Time to care?

It is becoming increasingly clear that social care is in crisis. The travails of Southern Cross care homes, coupled with yesterday’s revelations about the inadequate state of home-care, point to the strain the system is under.
A mixture of budget cuts and increased demand mean local councils mean the amount they are willing to spend on care is falling, putting pressure on organisations providing care. There has also been a reduction in council admissions to care homes, with Southern Cross reporting a 14 per cent reduction over the last year. But neither are councils willing to support these people by providing carers to visit them in their own homes. Most councils now only offer home-care to people with the most critical needs, and the remainder will soon follow-suit.
The result of this crisis in our system is two-fold. First, older people end up being admitted to hospital instead of receiving social care – blocking expensive hospital beds that should be used for other patients. Second, the quality of care is poor. Limited resources mean that carers have no time to spend on their jobs and older people are left for hours in between visits.
Given the low pay and training for carers, it is little wonder that it is hard to attract and maintain a decent workforce. Skills for Care have projected that up to 1 million extra recruits will be needed by 2025 to meet growing demand for social care. But in London the pay is so low that migrants have been the only ones willing to work – with 75% of the care workforce being born outside of the UK. The churn of people working in the profession makes it impossible to achieve continuity in care – yesterday one elderly person reported having 32 carers in the space of one week.
At the heart of this problem is a lack of money in the care system. Until politicians and the public face up to the need to inject more money into the system, it will be impossible to make improvements. Next month Andrew Dilnot will make his recommendations on funding social care. The most sustainable solution will be for people to contribute towards the cost of their care through a form of social insurance, which the state will top-up. This already works well in Germany where people are automatically enrolled on a scheme. For those who are already nearing retirement, there is not time for an insurance scheme to work. The best option for this group will be to release some of the equity in their homes to fund their care, as happens in New Zealand.
These are tricky decisions, but they cannot be ducked any longer. Once the lack of funding for social care is addressed, we can move onto the issue of how to use the extra investment to improve the quality of care. A forthcoming report from IPPR suggests how this could be done: by improving pay for carers, providing better training and regulation, giving carers more flexibility in how the go about their work, matching carers with older people that have similar interests, and giving older people themselves a greater say in how their care budget is spent.
Home-care has enormous potential to prevent older people ending up in more expensive care homes or hospital beds. It also has the potential to enable older people to live more independent lives in their own homes. But until there is adequate funding and reform of the system, it will fail to deliver on this promise.
Source http://blogs.independent.co.uk/