/ Roy Lilley on the Care Crisis

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Offwidth - on 04 Dec 2017
More dreadful news from the Care Crisis. Makes you wonder what kind of country we live in that this mess could be growing rather than being vigourously tackled.

"Ripped Off

News and Comment from Roy Lilley

If you have a relative in a care-home this'll interest you and if you don't it should...

Which? the consumer magazine people, have been busy researching. Results published last week, that didn't hit the headlines. Given the system-wide difficulties with care of the elderly, this news should have pushed Brexit, Trump and all the other malarkey, off the front pages.

Here's a flavour:

"More than half of care-home places in some parts of England are in facilities rated as 'inadequate' or requiring improvement"

The report, based on the CQC's own data, is a horrifying read. In 45 local authority areas, a third or more, care places are in poor quality care-homes.

We are paying the CQC to be spectators, watching the car-crash that is care of the elderly.

Where is Andrea Sutcliffe's "good enough for your mum" baloney?

If ever there was real-time evidence that inspection doesn't improve quality, it is in this report. Health Minister Philip Dunne, responsible for all this... asleep at the handles of the wheelchair.

The care sector is in crisis. One of the biggest, Four Seasons, threatened me with their lawyers last time I mentioned them... they posted a £264m annual loss and £500m debts, are back in the headlines.

They're responsible for 17,000 people. The Guardian reports;

"Four Seasons has [buckled] under the pressure of state funding cuts... shortage of EU nurses since Brexit... higher costs after the introduction of the national living wage and meeting repayments on a debt-pile of £525m.

The UK's second-largest care-home provider... put forward its own survival-plan last month, ahead of a £26m debt repayment, due in December, that it would have been unable to honour."

... bear in mind the CQC are responsible for regulating the industry as well as inspecting it.

Months ago I said the sector was surviving on a totally unfair subsidy from private payers. It seems the Competition and Markets Authority have finally woken up. Doing the CQC's job for them.

On average, self-funders pay 40% more than local authority rates. Private individuals paying a multi-million pound subsidy to keep the sector a float.

... time for a law preventing differential pricing.

The CMA also points to an inadequate complaints system, unclear T&Cs, family and friends banned from visiting.

It's not just the CMA, we all need to wake up. We simply can't allow the CQC to swan along, responsible for the care quality of 350,000 people, knowing a third of them could be warehoused (what other word is there) in poor quality, possibly dangerous places.

We have to ask, is the CQC incompetent, overwhelmed, wilfully blind, inadequate, out of their depth? It is dishonest to pretend they are on top of their task.

They're responsible for this mess and we can't challenge them or get rid of them. They are not interested in our complaints. They are unaccountable to the people who pay for them and the people they're supposed to protect.

There is a democratic deficit. Hand the money, the licensing job and supervision to local authorities. Unlike the CQC, if they make a mess of it we can vote them out.

The data is clear. Live in a care-home and you are more likely to be admitted, through A&E, for pneumonia, hip-fracture, sepsis, head injuries, volume depletion and dementia.

Time for an eye-watering focus on which of the 17,500 care-homes has high admission-rates. At a national level the data's a bit crude but easily finessed locally.

The demarkation between care-homes and nursing-homes is no longer valid. As care-home residents get more frail they drift into nursing care and few care-homes can manage the transition.

All care-homes should have a full-time, prescribing, nurse-specialist on the staff, 24-7, or no registration... simple. And, the local A&E should be able to veto registration. They'll know better than anyone, what's what.

The under utilisation of elective services, by care-home residents, probably tells another ugly story. Not enough GP visits picking-up potential problems.

The DH, palavering about with a Green Paper, is an obvious long-grass tactic. The price LAs pay, for care home placements, is being exchanged for the safety of the most vulnerable and the exploitation of self funders.

Austerity is being bought with the safety of the most frail and money ripped-off from families."
pasbury on 04 Dec 2017
In reply to Offwidth:

This, disability eligibility tests and Universal credit are the reality for millions of people. Austerity is an unnecessary, ideological and massively damaging policy.

Meanwhile the asset rich have just had most of the QE pot fall into their laps, tax free.
neilh - on 04 Dec 2017
In reply to Offwidth:

The care crises has been brewing for years and nobody in any political party seems to have the will or the balls to address the scenario.The public also wants to bury their heads in the sand and deny it exists.

This from somebody who has had both parents in care and has seen the issues first hand , but I recognise there are still alot of really good care homes out there.
Offwidth - on 04 Dec 2017
In reply to pasbury:
I agree but I'm even more surprised in this case as the care crisis affects almost everyone; as you need to be very rich to avoid getting caught up in it. This is grans and grandads, mums and dads, brothers and sisters. Imagine being in a home where conditions are failing as often and as badly as these surveys indicate and a huge proportion of the sector is facing bankruptcy. I agree with Roy that the CQC and the political process to resolve the problems they identify are completely unfit for purpose. The resulting health problems of course end up in an overstretched NHS and then affect everyone else (even the middling rich require emergency admissions at times).
Post edited at 11:38
Timmd on 04 Dec 2017
In reply to Offwidth:

Thanks for sharing.
toad - on 04 Dec 2017
In reply to Offwidth: I have a terrible feeling that the care crisis is being allowed to happen because too many people are complicit in this abdication of care for the elderly. Grandparents are great so long as they don’t make too many demands on your time and are on hand for babysitting, looking after the dog, comedy Christmas socks etc.

As soon as they start interfering with your holidays, it’s time to outsource their care. And of course the tragedy of dementia is that the cared for rely on others to speak for them, and far too many people haveoutsourced this responsibility to the care homes, and too many of them are only concerned in how to sidestep the living wage.

It’s really horrific that much of the political narrative is about how to maximise the return from these ageing assets by minimising care costs and death duties. Money that should be spent on quality of life being sequestered for the next generation to pay off their mortgage early. We should all hang our heads on this one, and then think long and hard about how many of us treat our elders.

baron - on 04 Dec 2017
In reply to toad:

Your points about our lack of actual caring for our parents, grandparents, etc is at the heart of this crisis.
Asking the government or others to look after our relatives when we can do so ourselves is not the sign of a civilised society.
I know it's a very complicated issue but they are our relatives and should be our responsibility.

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