Diana Athill interview: Why the private sector shouldn't touch social care

The writer tells Zoe Williams how the care home where she lives in puts propriety before profit

 Diana Athill: 'I'd been here for about a week and I thought, 'what is it about this place that's so marvellous?' And I realised, it is goodness – an extraordinary feeling of goodness.' Photograph: Murdo Macleod for the Guardian

'The ghastly thing is, a great percentage of homes are run by private companies. And you don't set up an old people's home as a private company unless you think you're going to make a profit. You can't make money out of old people."
The last time I saw Diana Athill was about six months ago, in Shoreditch House, where she was reading Desdemona, a short story she'd written in the 1960s that won an erotic fiction prize in Transatlantic Review. (If you have no interest in the lives of elderly people and would prefer to read something whose lines will be ringing in your mind for months, then I direct you to this collection: Midsummer Night in the Workhouse.)
I didn't at the time realise that Athill was even in a care home, but she had been for a year and a half. The Mary Fielding Guild is, she warns me, rated one of the best six care homes in the country. This is in no way representative of the way elderly people are treated in residential places. It looks genteel, and it's in a genteel part of town, but as she says, "We're fed, warmed, cleaned, kept entirely, on what we pay. And what we pay is considerably less than you can pay in far worse places."
Can this possibly be true? It feels like an Oxford college, with a cheerful atmosphere and deeply pleasant surroundings. But if the cost isn't much more than somewhere run by Southern Cross, then something has gone seriously wrong. Some people in care homes are able to live proper lives, while other people pay the same rates and get bottom-of-the-pile, collectivised treatment.
Athill has never, in my brief experience, been sloppy with her facts, let alone wrong, and this is no different: care homes, be they atrocious or Ritz-for-the-old, are all in the same ballpark. You can, if you really shop around, pay less than £400 a week (I didn't find any for less, but Southern Cross have taken their prices off the internet; or maybe they never posted them). And you could, if you were determined, pay more than £900. But around £550 a week seems to be where most places are sited.
This is as pure an argument as you need against the private sector going anywhere near social care. Where need is serviced by the third sector (Mary Fielding is a trust, run by "high-minded individuals. And I really do mean they're high-minded"), it is civilised. Where it's serviced by people trying to turn a profit, it is not.
"This place is a dream …" Athill continues. "I'd been here for about a week and I thought, 'what is it about this place that's so marvellous?' And I realised, it is goodness – an extraordinary feeling of goodness. None of these people are anything but genuinely kind. That's the secret of a decent place. You can't get it if you're a remote company, running a scruffy little place and trying to make some money out of it.
"A very nice young woman who comes and does my feet, she's a visiting chiropodist, she goes to quite a lot of homes. I said to her, what are the other places that you go to like? And she said 'Don't ask'. It's frightful what can go on in these places; you've got these helplessly dependent people who've got limited funds, and you've got to do everything for them."
Clearly, residential care is incredibly expensive whoever you are, wherever you are, and Athill says, "If I had daughters, I'm afraid I would probably be taking advantage of them. Daughters are sweet, and if you're sufficiently nice to your daughters all your life, they tend to rally round their mums when they're old and frail.
"I did it myself. I didn't quite go and live with my mother, but I changed my plans and I used to work three days in London and do four days with her. And I'm very glad I did."
There is a mischievous lack of rue in her voice, as if tacitly to note that daughters might be sweet, but they make plenty of demands of their own.
Equally clearly, it's a source of tremendous anxiety to old people that they flog their houses to fund this care, and then don't know how long the money will last. But the point is, a well-run care home can be a wonderful place. Athill says she can work and concentrate better here than she did when she lived independently.
'If I'm reviewing a book or something, it's lovely. I can spend the whole day without worrying about anything; no dog to walk, no shopping to do."
I wondered whether one felt one's age more, living in sheltered accommodation or living at home, and Athill replied, "I think how aware one is depends entirely on one's health. As long as you don't have aches and pains, and forget everything all the time, you feel just like you always did. But you do, when you start to get aches and pains, become aware of it."
None of this is easy. Athill remembers packing up her house, and says feelingly, "I had total panic, the awful horror of giving away your things. It was very, very, very painful – so painful that I ended up spending two days in hospital thinking I was having heart failure."
But there is one quite simple proof here, which is that you can, for the money, have a civilised life. If the business model is broken for Southern Cross, if life is miserable in the main tranche of care homes, it is because the private sector is unsuited to this work.
Source http://www.guardian.co.uk/