This report, published jointly with the Nuffield Trust, looks at the current state of social care services for older people in England, through a combination of national data and interviews with local authorities, NHS and private providers, Healthwatch and other groups. It considers the impact of cuts in local authority spending on social care providers and on older people, their families and carers. Alongside this work, we were commissioned by the Richmond Group of Charities to interview older people about their experiences of social care.
The picture that emerges is of social care providers under pressure, struggling to retain staff, maintain quality and stay in business; local authorities making unenviable choices about where to make reductions; a complex set of causes of delays in discharging older people from hospital; and the voluntary sector keeping services going even when funding was curtailed.
Key findings
Social care for older people is under massive pressure; increasing numbers of people are not receiving the help they need, which in turn puts a strain on carers.
Access to care depends increasingly on what people can afford – and where they live – rather than on what they need.
Under-investment in primary and community NHS services is undermining the policy objective of keeping people independent and out of residential care The Care Act 2014 has created new demands and expectations but funding has not kept pace. Local authorities have little room to make further savings, and most will soon be unable to meet basic statutory duties.
Policy implications
Based on the evidence in the report, the authors recommend that policy-makers need to address three major challenges in shaping the development of social care over the next five years, focusing on how to:
achieve more with fewer resources – for example, through better commissioning and integrated care – recognising that these initiatives will not be enough to close the funding gap
establish a more explicit policy framework, which makes it clear that primary responsibility for funding care sits with individuals and families
reform the long-term funding of social care because reliance on additional private funding is unlikely to be sufficient or equitable.
As someone trying to provide a practical, flexible and quality service to older people [mainly with dementia] and their carers. this article only reinforces our everyday experience [ years after publication].
We run as a social enterprise keeping costs to a minumum but the Social care system is too inflexible and too poorly funded to understand/ acknowledge the "changing"! needs of dementia or fund appropriate care for those with dementia OR their carers. Keeping people out of full time care should be a priority but is too often the quick fix to avoid blocked beds [blocked not blocking - the bed is blocked by the system failure NOT the individual] . One of our biggest issues is the lack of information available to people about real and practical support they might access [we look on it as daily respite] and a lack of willingness to fund/ invest in services that are effective, proven and cost effective so as to widen their reach and scope. Those already providing services should be consulted about changes but rarely are and as for joined up thinknig - why do both the NHS and Social care have pathways . policies and strategies for older people and / or dementia - surely bthey should be integrated into one pathway ????
The UK gave £13.4 Billion away in 2017 and this will increase to £14 Billion in 2020. In addition we pay the EU £13 Billion every year, less the rebate of £5 Billion they kindly give us back. When we finally leave the EU this £8 Billion will no longer be due. So with £21 Billion available the Cost of Care could be financed as well as safeguarding our NHS. The money is there - all we need is our MP'S to put the needs of their constituents before citizens of other countries. They are voted in to protect the interests of UK citizens so let them start doing it by
redirecting some of this £21 Billion back to our NHS and Social Care
Some vulnerable adults may require complex needs and as a result, it will be culpable if they are neglected because of the cost of securing care home support. However, It would be better to seek the opinion of the service users and their families wishes and feelings to promote individual best interest before professionals make their decision.
I really find it difficult to start my response: firstly we all pay National Insurance, based on our earning, those not in employment have their State Pension protected, however their are many 'working poor' who cannot survive' without visiting 'food banks' and 'handouts' from friends and family: to actually have a further 'compulsory' deduction from your already low wage, will have serious consequences. The United Nations are to Investigate the Increase in Poverty in the UK in November 2018, we should be ashamed.
I have recently attended a FOCUS group regarding CHC, commissioned by the NHS England, where this 'fits into this latest idea' is NOT clear.
Dementia is a HEALTH issue so where is the CHC.
It is clear' Care' needs to be provided closer to the COMMUNITY, smaller units, where family and friends could be part of their caring process (if they choose).
'ICS' should receive Government funding to allow the COMMISSIONING of these NEW smaller Residential/Nursing/Care UNITS, closer to the COMMUNITY. This should be included in ICS discussions re: 'integration'.
The LA should take over the STAFF recruitment and management of these HOMES.
There are many individuals who can't wait to help others for FREE.
The idea that these Nursing Homes are actually providing 'value' for money is a 'myth' £1495 a WEEK for sitting in a CHAIR with twenty other residents with the TV on is a disgrace, 'hard earned' SAVINGS gone in a 'wink'.
The current system is open to 'abuse' Financially and 'Physically' extra COMPULSORY payments by those left with hardly anything left to live on will have 'dire' consequences. Depression, Suicides will increase, and their younger family members will be the next generation to access the Mental Health System.
My idea is the only 'viable' one, it creates a better 'environment' closer access for family and friends (who can be included in the caring programme) lets be realistic, many CARERS and Friends visit as often as possible, why are they paying a Nursing Home £1495 a week, when they are there for hours, but 'charged' for the 'privilege'!
Residential Care is a BUSINESS and nothing more, STOP the 'GRAVY TRAIN' and bring it back 'in house'.
I agree with the last comment on the need to value those working in social care and to place a higher priority on caring for the vulnerable people in our society. I notice the policy implications include intention to place primary responsibility for funding with individuals and families. This is simply not fair or equitable that care will depend on how much money someone has to buy a service. Are we living in the USA with mainly privatised health and social care services? How long will it be before this is suggested for the NHS?
It is interesting that the "shortage of carers" is cited so frequently. All it takes is slightly different thinking. My local Social Work Department was surprised when I told them I was not looking for carers to support my mother to live at home. I was looking for Personal Assistants. Carers are task orientated, and will only do certain things. Quality of life can only be gained through personal assistance, where empathy is hooked, and you become a part of the individual's life.
I have been doing independent hospital visiting for CRCC, but funds finished last October. Rethink is now only funded on a yearly basis : we had to form an independent group because we thought that the paid workers had to leave in February. Their contract was renewed for 1 year but the room had to be changed to a smaller one for economic reasons & may close next February. It is disgusting as all people, old or young have an uncertain service & virtually no support at all.
Because of a shortage of carers we cannot get patients looked after in their homes although funding is allocated to them. This is due to poor pay and a shortage of personnel, now worsened by the effects of Brexit. Care homes are also closing as funding is inadequate to pay staff wages and red tape has raised overheads. Patients in hospital are in the same "bed-blocking" quandary. This causes crises at the admission stage.
Comments
As someone trying to provide a practical, flexible and quality service to older people [mainly with dementia] and their carers. this article only reinforces our everyday experience [ years after publication].
We run as a social enterprise keeping costs to a minumum but the Social care system is too inflexible and too poorly funded to understand/ acknowledge the "changing"! needs of dementia or fund appropriate care for those with dementia OR their carers. Keeping people out of full time care should be a priority but is too often the quick fix to avoid blocked beds [blocked not blocking - the bed is blocked by the system failure NOT the individual] . One of our biggest issues is the lack of information available to people about real and practical support they might access [we look on it as daily respite] and a lack of willingness to fund/ invest in services that are effective, proven and cost effective so as to widen their reach and scope. Those already providing services should be consulted about changes but rarely are and as for joined up thinknig - why do both the NHS and Social care have pathways . policies and strategies for older people and / or dementia - surely bthey should be integrated into one pathway ????
The UK gave £13.4 Billion away in 2017 and this will increase to £14 Billion in 2020. In addition we pay the EU £13 Billion every year, less the rebate of £5 Billion they kindly give us back. When we finally leave the EU this £8 Billion will no longer be due. So with £21 Billion available the Cost of Care could be financed as well as safeguarding our NHS. The money is there - all we need is our MP'S to put the needs of their constituents before citizens of other countries. They are voted in to protect the interests of UK citizens so let them start doing it by
redirecting some of this £21 Billion back to our NHS and Social Care
What was incorrect in my comments ?
Some vulnerable adults may require complex needs and as a result, it will be culpable if they are neglected because of the cost of securing care home support. However, It would be better to seek the opinion of the service users and their families wishes and feelings to promote individual best interest before professionals make their decision.
I really find it difficult to start my response: firstly we all pay National Insurance, based on our earning, those not in employment have their State Pension protected, however their are many 'working poor' who cannot survive' without visiting 'food banks' and 'handouts' from friends and family: to actually have a further 'compulsory' deduction from your already low wage, will have serious consequences. The United Nations are to Investigate the Increase in Poverty in the UK in November 2018, we should be ashamed.
I have recently attended a FOCUS group regarding CHC, commissioned by the NHS England, where this 'fits into this latest idea' is NOT clear.
Dementia is a HEALTH issue so where is the CHC.
It is clear' Care' needs to be provided closer to the COMMUNITY, smaller units, where family and friends could be part of their caring process (if they choose).
'ICS' should receive Government funding to allow the COMMISSIONING of these NEW smaller Residential/Nursing/Care UNITS, closer to the COMMUNITY. This should be included in ICS discussions re: 'integration'.
The LA should take over the STAFF recruitment and management of these HOMES.
There are many individuals who can't wait to help others for FREE.
The idea that these Nursing Homes are actually providing 'value' for money is a 'myth' £1495 a WEEK for sitting in a CHAIR with twenty other residents with the TV on is a disgrace, 'hard earned' SAVINGS gone in a 'wink'.
The current system is open to 'abuse' Financially and 'Physically' extra COMPULSORY payments by those left with hardly anything left to live on will have 'dire' consequences. Depression, Suicides will increase, and their younger family members will be the next generation to access the Mental Health System.
My idea is the only 'viable' one, it creates a better 'environment' closer access for family and friends (who can be included in the caring programme) lets be realistic, many CARERS and Friends visit as often as possible, why are they paying a Nursing Home £1495 a week, when they are there for hours, but 'charged' for the 'privilege'!
Residential Care is a BUSINESS and nothing more, STOP the 'GRAVY TRAIN' and bring it back 'in house'.
I agree with the last comment on the need to value those working in social care and to place a higher priority on caring for the vulnerable people in our society. I notice the policy implications include intention to place primary responsibility for funding with individuals and families. This is simply not fair or equitable that care will depend on how much money someone has to buy a service. Are we living in the USA with mainly privatised health and social care services? How long will it be before this is suggested for the NHS?
It is interesting that the "shortage of carers" is cited so frequently. All it takes is slightly different thinking. My local Social Work Department was surprised when I told them I was not looking for carers to support my mother to live at home. I was looking for Personal Assistants. Carers are task orientated, and will only do certain things. Quality of life can only be gained through personal assistance, where empathy is hooked, and you become a part of the individual's life.
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