Social care for older people: Home truths

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Part of The sustainability of social care services

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.

Comments

Vincent Yeye

Position
Care,
Organisation
Health and Social Care
Comment date
14 October 2018

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.

John Edward Flunder

Position
Retired,
Organisation
Bexley Pensioners Forum
Comment date
21 October 2018

What was incorrect in my comments ?

John Edward Flunder

Position
Retired,
Organisation
Bexley Pensioners Forum
Comment date
21 October 2018

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

Carole Augousti

Position
Manager Adult Day Centre,
Organisation
S.T.A.R.S Day Centre
Comment date
20 May 2019

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 ????

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