Welfare Reform on the Web (July 2011): Care of the elderly - UK

Care for elderly in balance as Southern Cross talks continue

O. Wright

The Independent, June 22nd 2011, p. 16

Southern Cross was last night holding talks with landlords, banks and the Government in an attempt to secure continuing care for up to 31,000 residents of its homes, even if it falls into administration. Ministers' hope is that a long-term deal might be agreed, ensuring that no resident suffers if the company collapses. The article reports that the company is likely to survive, but with many of its landlords withdrawing their homes from the company to run them independently.

Carers have no time to wash and feed elderly

R. Alleyne

Daily Telegraph, June 20th 2011, p. 1 + 2

Home help for the elderly is now so poor that some people regularly get left in bed for 17 hours and others are at risk of malnutrition, a new Inquiry by the Equality and Human Rights Commission claims. Visits by carers are often so short and infrequent that there is not enough time to carry out even the most basic tasks. That means overstretched home helps often have to make a choice between which essential needs to address, frequently foregoing meals, for example, in favour of washing and dressing. With councils under pressure to cut budgets, the danger is that services will be reduced even further. The Inquiry concludes that 'the full extent of the potential human rights breaches is likely to be masked by the fear of complaining and the low expectations about the quality of home care that many older people believe they are entitled to.'

(See also Guardian, June 20th 2011, p.8;The Times, June 20th 2011, p.12 )

Charities prepare to step in if care home company collapses

D. Kennedy, J. Sherman

The Times, June 2nd, 2011 p. 11

Rival care home operators, private companies and charities are preparing to take over 750 care homes from Southern Cross Healthcare, the biggest private provider, which has run out of money. The Government has been called upon to intervene and has responded by indicating that they would ensure that there was 'effective protection' for Southern Cross's existing residents.

Cost of elderly care 'capped at 30% of home's value'

S. Lister

The Times, June 29th 2011, p. 15

The Dilnot Commission report to be released on 4th July 2011 was expected to say that care in old age should never cost a person more than 30% of the value of their home. Recommendations were expected to include:

• A limit on the amount people may have to pay for care with the Government picking up the rest. The proposed figure is £35,000 but it could go up to £50,000. The cap will encourage insurers to offer products that people can use to protect themselves against this £35,000 cost.
• Expanding eligibility for free care by raising the threshold for the amount of savings/assets someone can have before they have to pay for their care
• Politicians should decide how to retrieve the monies owed for care up to the £35,000 maximum, possibly by claiming it from care users' estates when they die.
• Government investment of about £2 billion a year in long term care for older people

• bringing social care legislation into a single statute
• use of personal budgets
• improved integration of health and social care
• ensuring protection against business failures by care providers.

Don't damn elderly to an age of ruin, expert warns

S. Lister

The Times, June 30th 2011, p. 1 and 17

Andrew Dilnot calls for the recommendations for reform of adult social care to be accepted. If not the elderly would be condemned to spend their final years in a worsening care system that risks bankrupting them and their families 'unless politicians grasp a once-in -lifetime chance to change it'. Key recommendations will include a cap on the amount people have to pay.

Elderly care home residents 'victims of cuts'

T. Ross

Daily Telegraph, June 15th 2011, p.4

Elderly care home residents in Britain are being denied 'basic justice' as austerity cuts leave the system in 'crisis', Thomas Hammarberg, the Council of Europe's Commissioner for Human Rights, has said. Private care home operators in Britain have been struggling to balance their books as councils reduce the fees they pay for residents in an attempt to make savings. There was evidence that the quality of services in these homes had 'deteriorated to a worrying degree', he has said. Companies running the care homes have reduced services in order to remain solvent. But, Mr. Hammarberg suggests, austerity measures should not come at the expense of vulnerable people's well-being.

Elderly will have to pay more for care as councils cut costs

R. Bennett

The Times, June 27th, 2011 p. 16

The charity Age UK used the Freedom of Information Act to obtain figures that show that councils are planning to cut their spending on old-age care by an average of 8.4 per cent by next March, The consequences of this cut on top of other cuts in funding for the elderly could be devastating. These figures were released just before Andrew Dilnot announced the proposals on the Funding of Care and Support in old age. Mr Dilnot has argued that spending by individuals and the Government has to increase in order to avert a crisis. The Dilnot Commission is set to recommend that individuals pay for the first £50,000 or so of care themselves after which the Government will pay. This will enable banks and insurance companies to develop new products allowing people to draw down some of the value of their house, or insure against the cost. Age UK is calling for the Government to commit itself to a minimum £3 billion additional spending, to guarantee essential services for those older people with the highest needs and the lowest incomes to prevent 'condemning many older people to a miserable existence behind closed doors struggling to keep safe and well.'

Failure to reform elderly care will be catastrophe, charities warn coalition

J. Kirkup

Daily Telegraph, June 27th 2011, p. 14

Leading charities and experts have warned in a letter to the Daily Telegraph that the current care system for older people is reaching crisis point and must be radically reformed, even if people have to pay more. They call on the government to implement the recommendations of the Dilnot report on funding elder care, even if these are controversial and potentially unpopular and on politicians of all parties to put aside divisions and work together to address the problem.

Food and nutrition security at risk in later life: evidence from the United Kingdom Expenditure and Food Survey

C. Deeming

Journal of Social Policy, vol.40, 2011, p. 471-492

This article considers household characteristics associated with food and nutrition insecurity in the older UK population. Data are taken from the UK Expenditure and Food Survey 2002-2005, providing a total sample of 5,600 households. The results suggest that certain sections of the older population are more at risk of food insecurity than others: low-income households, the oldest-old, elderly from black and minority ethnic groups, those with a disability and men living alone. Coordinated activity will be required at national and local levels to ensure that these vulnerable groups achieve healthy, balanced diets.

How the care home gamble backfired

D. Kennedy,

The Times, June 1st 2011, p. 13

By committing to pay high rents in expectation of getting ever increasing income from local authorities needing accommodation for an increasing aging population, Southern Cross Healthcare was following a risky business model right from the start. Since the financial crisis of 2008/09, local authorities have tighter budgets and so are looking to save money on housing the elderly. Southern Cross followed the 'opco/propco (operating company/property company) model popular during the boon times. They raised capital by selling their care home properties to groups of landlords and then leased them back at very high rents. However the rent burden became so heavy that the business had little spare cash to spend on improving standards and the care of the elderly suffered. This created a vicious cycle as numbers sent to the homes by local authorities dropped from 92% in 2006 to 85% in 2010. Southern Cross has decided to solve the problem by cutting the amount of rent paid by 30%, saving £5 million per month. How the landlords will react to this is not yet known

(See also Independent, June 3rd 2011, p. 6)

Our invisible addicts

Older Persons' Substance Misuse Working Group, Royal College of Psychiatrists

2011 (CR 165)

This report argues that everyone over the age of 65 should be screened by their GP for drug and alcohol misuse to help to treat a growing generation of 'invisible addicts.' There should also be tougher safe drinking limits for the elderly and greater efforts to reduce the stigma associated with seeking help. The unacknowledged alcohol and drugs misuse is a rising problem among older people and a serious threat to public health. Current advice is based on the effects on younger age groups and should be tightened for the over 65s. The upper safe limit for older men should be 1.5 units and women to 1 unit a day. Problems develop as a result of changes such as retirement, bereavement, loneliness and depression.

URL: http://www.rcpsych.ac.uk/files/pdfversion/CR165.pdf

The pursuit of integration in the assessment of older people with health and social care needs

M. Abendstern and others

British Journal of Social Work, vol. 41, 2011, p. 467-485

Integration of assessment processes for older people by a range of professionals and agencies has for some time been part of the policy agenda in England. The rationale for this approach is that fragmented systems of assessment lead to duplication, delay and inefficiency, reduce service-user satisfaction and can result in inequitable access. This paper considers two interrelated themes. It explores the nature of integration within assessment alongside local progress in implementing national guidance to promote an integrated approach within the context of the Single Assessment Process (SAP) introduced in England in 2004.

Southern Cross decision to shed 3,000 jobs provokes outrage

A. McSmith

The Independent, June 9th 2011, p. 17

Southern Cross, the nation biggest provider of homes for the elderly, has announced that it is to shed 3,000 staff by October 2011 in an effort to survive. Unions have attacked the plan and asked the Government to step in to protect residents. The Government has announced that no resident will become homeless as a result of the restructure.

(See also Times, June 9th 2011, p. 3)

Your home is 'a vital part of the funding equation'

R. Bennett, A. Asthana

The Times, June 8th, 2011 p. 15

Families will be required to use the value of their home to pay for care in their old age under a new system designed to solve the funding crisis in social care. However the contribution would be limited to a national and predetermined level with the Government footing the bill for all further costs. Sources believe that the cap will be set at £50,000.