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Welfare Reform on the Web (June 2002): Care of the Elderly - UK

ASSET STRIPPING: LOCAL AUTHORITIES AND OLDER HOME OWNERS PAYING FOR A CARE HOME PLACE

F. Wright
Bristol: Policy Press, 2002

Finds that older people who pay for a care home place in England and Wales are unlikely to get fair treatment from their local authority. Shows that many older people with assets of over £18, 500, who are therefore not entitled to a state funded care home place, do not receive a needs assessment from their council to determine whether residential or some other form of supported care is the best option for them. There is also a huge variation in the circumstances in which local authorities will make a contract with an independent care home provider for an older person funding their own care. Local authority contracts are usually better than those made by an individual payer.

THE BARE MINIMUM IS NOT ENOUGH

J. Smith
Community Care, Apr. 4th-10th 2002, p. 34-35

The new national standards for care homes define the lowest acceptable levels of care and can only be revised at the behest of the Secretary of State for Health. There is a danger that they will not encourage progressive improvement.

THE CARE STANDARDS DAWN: BUT WHAT WILL THE CONSEQUENCES BE?

G. Hodgson
Caring Times, Apr. 2002, p. 1+3

Imposition of the National Minimum Standards for care homes is driving smaller providers out of the market. Their place will be taken by corporate providers operating large homes of up to 200 beds (formerly known as geriatric hospitals!)

CHARITIES JOIN FORCES TO CALL GOVERNMENT TO ACCOUNT ON FEES

J. Carvel
Guardian, Mar. 19th 2002, p.8

Reports the formation of a new campaigning group, Fair Rate for Care, which will lobby for more state funding for residential care homes for older people. Many care homeowners are quitting the business under pressure of increased standards and low fees paid by local authorities for state funded residents.

COST OF AGEING POPULATION 'MAY BE AFFORDABLE'

N. Timmins
Financial Times, Apr. 8th 2002, p. 2

The ageing population is likely to add only 3 to 4% of gross domestic product to public spending by 2050, according to a study by PWC. Such an increase, which would still leave the UK's public spending below the levels already in place in many other European countries, "may not be unaffordable", according to the professional services firm.

COUNCILS MAY BE FINED FOR HOSPITAL BED DELAYS

A. Frean
The Times, Apr. 19th 2002, p.12

Local authorities could be fined if they fail to find care home places for elderly patients. Councils will have to pay the NHS the cost of keeping patients in hospital. This amounts to about £170 a night, compared with £65 on a care bed home.

FEE LEVEL INITIATIVE

Anon
Registered Homes and Services, vol.6, 2002, p. 164-165

Amidst growing evidence that care home providers are rebelling against local authority fee levels, the Association of Directors of Social Services has held talks with national representatives and senior executives of independent health sector and social care providers to discuss the creation of stability in the sector. The meeting produced agreement on:

  • the need to create a national method of determining fair fee levels payable to care home owners;
  • the need to create a new partnership between social services and the independent sector to look at funding and future provision.

GETTING INVOLVED

H. Herklots
Working with Older People, vol.6, Mar. 2002, p. 28-31

Discusses removal of the barriers to the involvement of older people in service development. In order to be empowered older people need reliable information and access to an effective complaints system. Effective user involvement also requires staff commitment, investment of time and resources and avoidance of professional jargon that excludes clients.

GETTING MORE THAN WE BARGAINED FOR

B. Ferguson
Caring Times, Apr. 2002, p.32

Discusses anomalies in levels of fees paid to care homeowners by local authorities for state funded residents. Also looks at how care homeowners are fleecing self-funding residents by putting up fees in order to get their hands on the nursing care allowances paid by the state. This money is then used to subsidise state-funded residents.

INTERMEDIATE CARE: DEVELOPMING VOLUNTARY SECTOR SERVICES

D. Pearson
Working with Older People, vol. 6, Mar. 2002, p. 32-34

Describes the new Help the Aged Intermediate Care Programme which aims to encourage collaboration at local level so that health and social care staff responsible for coordinating intermediate "packages of care" are aware of the potential contribution of the voluntary sector.

NATIONAL MINIMUM STANDARDS: WHERE NOW?

P. Grose
Caring Times, Apr. 2002, p. 12 + 15

The imposition of onerous environmental standards on care home has caused many small, private homes to close. Government has taken fright at the loss of beds and guidance has now been issued to inspectors instructing them to apply the environmental standards "flexibly".

NHS NURSING CONTRIBUTION

Anon
Registered Homes and Services, vol.6, 2002, p.161-162

Following allegations made in January 2002 that some care home providers are failing to use NHS "free nursing care" payments to reduce residential home fees, the government has introduced a package of measures to tighten up the system. Article includes comment from care providers and politicians.

NUTRITION SURVEY TASTES A LITTLE BITTER

G. Hodgson
Caring Times, Apr. 2002, p.10

A survey conducted by the National Centre for Social Research (Nat Cen) has found that elderly people living in care homes have a less healthy diet than those living in their own homes and are more likely to suffer from nutritionally related illnesses. Author points out that people in care homes are frail, and sick. That is why they are living in residential care. Their underlying medical conditions are the cause of their nutritional problems.

RESEARCH ON CARE HOME CLOSURES

Anon
Registered Homes and Services, vol. 6, 2002, p. 167-168

Summarises findings of recent research by the Personal Social Services Research Unit at the University of Kent on care home closures. The most significant finding was that Registration and Inspection Units rated 61% of closed homes as excellent, good, or OK and only 19% as poor. Most closed homes were privately owned and smaller than the national average. Factors leading to closure identified by owners were: fee levels, low demand, care standards, staffing difficulties, the property market and regulation.

RETURN TO SENDER

J. Board and P. Gardiner
Health Service Journal, vol. 112, Mar. 28th 2002, p. 26-27

A study of elderly patients who were repeatedly readmitted to an acute hospital found many admissions could be averted by providing more intense alternative care. Many admissions were made by on-call GPs who did not know the patients' case. Some discharges appeared to have been premature. More attention needs to be given to preventive care, and greater use made of community nurses as the focal point of a support system. The study also highlighted the need for pooled budgets between health and social services.

RISES IN CARE HOME FEES CASTS SHADOW ON FREE NURSING CARE

A. Legge
Primary Care Report, vol.4, no.5, Mar. 20th 2002, p. 34-37

Reports on how Primary Care Trusts are coping with the Registered Nursing Care Contribution (RNCC) tool, which is used to work out the amount of free nursing care to which elderly people are entitled. Goes on to discuss concern that care homeowners are taking advantage of the nursing care payments to raise fees. The Department of Health has responded by issuing a model contract for how the RNCC payments should be accounted for by care homes.

WHY AN AGEING POPULATION IS THE GREATEST THREAT TO SOCIETY

J. Laurance
Independent, Apr. 10th 2002, p. 17

Discusses the impact of population ageing on cost of health care, demand for residential care, and the pension system.

WOMAN, 102, TAKES HOME PLEA TO BLAIR

N. Martin
Daily Telegraph, Mar. 19th 2002, p.8

The care home where Miss Rose Cottle, 102, lives is threatened with closure because it is losing money. Her plight is not uncommon as residential care and nursing homes are closing due to inadequate fees paid by local authorities for state funded residents.

(See also Guardian, Mar. 19th 2002, p. 8; Times, Mar. 19th 2002, p.16)

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