the profession is viewed and increase recruitment, leading to a plethora of high quality and well trained staff.

Evidence of the imbalance between NHS managers’ and nurses’ wages was highlighted by this Independent article and will only reinforce the view that nurses and carers are taken for granted and paid poorly for it, discouraging people from wanting to work in the sector. NHS managers’ salaries have increased at four times the rate of nurses’ salaries while the Independent also reports that in the past two years, NHS spending has increased by 6.1 per cent on executive directors while nurses, midwives and health visitors only saw a 1.6 per cent rise.

It is clear to see, therefore, that the challenges facing the care sector – the shortage of workers, council cuts to funding and poor quality care which leads to abuse – are intrinsically linked. And that, only by tackling them all will the care sector see substantial improvements.


Ending abuse of zero hours contracts and improving pay for workers

Thursday, June 26th, 2014

A crackdown on zero-hours contracts was announced yesterday as Vince Cable lambasted employers who prevent staff on such arrangements from seeking extra work, saying that such measures constitute ‘abuse.’ Employers are to be banned from tying zero-hours contract workers to an exclusivity clause; a move the Department for Business, Innovation and Skills hopes will benefit an estimated 125,000 people, as summarised by this Guardian article.

A six month government consultation on zero-hours contracts found that more than eight in ten people were in favour of banning exclusivity clauses as part of measures to ensure that workers get a fair deal.

The ONS estimates that 1.4million zero hours contracts exist in Britain with around one in eight businesses using such contacts. For many staff who work under these arrangements, it also means they are not offered paid holidays, maternity pay or other traditional benefits.

While poor use of zero-hours contracts by employers – including exclusive causes – can lead to financial instability, there are also benefits in having this option. Those who wish to work flexibly, such as students, older people or those who want to supplement their main source of income are able to do so easily through a zero-hours contract.

What is perhaps more alarming is the poor wage that some workers receive for the hours they do work. The Living Wage Commission released a report focusing on the estimated half a million employees employed in the UK public sector that are paid below the living wage and the importance of addressing this. While a living wage is something we fully support, the UKHCA made a valid point when meeting with the commission. It underlined the need to recognise that for homecare workers to be paid a living wage adequate funding has to be reflected in council rates paid to providers.

As we examined in a previous Prestige Care + Nursing blog, councils across the UK are paying less than the recommended amount to home care providers. The UKHCA recommends an hourly rate of £15.19 to account for wage and benefit guidelines, provide adequate training and take travel between service users’ homes into consideration.

There is currently far too large a disparity in the council commissioned rates and the money required to pay workers a full living wage to a point that it is currently unfeasible to do so. With the average rate being paid at £12.26 an hour and further cuts anticipated over the next few years, quality care is harder to maintain as care providers become unable to deliver sustainable services resulting in additional pressure on the NHS.

Wake up to the carer needs of the UK.

Friday, June 20th, 2014

Last week, new analysis of the 2011 census by the Office for National Statistics (ONS) found just how hard council cuts and nursing shortages have impacted the provision of care and the way it will worsen over the coming years. It found, perhaps unsurprisingly, that the care of family members falls disproportionately on women.

This is an issue that will only worsen as the population ages with girls aged 15 today predicted to dedicate more than nine years over the course of their lives to care for loved ones or family members in the future.  As such, this places a heavier burden of care on them than any generation previously as a result of rising life expectancy and improvements in medicine.

Overall 5.8m people in England and Wales – a massive 10% of the population – provide unpaid care to sick, disabled or elderly loved ones, an increase of 600,000 since 2001. It raises serious questions about the financial burden and pressures families will be placing themselves under in future.

This follows a BBC article showing that while 1.4m people work for the health service, and a similar number are care workers, around 6.5million people identified themselves as carers in the last census. This is a figure that is expected to grow to 9m over the next 20 years – something that could have a dramatic impact on the wider UK economy as well as millions of family finances. Estimates show that 40% of those who will be required to look after loved ones as unpaid carers will have to reduce the amount of paid work they do in order to provide the level of care needed of them.

Previous Prestige blogs have talked about council cuts to social care, something which is obviously a factor in this topic. Cuts to council care have had a devastating impact on the services they can provide with eight out of ten local councils now only funding care at a ‘critical’ level. There are calls for the government to find a way to “fund social care services in a sustainable way” that don’t require millions of people to go without pay. The government carers grant is currently £61.35 a week, a figure that could easily be argued is too low, but more important is the fact most people aren’t even aware it may be available to them.

The nation as a whole needs to wake up to the country’s caring needs rather than brushing the issue aside. Our blog only last week showed how the requirement for carers as a profession is set to increase over the next twenty years but that will not go far enough to satisfy anticipated demand. The government needs to step up to the mantle and deliver a longer-term strategy so that families receive sufficient support to care for older family members without risking financial hardship or exhaustion.