Review: Adult Social Care

Review of our May meeting by Helen Warner

Adult social care is a very real issue to many of our members either through provision of care for elderly, sick relations or friends, or in considering options for themselves. People are living longer lives.  Age UK has estimated that about 1.5 million older people (65+) in England, may not be getting the social care they need, that’s about 1 in 7 of the entire older population. Demand for adult social care is increasing rapidly.

The Kings Fund report Building the dementia pathway, finds dementia is the leading cause of death in England and Wales with one in six people over the age of 80 having dementia rising to more than one million people by 2025 and 1.2 million by 2030.  

There was a personal account from SELHuG’s Treasurer Ann Pickering who reflected on her experience through early working days, (late 70s ‘abusive’ care to kindly care in unsuitable accommodation in the 80s), to her often poor experience with her own family. A lesson learnt was that Homes varied greatly and unregulated private support can be very problematic. This was echoed by SELHuG member David Lewis.  

David is part owner of a care home. He highlighted how a home should be run, with on-suite rooms, choice of meals, refreshments ‘ontap’, activities, a well-kept accessible garden and a Registered Nurse there at all times. Most homes should redecorate the residents room if they want it.  His private residents pay more than LA funded places and get a larger room. Inadequate funding was the major issue. Local Authority fees do not cover for dementia care. In the south of England funding is particularly insufficient so many Homes are closing. 

He emphasised that most people make the decision to move into Care too late.  It needs to be done before required. Care and nursing homes are not an extension of the NHS – so the issue is expectations are often unrealistic.  When choosing a Care Home, consider the location, reputation and ‘the feel’ and ‘smell’.

Unfortunately, the Local Authority Social Care lead expected to talk was unable to attend so SELHuG secretary Tony Brewer highlighted some of the political issues speculating that perhaps governments don’t grasp the nettle of the “Cinderella service” because it’s so expensive. 2011 Dillnott report recommended a cap any individual would have to pay for their own care and government would pick up additional costs but …. that too is capped. Wage rates are too low and the career path is limited. So this affects quality of staff. Delivery is often with the Local Authority but funding allocations are from central government. The regulatory body, the Care Quality Commission sets parameters such as staff ratios and the needs assessments allocations, e.g. how many incontinent pads a person can have.  If the allocation is insufficient for the resident, there’s no additional funding and nothing a Care Home can do.  There were now issues with visa’s for recruiting care staff from overseas adding to the staffing pressures. 

It is clear that there are many difficulties currently, so there is both a need to continue political pressure and to work towards a stronger ‘culture of care’.