/ Health

Are changes to the care home sector on the horizon?

Care homes

The Competition and Markets Authority has reached the midpoint of its year-long review of the care home market and published its interim findings. So are changes afoot for care homes?

There are a whole host of problems that people have come up against when they or their loved ones have dealt with care homes. We know this simply because of the stories many of you have shared with us.

Earlier this year, we asked people who had experienced a problem in a care home to share their stories with us so that we could help inform the Competition and Market Authority’s (CMA) review – and the response was incredible.

Care review

So far, we’ve gathered nearly 700 first-hand experiences from residents in care homes and people responsible for organising their relative’s care. These stories have made up the bulk of evidence for the CMA’s study.

The stories you‘ve shared have helped to uncover some real failings in the market, and once again reveal the true distress and pain this can cause people who are impacted by them.

We’ve heard people tell us that they weren’t given a contract to outline terms when their relative had to be placed in a care home.

Some have paid burdensome hefty charges upfront – one person even told us that they had to pay £10,000 before their relative could move in. And others have mentioned what a minefield it can be to find information about funding once their relative’s financial situation had changed.

So it’s safe to say, given the awful stories shared with us and the CMA, we had great expectations of the CMA findings.

CMA findings

The CMA reported that it has found some worrying signs that the care home market isn’t working as well as it should for those who require their services and support.

In particular, it found that:

  • People are genuinely struggling to make good decisions about care, due to the lack of information available, the impact of the stress and pressure people can be under at this time, or because they just find the system plainly confusing.
  • It’s a challenge to complain – many find it difficult to complain when they are so reliant on the care, but even when some do, the complaints system isn’t working well enough.
  • The future of care homes – uncertainty about the future of the sector has meant that investment for growth and improvements has been stunted in this market.

But most promising of all is that the CMA is also taking action by opening up a consumer protection case to investigate concerns that some care homes may be breaking consumer law.

Future of care

As the CMA continues with its review, we want to see it continue to take action where it’s needed.

But there are still five months to go until the regulator concludes its investigation, so there’s plenty of time for more of your voices to be heard by sharing your experiences of care homes.

Have you had experience of the care home sector? How do you think care homes could be improved for residents and their relatives?

Comments
Profile photo of PatrickTaylor
Member

” The future of care homes – uncertainty about the future of the sector has meant that investment for growth and improvements has been stunted in this market.”

Without addressing the long term future of legislation in the market any businessman would avoid this area completely. Higher regulations and perpetual criticism will ultimately force the closure of many and the cost of providing falling back on the family or Councils.

I hope CMA are allowed to think radically to improve the concept. What has been written so far is fair and does make the point that most residents are treated fairly.

assets.publishing.service.gov.uk/media/5941057be5274a5e4e00023b/care-homes-market-study-update-paper.pdf
53 pages

Profile photo of duncan lucas
Member

Now that the case for the business community has been put here is the case for the general public forced to suffer huge indignities in those “supposed good care homes” . About 400,000 people in care homes (England ) – great commercial market for big business /City – worth $14 BILLION – £10 Billion goes to provide them . MP,s- frail old people treated like objects in business dealings-pensioners repeatedly prevented from any decision making denied treatment on an age basis , patronised, denied privacy . Over medicated to keep them quiet -aka- DRUGGED to the gills -LEGALLY – restrained-aka- criminal mental hospital practices enforced – Action on Elderly Abuse- Gary-Fitzgerald -standards dropped so low in 10 years that neglect taken for granted- heads of Age UK-Royal College of Physicians- TUC- Care-Quality -Commission who themselves say -playing Russian Roulette with old peoples lives , found “”care homes “” not preventing dehydration , pneumonia, malnutrition, urinary infections in 78 out of 151- NOT-care homes FIFTY TWO PERCENT – staff not trained to deal with dementia old people having to be transferred to the NHS hospitals . One in three had NOT had loss of cognitive function recorded . Jimmy Hughes -CO of Alzeimers Society- scandalous . I have many Mbits of storage on this that anybody can put up a case for big business then I am completely lost for words . I know personally what malnutrition means – I suffered from it – fainting – no energy – dizzy- weak -unable to think properly -cant walk etc . I am so angry over this that I challenge anybody to defend these ouragous practices jusyt because its a political subject and shows up really how they think- old people ??? why are they still alive ??? . And they talk of 1930,s Germany ?? I hope for a very lively debate as I have very much data on this subject I hold dear to my heart – human life and human dignity, in this I bow to NO man or NO woman even with fine words. Yes the TRUTH hurts .

Profile photo of Lauren Deitz
Member

Hi Duncan, we know how much of an emotive subject this can be – having reviewed the near 700 first-hand experiences of care, we feel that we’ve just seen the tip of the iceberg too. I’m sorry to hear that you’ve suffered yourself, please do let me know if there’s something we can do to help you here.

Profile photo of duncan lucas
Member

Thanks for your reply Lauren , while what I posted is probably not what many wanted to hear its the Truth Lauren , I know what its like to be so weak as a child when I was in a room by myself I could not walk to the next room but crawled on my hands and knees , i was also “interfered with ” which , nowadays would be a long jailing offence so when I post it isnt from conjecture its from real life and when I say I sympathise with those in these situations I really know what they go through. I appreciate your kindness Lauren.

Profile photo of Lauren Deitz
Member

I appreciate your honesty, Duncan. I hope you that are getting the support you need now, but if you’d like speak with me or any of the convo team, do drop us an email at conversation.comments@which.co.uk

Member
T G says:
20 June 2017

Nothing much mentioned about the joint fraudulent behaviour by the care homes and local authority whereby self funders are charged more by the care home to enable the local authority to pay less

Member
bp says:
21 June 2017

spot on too many private care homes run for profit and not for care of people’s loved ones

Member
John says:
20 June 2017

All concerned are playing games around the edge of the matter. There are just too many vested interests in this major problem which will overtake all other problems that the country faces. Considering recent suggestions which have been made by Politicians most of which are unacceptable to the public and are riddled with unfairness to one or other parts of our Society. The function of both the NHS and Care are driving staff into a hopeless situation which is worsening by the day.
Joint non political All party discussions are required.
A discussion paper presented to the said parties by independent bodies involved in all aspects of the caring industry to be devoid of all political comments, should be totally discussed. All concerned to be locked in a room for months, if necessary. Total Blue Sky thinking is required, no ideas barred, no suggestions ignored, no matter how way out.
A major rethink on how these two Bodies should be run or merged MUST be produced.
Great Britain thought, discussed and produced the NHS from scratch. If we could do this in 1948 then we can do what is required today. What we do not require is Labour via Conservatives arguing which ideas are the best or worse!!!!!! We need a solution and no one cares whose idea is best just come up with the thoughts and agree on a finished solution.
It is an absolute certainty that the present Health arrangement in all it’s disguises cannot continue for much longer. It MUST be evident to all concerned that we are near to breaking point. Let us get a grip before it is too late. We require just one strong individual to take the whole problem by the scruff of its neck and come up with a solution.
You can shout “Costing” but lets get a system in place first and then consider the cost. If extra taxation is required to fund then so be it, but for Gods sake keep the Politics out of the whole discussion.
It’s not solely about money.
Any current MP who does not believe that this is a crisis of monumental proportion should knock on doors and see what the views of their constituents really are when they are unable to get a doctors appointment for three weeks or spend hours in the A&E, most of their visits being because they are unable to see their GP. The problem commences at the bottom and continues to the top. The spiral has to be squared and this means a complete change of our systems for young and old.

Member
bishbut says:
21 June 2017

privately owned care homes are just another way to make as much money as possible ,not all but a great number of them ,why are many owned by large companies who all about making money ,they keep buying more ,it must be a money making thing, large companies have to keep their shareholders happy

Profile photo of John Ward
Member

The important things about care home provision are care standards and monitoring to ensure conformity. The Care Quality Commission has improved its performance but I don’t get the impression it is ahead of the game and leading instead of chasing. Since local authorities no longer have the resources [and possibly not the competence] to run care homes they all seem to be private companies or run by charitable or not-for-profit organisations. This is not necessarily a bad thing provided they are competently run and meet the relevant standards. Obviously, privately-owned care homes have to make a profit to repay the shareholders who have invested their money in them and to invest in further developments. If investment is artificially constrained then quality care provision will be jeopardised.

Many care home residents like being in private care homes if they are run to high professional standards. Obviously they have to be able to afford the fees but a goody minority of the elderly population seem to have the means to reside in such establishments. One of the things they are paying for is exclusivity so that all the other residents are self-funding and not placed there by a local authority that has bought a block of placements.

This arrangement cannot work for all and the problem that has arisen is that local authorities are having to beat down the cost of placements to the point where the operation is not covering its costs. In those situations the quality of care and standard of provision are bound to suffer and the experience for residents will be diminished. It is a valid criticism that self-funding residents are having to pay considerably more than the state-funded residents for a care experience that is unsatisfactory for them. The pressure placed on the care home staff by these conflicts also diminishes the quality of experience for all. Unlike with the NHS, where I do not consider throwing more money into the bottomless pit is necessarily the answer, in the case of social care I think it very much is the answer so that there is enough incentive to operate high-standard care homes for all sections of the community, that good staff wages and long-term futures attract people with the right motivation, qualifications and willingness to develop their professional skills, that care establishments are maintained to high standards for safety, hygiene and welfare, and that managements are driven by the needs of residents rather than by the constant need to cut costs and reduce quality.

Member
Sophie Peterson says:
21 June 2017

It all boils down to money – we should bring the homes back into council ownership and pay people properly but even more important is to have much better home care provision so that more of the elderly can stay in their own homes.
Why is it that outsourcing everything is seen as the holy grail – can’t the state run something equally well without there being a profit motive?
And we should all be prepared to pay more tax to fund it – we will all be old at some point – but society seems to expect Scandinavian levels of care but only pay American level of tax – it just won’t add up…..

Profile photo of John Ward
Member

I have no objection to councils running residential homes again so long as they can do it as well as, or better than, the best alternatives – and that is where I am doubtful. Most councils closed their care homes a long time before economic stringency forced them to do so and that was because they could not run them properly. Institutionalised behaviours were prevalent, there was an anonymity about them, management was remote and unsympathetic to the differences between individual homes, and residents were moved around between them like stock in a warehouse. For historical reasons, many of the homes were a long way from the community backgrounds of the residents so they felt isolated. There were, of course, very good examples as well but, basically, the doctrinaire municipal approach is not well suited to good social care. Local authorities appeared to be indifferent to prolonging and enriching the lives of the residents because they operated on a restricted waiting list principle where reducing the waiting time was an important consideration.In a private home, continuation of income is the driving force, whereas in the state sector cutting the losses is more powerful.

Member
TonyF says:
21 June 2017

Care-homes are regarded by many politicians as objects simply to be devolved to the private sector, germane to their generic long-term intentions for the NHS and for social care. They do not want to spend more than a certain percentage of GDP on the NHS, social care and care-homes, so we are where we are now.

The private sector has to regard them as business opportunities because of the capital involved, and expenses of employing and supervising staff. They are in business, with shareholders to respond to as first priority.

Accepting these realities relegates those in need of care-homes (and their relatives) as pawns in a chess-game of priorities other than those of attending to their needs.

The first step to improving care-homes can only be in adjusting the attitudes of politicians to focus primarily on the needs of those requiring care-home accommodation. We have seen their priorities when it comes to contrasting attitudes in budgeting for refurbishing the Houses of Parliament with that of refurbishing council-run apartment blocks like Grenfell. The recent manifesto U-turns on social care funding by seizing homes to pay bills tell a similar story.

Member
Tony Papard says:
21 June 2017

The Head Office of my mother’s Nursing Home took a huge lump sum out of her bank account just two days after she passed away. I’d paid the deposit for her funeral that day from her bank account, and if I hadn’t noticed this unauthorized debit from the Nursing Home her account would have been overdrawn or her funeral would have been canceled. I had received no warning that this money would be taken out by the Nursing Home. In the event my brother had to put £1000 into the account so her funeral could go ahead and the account didn’t go into overdraft. The payment the Nursing Home took was incorrect, and they eventually had to refund most of it. It took a threat from my mother’s bank to take the money from the Nursing Home bank account before they actually refunded the money they had taken.

Member
Gerry says:
21 June 2017

When my aunt died, I cleared her room the same day. But Barchester still charged us over £1000 for an extra week, craftily sneaking it into the final bill a few weeks later and hoping that we wouldn’t notice: close inspection revealed the final care date being seven days later than was actually the case.

When challenged, they just pointed to an item buried in the small print of the terms and conditions. That was way back in 2009, so I shudder to think how much they are charging today…

This should be outlawed. I don’t believe care homes incur any significant additional costs after a room is vacated (it certainly hadn’t been redecorated / refurbished before she moved in), and even if they do, these costs should be factored in to the normal weekly rates. Charging a fee after a resident has died is just a trick to make the weekly rates seem lower than they really are.

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Profile photo of John Ward
Member

I agree with you, Gerry; that is a very unsatisfactory practice and should be deemed to be an unfair contractual condition and therefore void – the date of death is unpredictable [he says with no hint of irony] and should not incur a penalty. Perhaps it has never been tested in law.

I had been of the opinion that Barchester Group was one of the better private care homes operators. I am a member of a local organisation that has its meetings in the library of a Barchester home and I must say I have formed a very favourable impression of the quality and the amenities of the establishment and the apparent contentment of the residents [with an eye on our own futures perhaps].

Member
Gerry says:
21 June 2017

Yes, I fear that other operators are probably far worse. But I was never really happy with them: I could never relax and be fully confident that everything was being managed pro-actively. For example, the emergency pull cord was often coiled up and placed out of reach rather than being left extending down to floor level. (My concerns weren’t just academic: when still living at home she had fallen and broken her hip. Fortunately I found her in time because the phone wasn’t answered.)

I was also conflicted about a member of staff who was deaf; you could be understood only if you faced her directly and spoke very clearly and distinctly. I didn’t complain because I really hate to discriminate against a person with a disability, but I was worried that my aunt (who had early signs of dementia) would not be heard if calling for help, especially after they adopted a ‘closed door’ policy for residents’ rooms.

Another concern was that the corridor doors were locked in the evenings and overnight and could be released only via a secret code: there was no panic button. There was no escape if a problem hadn’t triggered the fire alarm and released the doors, e.g. being cornered or assaulted by an intruder or a disturbed resident.

The saddest memory I have of the place is having to lie to my widowed aunt that her engagement and wedding rings were being stored in the safe for security. The truth was that they had vanished soon after she arrived and were never seen again.

Profile photo of wavechange
Member

I have had little experience, good or bad, with care homes. I was visiting a care home when a friend was on holiday and found that her father, who was in his 90s, had fallen and lain on the floor for a time before he was able to drag himself onto his chair and call for help using a handset on the table. When I arrived, he said that no-one had turned up. Even then, it took be long enough to get him attended to, and I learned that he had fallen several times recently. That was in an immaculate and expensive nursing/care home. Surely he could have been issued with a call button to put on his wrist and asked not to attempt to stand up unless someone was on hand.

None of us relish the thought of going into a care home but we do need our care homes to be run safely and effectively. I’m very grateful that Which? is keeping us aware of developments. To me, care of the elderly is more important than letting subscribers know which toasters perform best.

Member
Kati says:
21 June 2017

Some years ago my mum was in a Southern Cross care home. One Tuesday I got a letter from Southern Cross accusing me of being £7K in arrears with her care home fees. They wanted the money by Friday that week. My mothers solicitor paid her fees, after I forwarded the invoice, from my mother’s funds. I informed my mother’s solicitor of this claim, she was able to prove all bills were paid up to date, but she charged £250 for doing so. I sent the bill to Southern Cross, but they would only pay £100 of the bill. I thought it was just a genuine error. But, on visiting the home, the relatives of other residents said they had received similar letters. All had paid their bills. To my knowledge they got away with it. Disgusting.

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Profile photo of John Ward
Member

And was anybody ever charged with corruption? . . . . No, I didn’t think so.

Profile photo of DebbieCoates
Member

I personally think we all need a long hard think about care for the elderly, the baby boomer generation are just coming into the elderly age bracket, and their are loads of us, I think that there should be a flat rate which Government takes out of your wage packet every month say £25-30, automatically like Tax and NI, so at least we dont have to see care home funding via Councils being cut by all Governments, no-one realised we would be living until our 90s or 100s, so Im afraid we have to contribute. If you die young then whatever contributions you have made into the fund then goes to pay towards your funeral

Profile photo of John Ward
Member

I agree with you, Debbie. As a ‘baby boomer’ myself I have been conscious of the implications for a long time and hopefully have taken appropriate measures for later life, but what I have provided might not be enough and other unforeseen complications could arise. It would not surprise me if many other ‘baby boomers’ while being aware of the outlook have done nothing to support themselves in the future and, in the absence of state support, will become destitute.

The government will probably say that it has not actually cut the money that local authorities can spend on social care and point to additional sums that councils have been allowed to levy as part of the Council Tax, but that ignores the fact that for many years the amount of Council Tax increase has been severely restricted each year such that it was no longer enough to maintain services at a standstill level. It will argue that it is up to local councils to decide how to manage their priorities within the funds available, which is true, but it explains why public libraries and trading standards – to name but two services – have been cut to the bone; the resources released are still not enough to provide a decent social care programme.

Member
Joyce says:
21 June 2017

There should be parity when it comes to care home fees. Self funders can pay over £200 per WEEK more than local council funded residents. This was the case with my mother. Also, if you are self funding, they actually expect you to give two weeks notice when you die! Maybe that’s a little cynical, however you do have to pay for two weeks AFTER you die! Seems they need time to clean, decorate etc. the room for the new resident, and they are definitely not going to pay! However, after my mother paid in excess of £100,000 in care home fees before she was left with the basic limit (£23,500 comes to mind) she was part funded by the local council for about 2 months before she died, and they paid nothing extra after her death. Seems if you have enough clout, I.e. paying for multiple residents, you get “perks”. Sad day when our local council closed down all of their local authority care homes. Lastly, I would add that in my opinion, Alzheimer’s/Dementia is an incurable disease, requiring nursing care, and should be exempt from fees.

Member
Brian Buxton says:
21 June 2017

Why does it cost £1000 each resident per week to employ a few “carers” on minimum wage, when their time is spent between up to 20 others? £20,000 per week for, say 6 carers on minimum wage leaves an awful lot of money left for heating, maintenence, food and profit.

We were charged a whole months accommodation charges even after my father in law had died, and we’d cleared his room!

Profile photo of duncan lucas
Member

Brian that is , to me , one of the Statements of the Year , for those that disagree I long to see a full financial costing displayed on Which,s website and that includes social workers employed by local councils as the figures I was given both for care and supplying help during the day look like I was being payed “peanuts ” in the various jobs I worked at during my life. If I can find a breakdown on the web I will post it.

Profile photo of John Ward
Member

I can easily see how running a care home properly can cost a lot of money when you take into account that it has to be staffed on shifts and rosters for 168 hours a week with cover for holidays, absences, etc. By the time the personnel administration costs and employer’s NI contributions are factored in, the average wage cost is probably around £15 per operating hour per employee [£15 x 168 = £2,520 a week]. Assuming that an average of eight employees are on duty for each hour that is over a million pounds a year [£2,520 x 8 = £20,160; multiply that by 52 = £1,048,320] required just for basic staffing before taking account of food, bed linen, cleaning, grounds and buildings maintenance, energy [hot water, space heating, lighting, cooking, etc], repairs & renewals, transport, laundry, protective clothing, other services, insurance, business rates, administration and management. I can only guess these amounts so let’s say £2 million pounds a year to operate the establishment [it might be higher]. That will require a minimum occupancy rate of at least 45 residents throughout the year at £50,000 a year each to cover expenditure and provide a profit. If local councils have negotiated a reduced rate for their placements that puts more pressure on the charges to the self-funding residents. As Duncan says, it would be most interesting to see a realistic breakdown of the operating costs for a medium-sized care home.

Member
John says:
7 October 2017

I would be amazed if there were 6 carers for 20 people. At least 2 on night cover, at least 3 probably 4 on each of 2 day shifts. Cleaners? Cooks? And you do have to expect some management, particularly with care plans, staff management, just running the place… And a newish care home will probably have something in the order of £1000 per room per month to pay for having built the place and maintain it. More worryingly is the idea that a local council can put in c£480 per week and expect a reasonable level of care, management and premises.

Member
anon says:
21 June 2017

It’s obvious to me by many of the comments on here, and of my experience and of that talking to others, there are major / serious / and regular FAILINGS across the whole system. A scandle of epic proportions that a significant number of people hope, wish and activily scheme to keep the whole thing under wraps.
A bit strong some may think, no where near strong enough for others who have experienced first hand the things that go on. Now lets just say that in some homes all over the country some people have an OK situtation. I’ll stop there though, because yes its difficult to provide care to 100,000’S of Individuals with complex needs 24x7x365 but just think how you would want to be treated let alone a loved one.
So starting at the begining for me …… CQC what a total waste of time, money, and office space. If the “enforcer” the “standard setter” the Judge of Right & Wrong is clueless …. the system will never work as it should.
Eg if the food inspectors visit a Fast Food Oulet and its bad enough ….. they close it.
Of course it wouldn’t be that easy to do that in the case of a Home, but they carry on ! for months … and months, and often those paying circa £36K PA and upwards are getting a very raw deal.

I ask you to study the results of any visit to a care home, then another and another …… just look at the “cut and paste” of the reports the meaning less comments …. homes are so hot on filling forms for this and for that , the problem is about 60% of whats recorded is false/fake/made up. My mother for instance nearly always manages to be in bed at least 25 ins before they record her being so !!!
No one ever knows where a bruise came from, how she ended up with a black eye, why she has had constant UTI’s ( we have been with her for over 3hrs on many occasions and no one has come to check her, we have found her wet, for how long we wonder?) We have watched others in the home go to the toilet in the corridors, on chairs etc, staff walk by when its obvious someone needs changing … I could go on.
Of course when the CQC say they are coming all the best staff are on and they are “over staffed” just ask others .. I bet everyhome says the same, do the CQC work weekends ? early evenings? from reports I have seen I doubt it.
Oh I hear you say …. it costs such a lot to do the visits ….. and there you have it … it can never COST too much !
but you are allowed to MAKE money … thats fair…
Controversial some might say …… A recent Fire in fire in London … seems if you are poor you are not worth it ….. well add to that being Old and not Well. It’s some one elses problem …. made so by a system that protects a huge number of people earning / making a fortune out the whole debarcle.
Oh and just what is Social Care ? if you are lonely, have trouble with doing a few tasks, and want /need assistance maybe…… but Dementia is not a lazy syndrome, its an actual problem like cancer, a part of the body has failed in a big way ….. this is a medical condition …. but not treated as such.
I have already gone on too much but haven’t really covered a fraction of whats wrong.
The mutinationals that operate are no better (worse in many cases) than the single / small group operators, cheap labour, “ecouraged” to work long hrs in return for “cheap” ? rent in properties they own (no doubt financed via the business) but privately owned, ..conflict of interest as it “controls” the loyalty of those who have more than a job to loose. Actual Care is low on the daily tasks …. unless the staff are themselves the “Best” and rise above the standards set.

For years now, study after study, TV undercover program after TV undercover program, Comments via the Nursing Council, 1,000’s and 1,000’s of residents and their loved ones, letters, comments, filming, whistle blowing by staff who do walk out …… and we need another “report/study” …. Please ….. just write to everyone who has a relative in care …. and publish their letters in full giving them protection …… you will reduce many to tears in the same way as many of us feel for those whose fate was decided upon by a “committe” who patted themselves on the back for saving a few quid.

Discuss….

Member
Jean Jones says:
21 June 2017

The most crucial thing is the quality of the staff – fortunately for my husband they are kind and endlessly considerate – even though they work very long hours, are overworked and the building – which is privately owned is below standard and the dishwasher has been broken for weeks.

Member
Ann Ling says:
22 June 2017

After I had removed my Granddaughe from the care home I had carefully chosen for he because of negligence, I was informed by the Manager that they were always notified before a care inspection was due, which resulted in the negligence that ocurred, fortunately when I reported this to the local PROVA Team they swooped in and found this was the case and insisted on changes being made and notified me they now would be keeping a close eye on things. By thenI had lost all faith in the System. Social and Health authorities need to be much more diligent In overseeing the safety of our precious loved ones, these places are paid a lot of money for young people like my grandaughter who was severely disabled.

Member
James Tulip says:
22 June 2017

Care homes should come back under the umbrella of the NHS and should not be a profit making PRIVATE enterprise. I signed up for ‘ Cradle to Grave ‘ in 1958 and now I am being told that because I foolishly saved I now must donate my savings to the care home to pay for something I have already paid for. Whilst those that chose to spend their salary, have a life of luxury at no extra cost. Why not give me a refund since 1958 ( plus interest ) then I will willingly pay for my care.

Member
James Tulip says:
22 June 2017

Care homes need to be brought back under the umbrella of the NHS, They should never have been allowed to run as a profit making ‘PRIVATE ENTERPRISE ‘. I signed up to the NHS in 1958 for ‘Cradle to Grave ‘ And now I am told because I’ve saved I must pay again for my care. Those that chose to spend and not save live a life of luxury free of charge in care homes. I would willingly pay if I was given a refund from 1958 plus interest . WHY should I have to pay twice, when others do not?

Profile photo of Kati
Member

I agree, care homes need to be brought back under the NHS. They should not be profit making enterprises. One thing I noticed in my mum’s care home was that at one stage, half the clothes in her wardrobe were missing, in spite of being labelled. It was all the new and nearly clothes that had gone. A search of the laundry and rm 19 , for unidentified clothing did not find any of them! After kicking up a terrific fuss, we did get a refund for the “missing” clothes. If you ask me, someone helped themselves to her clothes. You would need eyes in the back of your head. A christmas outfit we bought for her never even went on her back. It vanished. The problem is not confined to my mother, other residents have the same problem. Anything decent vanishes, even if it has been labelled.

Member
tina says:
22 June 2017

A radical approach should be taken, starting with assisted housing, where occupants are facing yearly increases in rent but it would appear that most providers are cutting costs by not providing 24 hours in house wardens. The level of assistance has shrunk to morning calls to each residence (not in person) and a 24 hour call button. If the level of care in this area was returned to live-in warden cover as was usual a decade ago then people could benefit from remaining independent for longer.
Next there should be a tier system in the provision of care homes so that those requiring less care could be housed together with provision of enough care and stimulation to keep them healthier for longer and pay less for their care. Those requiring a higher level of nursing care should be housed in homes where this care is provided and staff are fully trained to meet their needs, obviously at increased cost. There should be separate care homes for dementia patients staffed by fully qualified carers where their needs can also be met in full.
I advocate this idea from experience, someone close to me could have remained in sheltered accommodation much longer than they did had the live-in warden provision not been removed and replaced with a morning call and office hours warden care and 24 hours call button. During their subsequent move to a care home they became very isolated as they were still mentally very active but most of the residents were suffering with dementia. During their eighteen month stay they were routinely subjected to uninvited visits into their room by some of these residents, in various states of undress and one night they were physically removed from their bed sustaining a serious arm injury. This happened in a care home with an excellent rating, a fantastic local reputation and a majority of caring, well trained staff at a cost to the patient of £2, 500 per month.

Member
John says:
7 October 2017

Agree with Tina- low level care, more affordable and helping people to stay independent longer makes sense. Why did sheltered housing seem to disappear? The support staff can focus on limited service need with the advantage of a lot of clients near to each other instead of having to spend a lot of their badly paid time getting from one house to another.

Member
Finola Moss says:
22 June 2017

The old are the new gold mine for US Venture Capital, which already owns half of the institutions where the autistic and learning disabled are encaged, each earning on average £4,500 per week.

This is why there is such an altzeimer/loneliness awareness push financed by government to harvest cashcows.

The placements are enforced by the Court of protection and the residents get no choice and they or their family no rights over care.

There is no check on amount of medication used, CQC have no teeth, no one can complain, so perfect business model.

The only oversight is an Adult Services Manager employed by the LA Commissioners of the Care who would make their LA boss liable if they found the services inadequate.

For more details of the billions being made and to be made as they start small, and then are bought up by ever bigger boys google finolamoss and read my blog.

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Member

Yes I read your blog Finola and I am in agreement with the posters on your website -HORRENDOUS !! my wife is right not to trust social workers etc. Lie to your face which I cant stand or accept from anybody to me lying is a disease in itself no matter the pat comment -“its for your “”own “” good ” that just makes my blood boil-patronising, condescending, arrogant, officious . I have been lied to all my life and I detest it, I hate liars . How is your daughter now , have you access ?

Member
Rob Duff says:
23 June 2017

Care is expensive & poorly provided. This is because dementia is considered by Government/NHS to be social issue & not an illness. Therefore care for patients with dementia must be paid for, whilst that for people with say cancer, is free.

As raised already, local authorities use their position to reduce the cost of care to them. If they pull out completely, care homes fail. They have an unfair monopoly of the market.

As a result, a local authority (LA) will pay £575 per week for an £800 room. The impact being that my father in law (Edgar), in the identical neighbouring room, must pay almost £1000 per week. He is directly funding LA care, as are all private patients. This is not fair on him & is causing him real harm.

Once Edgar money runs out, which will be very soon as he is also funding the LA, the care home will ask for a financial top up, as they also cannot afford for everyone to be on the £575 LA rate. As we do not have a spare £425 per week, he will most likely be kicked out of his home yet again: Where we will put him then is anyone’s guess. We are seriously considering leaving him on the street. The system treats our most vulnerable like rubbish to be thrown on the street.

Edgar has in fact already been forced to move home only 4 weeks ago, because the home he was in could not afford to employ specialist staff to care for his failing health & the Health Trust believed that his health was not poor enough to justify financial assistance. His doctor thought that it was, the local NHS Trust mental health team thought that it was, his careers thought that it was, but the NHS assessor did not agree.

As the home could no longer afford to employ specialist staff to care for Edgar, notice was served & he was forced to move within 2 weeks!! Our most vulnerable elderly people, literally thrown onto the street. Edgarwas thrown out of his home because most residents are now paying the LA rate of £575 per week & the home cannot afford specialist dementia care at this rate.

As Edgar is privately funded, he receives no assistance choosing a new care home. We are not care professionals, but we must make that choice for him. If Edgar was state funded, he would have a social worker & lots of assistance, but not if he is privately funded. Edgar is just financial burden that no-one cares about.

The system is broken. It fails our most vulnerable. We know how much our government cares for people with dementia (Dementia tax). They do not care, they do not treat dementia as an illness, they treat it as a burden & are not worried that people with dementia are literally moved around from home to home as objects.
People with dementia are our most vulnerable, with possibly the most distressing illness anyone can have.

I am ashamed to be living in a country where our most vulnerable, including Edgar, are treated like this. It is inhumane. He lost his home a few weeks ago & will loose it again within 12 months. Something must be done very quickly to stop this inhumane system.

Member
K.kirby says:
14 July 2017

A friend of mine who is in a care home often has to wait up to 20 minutes to be taken to the lavatory. She is paying over £1,000 . pound a week for this “service “

Member
Hilda Sommerville says:
5 October 2017

I did voluntary work within the voluntary system as a lay assessor. My main reason for becoming a Lay Assessor, was to understand how nursing homes and care homes function. I did have some training on identifying what should and should not be within that home. The way that it worked was that I would meet the officer and visit together, this was social services. I went to the first residential home and was allowed to chat with the residents. I found that some of the residents were truely engaging and quite happy to tell me about the home, is what they did and what they liked the most. I went around the home and used the toilet. There is front of me was a notice above the wash basin saying PLEASE DO NOT LEAN ON THIS SINK IT IS LOOSE?. Othere than that the home seemed to be OK. I brought this to the attention of the Officer that was present. The next home I attended was another Care Home, I found the residents quite happy, that was until they brought to my attention, 1} that there were only playing skitles that day because the Social Services were visiting. 2} Outside the home there was a bus depot, with buses running back and fore. I asked the few residents did they ever go outside, the reply was no, only when there was an outing, they then played bowls, one resident said, we all said that Social Services must be coming today, they have the bowls out. I then had to go to management and explain what I saw , I explained what I had been told by the residents, I then said what I had seen and heard, did I have some backlash, I was threatened with the law, the officer from Social Services did nothing to defend me. But I had told them honestly. I was absolutely appalled. Even after being grilled I still said what I had seen, I WAS ASKED WHO SAID THIS TO YOU, I WOULD NOT SAY. I was afraid that they the home was going to sue me. I never ever went back and would not even if they paid me a fortune, I did not get paid any expenses for travelling. I could say a lot more but I do not want to upset anyone.

Member
Ade Turner says:
5 October 2017

Recently, my Mum died with Alzheimer’s, aged 98 . She received good care in her care home- physically and emotionally, but hours were empty of Mental stimulation. Visiting my house, she could still chop an onion better than I, and tie a knot with just one hand… Great muscle-memory.
The care home asked her if she’d like to place the napkins on the tables, but as she needed reminding before each meal, that soon stopped. When care staff are allocated 5.3mins per ‘client’ per day, there’s no time for such niceties. I’d like to see a simple gym installed!
A high flying pal of mine, having seen her own intellectually brilliant mother decline and die in a care home, has already started looking into Dignitas. ‘I am not putting on my daughter what I had to do and the sense of hopelessness about the way the system operates,’ she vows. She has decided that 85 is a good age to end it all.

Member
Fred Horley says:
5 October 2017

When I complained to the local hospital that they were using care homes that had very poor ratings, failing three out of the five inspection criteria and “Requires Improvement”
The hospital replied – “Whilst the CQC inspection reports may reveal that improvements are needed, that in itself would not be enough to halt our use of a particular home unless we were advised by Adult Social Care to do so. Indeed it should be acknowledged that a home deemed as needing improvement should be given opportunity to make those improvements as long as safety is not comprised” In other words putting Care Homes first rather than patients!

Member
fratercula says:
5 October 2017

As someone working in the care home sector I can empathise with many of the comments here- but the solution is never going to be simple. As a business, other commentators have rightly pointed out that if you do the job properly, you’ll go bust if you restrict yourself to state funded residents.
Regulation has it’s place, but over-regulation will make the business paper-work driven, rather than care driven.
Attracting good quality care staff (and keeping them) is a headache for all care homes, moreso since Brexit. Most only get the National Minimum Wage and can earn more at supermarkets, stacking shelves.
Nurses are in short supply everywhere, and will put their need to keep their registration ahead of loyalty- which is why care homes in trouble find it so hard to get good nurses, and why long hours are commonplace- 13 hour shifts and unpaid breaks.
The only way I can see to improve services will involve raising fees paid, and getting the statutory sector back into the care home business. This will cost money (from the tax-payer), and unless wages go up significantly for the lowest paid, won’t address the staff shortage.
Other possible options could include improving local ownership, and making increasing use of Charities such as Dementia Friends and Age Concern to help with the non-clinical side of care, such as activities, trips etc.

Member

I have experience of care homes from both sides- as the child of a parent being well taken care of in one, and as an employee of another. It has brought an interesting and enlightening perspective, providing me with a greater understanding of the challenges that are faced by the staff in both. There is one issue that I don’t see raised often and that is the lack of sick pay for staff. There is no onus on the employer to provide this and there is then only Statutory Sick Pay- which gives nothing for the first 3 days and is not enough for anyone to live on, especially those with families to support. I have seen time and time again staff who are caring for vulnerable people come into work when they are ill, simply because they cannot afford to do otherwise. They put those in their care at risk, but they balance that decision with being able to put food on the table and so they have little choice. The employer in the home I work in is a large and extremely wealthy company whose bottom line is profit and their shareholders above all else. Care is good, because the staff care, but I am of the firm belief that it should be a legal requirement that a company providing care for vulnerable people should HAVE to provide sick pay for every employee. This benefits everyone in the long run.

Member
Enn de Glanville says:
7 October 2017

Staffing costs are, in my view, at the epicentre of the problems.
Carers are overworked, underpaid and largely undervalued.
A common theme among carers working , or who have worked, in care homes is that they do not get enough time (and sometimes support) to do their jobs properly: to spend time feeding, bathing, responding immediately to calls, etc. Largely because of staff shortages, the ones that are present are asked to work long hours often without sufficient breaks just to ‘keep things going’. Many quit because they do not want to be party to the neglect and abuse they are required to participate in. Virtually all interactions with older people require time and, especially when dementia is present, extreme patience. It is very difficult to be patient when tired and rushed. And it is very difficult to be understanding when dog tired with the relentlessness of all that a person with dementia can generate. I don’t know what staff-turnover levels are, but I wouldn’t be surprised if it’s quite high.
Other gripes among carers are zero-hour contracts and the absence of holiday and sick pay.
Besides unhappy working conditions for carers, a major factor is low pay. Many good and experienced carers look for positions in the private-home sector, which pays roughly double. A look at the websites of the placement agencies and the likes of Gumtree, where freelancers also advertise, show there is not a shortage of carers.
Care homes, like any business, expect to have enough regular income to provide a good service and make a profit on investment. They cannot raise their fees to cover better staffing levels without risking heavy losses or going bust, especially when a large proportion of their clients’ fees is paid by their local council . Council funding calls the tune; across the board it keeps the entire industry running at shoe-string level.
My view is based on talking with and listening to the experiences of the many carers who helped me in the 24×7 care my late mother needed and who are currently helping me look after my husband, who has advanced dementia. I am a retired company director.

Member
Andrea Dunlop says:
7 October 2017

My mum died in March in a local authority sheltered housing, her body wasn’t found for over a month, despite other residents raising concerns. A smell in the corridor was noticed however this was masked over by additional air freshness. The postman noticed that the mailbox was full and eventually raised the alarm. Due to the state of her body they were unable to identify how she died. For the last 6 months I have been trying to come to terms with this event, the council have never spoke to me or addressed the failures that clearly occurred. Infact at the inquest i found the sheltered housing manager to be somewhat hostile towards me. I want to do something about this, so that no one else has to go through the same. Interesting another man died in another sheltered home under the same council a few weeks later and wasn’t found for a few weeks. Any advice on action I could look take much appreciated, or anyone else that has been in this situation that wants to raise awareness, please reach out.

Member
Joan Cool says:
13 October 2017

Eason the middle of reporting my experience of a local Care hom in which I am no longer staying. And suddenly all my report disappeared. And I can no longer find it to carry on the details

Member
Margaret says:
13 October 2017

I am one of the lucky ones, my mother has been in two care homes. The first was closed because of problems with the building. After visiting 10 care homes I found a second where she is now which is extremely good as well. However the company closing the first home were absolutely rubbish at providing support with finding another home – they provided a list of local homes with no phone numbers, furthermore they made no effort to keep places open in their other care homes for those about to be displaced! They knew the closure was in the pipeline for some time! Additionally the local council tried to enforce their own choices, I argued about the number I had visited but agreed to look at the three they recommended; one I had already visited and two had QCC strikes against them. When I spoke to the social worker about this she had no idea!
I do visit often and have a very good relationship with the staff and I know this helps. However the care staff feel extremely sorry for those who don’t have visitors. Yes there are staff who are better than others but they work extremely hard doing a job many, many people don’t want to do. Yes I do know what it’s like as I cared for my mother at home before making the decision about a cae home.
Finally a political point – Brexit will exacerbate the problem we have; the majority of all staff; carers, nurses, cleaners, cooks and laundry staff are either EU or non EU immigrants.

Member
derrick porter says:
13 October 2017

From my own experience having visited my mother on a daily basis, I am convinced that care home managers – in regard to the quality of care provided for the elderly – are the last people to be trusted with ensuring that even reasonable standards of care are maintained. The families of residents are frequently afraid to speak out through an
undeniable fear of what might happen to their loved after those who carried out the investigation have left.
Former staff would be the most reliable source for collecting information, although rarely will they come forward in the belief that any adverse revelation might reflect on their own future employment. My view is that the inspections of these homes should be unannounced and that no area be excluded. If such enforcement is already in existence the public might reasonably ask why the standard of care in many homes is so wanting in compassion.From my own experience having visited my mother on a daily basis, I am convinced that care home managers – in regard to the quality of care provided for the elderly – are the last people to be trusted with ensuring that even reasonable standards of care are maintained. The families of residents are frequently afraid to speak out through an
undeniable fear of what might happen to their loved after those who carried out the investigation have left.
Former staff would be the most reliable source for collecting information, although rarely will they come forward in the belief that any adverse revelation might reflect on their own future employment. My view is that the inspections of these homes should be unannounced and that no area be excluded. If such enforcement is already in existence the public might reasonably ask why the standard of care in many homes is so wanting in compassion.From my own experience having visited my mother on a daily basis, I am convinced that care home managers – in regard to the quality of care provided for the elderly – are the last people to be trusted with ensuring that even reasonable standards of care are maintained. The families of residents are frequently afraid to speak out through an
undeniable fear of what might happen to their loved after those who carried out the investigation have left.
Former staff would be the most reliable source for collecting information, although rarely will they come forward in the belief that any adverse revelation might reflect on their own future employment. My view is that the inspections of these homes should be unannounced and that no area be excluded. If such enforcement is already in existence the public might reasonably ask why the standard of care in many homes is so wanting in compassion.

Member
JOAN GARNER says:
13 October 2017

With the threatened loss of beds and other services from our local Hospitals, I and many of my peers are very worried for the future of our local Health Services. To me it would be a total disservice to the Communities if the Hospitals were sold for Housing Development, so much money has and is still being raised by the community to provide extra facilities.
An alternative could be :-

To keep the present Out Patient Clinics in these Hospitals. (appropriate buildings in other areas)
Then the remainder of the Hospital could easily be converted to Special Sheltered Housing accommodation for those who cannot totally look after themselves and require daily Care visits, with Bedroom and W.C. FACILITIES’ Plus a ‘between’ rooms for Patients en route to their homes after Hospitalisation. Residents would prepare their own Breakfast and Tea.

Within the complex would be a Kitchen and Dining Hall for a good midday meal to be provided and a communal lounge area for Residents to socialise. A Bathroom area with walk-in Bath etc.. The flats would all have easy access to these facilities. They would be let to Single Residents on a need basis, whether they are tenants or own their property. A Proper rent would be charged, in full for those who can afford it and the Housing and Care Benefits of the time will help those not able.
Carers would visit Residents every morning and check their needs for the day.
I feel that to have Carers on hand in this way will be Health and cost effective rather than harassed Carers rushing around in cars on home visits each day, only being able to spend 15 to 20 minutes with each Client, rather than using up time and fuel each day. Also for Residents to have the company, if they wish, of others is another big Health and ‘Quality of life’ benefit.

On site, after space being allotted for car parking I would think that there would be room for several small bungalows/apartments for the elderly who would like to downsize from their family homes. This would free up family accommodation in the area.

I had experience of a similar Special Sheltered Housing scheme in Surrey, Toldene Court, my Mother lived there happily and was extremely well looked after for 3 or 4 years, Toldene was converted from a redundant School. I believe it was the first in the London Borough of Croydon of its type and I see that they have a further 5 now in the Borough, Further information can be sought on the London Borough of Croydon Website, see below.

If my proposal is of interest and you would like more information from me I will be pleased to help.

Special sheltered housing / extra care – London Borough of Croydon
https://www.croydon.gov.uk/healthsocial/adult-care/support…home/…/specialsheltered

Member
Anne Wild says:
17 October 2017

I know there are significant problems but there are good homes out there too. My parents (98 & 96) are in a care home in Bedford, near my sister, who sees them almost every day (so would notice if there were problems). Although the building leaves a lot to be desired the staff are kind and caring, which is by far and away the main thing. The cost is significantly less than many others we approached, too, and although my parents are paying out of their savings and from the proceeds from selling there house (as they should – why should the tax-payer foot their bill if they can afford it? We, as offspring have no inheritance ‘rights’. Family greed makes me so cross!) many others in the home are funded by the state.

Member
Angela says:
18 October 2017

We were lucky as our mum went into a private care home called Westward Hall on the Wirral. We could afford her care and it was exceptionally good care. The staff were kind and understanding, nothing was too much trouble to them.
This should be possible in all care homes not just private ones and not just down to luck.
I would happily pay more income tax if it meant we had the same good quality establishments with the best staff and paid a decent wage.

Member
Jean Deval says:
20 October 2017

Jean says:
My mother went into hospital care when she was 100. Visitors had to leave at lunch time and return later. They would not allow me to feed my mother although she was incapable herself and so went without food often. They took no notice of my complaints. We moved her into a residential care home where she was properly cared for and I could help when needed.

Member
John Swan says:
20 October 2017

In respect to NHS contributions to nursing fees, my wife was assessed as requiring the contribution of £155.05 pw. According to the Which information this sum should be deducted from the self funding amount paid by my wife to the nursing home. The operators of the home say this is not the case and take the NHS contribution on top of the fee. Upon enquiry to Which I was referred to Care Aware, an advice charity, they say that whilst the system says that the home should deduct the NHS contribution,they rarely do and seemingly cannot be made to do so. Assuming the home did deduct the contribution there is nothing to stop the home increasing the fees to cover the deduction, as a private company they can adjust fees at any time.

Member
Carol says:
20 October 2017

After working in the retail sector, I started working as a care assistant in a nursing home, I paid to do my NVQ in social care, then free funding became available through the government, now that has stopped, so many problems occur in the private sector due to lack of training, this all has to be paid for and nothing is for free!
It’s an underpaid job and staff mostly are hard working and get very little praise, it’s only bad press, never the
good homes getting publicity. As a member of the management team, we all know we are not perfect and things do go wrong, I always try to say thank you to the staff for doing their best, maybe the owners of care homes should take a good look at what their staff do, take on a shift or two and deal with what their staff do on a daily basis mostly on minimum wage! After all most of the people I work with do just do the job for the money, they do it because they truly care. It’s not always the care staffs fault when things go wrong, it starts from the top. I wouldn’t change my job for any other now, I might change the homes I work in, but always strive to make the homes I work in a better place where the residents are comfortable and safe with staff that are trained and care for the people in their care.