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Have you planned for care in later life?

Pensions savings

Only a small fraction of us are planning for care costs in later life, according to our new research. How concerned should we be?

As I plan my day to day spending, I don’t think much further than the next holiday. Even home improvements that are a year away seem too far in the future to save for.

So it doesn’t altogether surprise me that only one in ten adults aged 55 years or over say they have put aside money to pay for any care needs as they get older, according to our new research.

Like me, more than half of those over-55s say they are prioritising other things they want or need to do right now, over planning for potential care needs.

And this is backed up by behavioural research: even if we get good information and advice, we don’t want to think about ageing and needing care.

Non-planners

So how can the government help people like me – the non-planners? Well, rather than encouraging me to plan, a new policy report by Which? says it can improve the system to help me live at home for as long as possible in retirement.

When asked to think about what changes they may make if their health and mobility did deteriorate, nine in ten people aged 55 and over said they would be willing to make adaptations to their homes to aid mobility and a similar percentage said they would be willing to use mobility aids outside the home.

This resonates with me. My parents have installed a number of aids and adaptations to help them enjoy their home: the bath lift that allows them a well-earned soak, the riser-recliner chair that looks like a very superior addition to their furniture rather than something you’d find in a hospital, the very smart trolley that also serves as a walking aid.

Such equipment – more acceptable when it looks desirable – could cut falls needing medical treatment by a quarter, and save the NHS and social care services £500m each year, the Centre for Ageing Better estimates.

Info deficit

The key to planning is also good information, but our research tells us that less than half of people know where to look for information about care. This is where Which? Elderly Care can help, which provides information on all aspects of choosing care, including financing and housing options.

The GP is trusted to give good advice and support, along with friends and family, but is the already packed 10-minute GP consultation really the best place to get care information?

What’s needed to make sure people get the advice they need from the places – like the GP surgery – they turn to?

Would you plan for your care? Is it on your list of things to save for? And – as the government works towards an Autumn social care green paper – what do you think is needed to support older people in the best way we can, given that many people use the care system for the first time at a time of crisis?

Populus, on behalf of Which?, surveyed 2104 UK adults online between 11-12 June 2018. The data were weighted to be demographically representative of the population.

Comments
Member

Care Home Abuse in England –
1- https://www.independent.co.uk/news/uk/home-news/care-homes-abuse-residents-funding-staff-uk-elderly-protection-a8266936.html
2- https://www.express.co.uk/news/uk/736177/CARE-CRISIS-Abuse-neglect-UK-care-homes-new-report
3- https://www.telegraph.co.uk/science/2017/02/28/23000-allegations-elderly-abuse-carers-resulted-just-15-prosecutions/

Quote – Daily Mail

Exposed: ‘Horror of institutional abuse’ in Bupa care homes as secret filming reveals shocking catalogue of abuse towards elderly dementia victims

Reporting finds Bupa is guilty of ‘institutional abuse’ towards dementia patients
A watchdog, Care Quality Commission (CQC), has threatened to prosecute Bupa
Bupa charges over £1,000 a week for residents at its UK dementia care homes
Channel 4 documentary will show some examples of abuse suffered by patients

By Nick Craven for MailOnline

Published: 23:49, 17 June 2017 | Updated: 17:25, 18 June 2017

Anxious families seeking care homes for elderly relatives with dementia would no doubt be reassured to see the name Bupa above the door.

But an undercover investigation at a home run by one of Britain,s most prestigious private healthcare providers reveals shocking ‘institutional abuse and neglect, including giving residents used incontinence pads and forcing them to have bed baths at 3.30am.

Social care watchdog the Care Quality Commission (CQC) has threatened to prosecute Bupa if it fails to raise standards after the appalling conditions were exposed

A pdf submitted by Steve Moore -a thesis submitted to the University of Birmingham for the Degree of Doctor of Philosophy – Institute of Local Government Studies .
The Abuse of Older People in Private Sector care homes : Why does it occur ? Why does it endure ?
http://etheses.bham.ac.uk/6983/1/Moore16PhD.pdf
I have reams of more shocking facts , I hope Which ? realises the importance of the safety of old people in private care homes –I do.

Member

We know of abuse and poor care in these homes, and bringing them in front of the public might eventually see better oversight and action although, as with many institutions, there will always, it seems, be bad apples. The prison service illustrates that, as did children’s homes and social care in some authorities (public, not private, organisations).

However, while individual cases are vital to examine we also need an overall picture to see just how widespread, or not, such poor behaviour is before condemning a whole industry. My perception is, from all that has been written, that the majority of the sector is run properly, and that these are exceptions. They must be dealt with, of course.

A headline however, online in the Independent 22/3/18 says “Abuse taking place in 99% of care homes amid “chronic” underfunding, survey shows.“. Can this sort of statement possibly be true? Only 1 in 100 care homes are properly run? Does someone have substantiated figures to give a picture for the whole care home sector?

The thesis above acknowledges the very limited survey on which it was based.

Member

Malcolm you are not going to get the real figures “on a plate ” . Have a read of-
https://www.centreforwelfarereform.org/uploads/attachment/534/whats-wrong-with-cqc.pdf

Member

Malcolm the only reliable source for this data has to be the CQC, they are responsible for dealing with complaints and surely the keep records. I am not sure if they will communicate this to private individuals but I would have thought Which? has a chance.I am of a similar opinion to yourself that 1 poor home in 100 ie 1% is more reflective of the real situation than 99% , we must remember that all local Authority funded residents have Social workers dedicated to them and they monitor the Homes performance, there is also the Council’s “Safeguarding” who.’s job it is to respond to complaints with full investigations ( a newly opened home of mine actual suffered 3 such investigations in a period of 6 months each time 8 inspectors came (Nursing and Social services and reported back that we were totally in order, we found out later during job interviews that the anonymous callers were from a Charity run home which was being closed down by the CQC for mismanagement and were done out of malice.

Member

Malcolm
Hot of the presses from Community Care comes a Legal Interpretation please refer to my conv. below

Member

The reality is, not all private care homes have CQC registration but vulnerable people are still being sent to them by Borough Councils. Social workers will visit but reports are ignored because suitable replacements are difficult to find.

Member

Are you sure, Beryl? The CQC website states the following:

We monitor, inspect and regulate services that provide health and social care.
Activities we regulate include:
Treatment, care and support provided by hospitals, GPs dentists, ambulances and mental health services.
Treatment, care and support services for adults in care homes and in people’s own homes (both personal and nursing care).
Services for people whose rights are restricted under the Mental Health Act.

There are no exceptions. So far as I am aware care homes are not ‘registered’ by the CQC but by local authority social services departments if the establishment wish to accept local authority placements and then the department inspects them to ensure that the residents they have placed there are receiving satisfactory care. That is independent of any CQC regulation.

Member

In Scotland all care homes are inspected by the Care Inspectorate which covers-

The Care Inspectorate regularly carries out inspections on care services to make sure they’re meeting the right standards.

This includes reports on:

childminders
child day care
care homes for adults and children
childcare agencies
care at home
support services
housing support
adoption
adult placement
fostering agencies
nurse agencies
offender accommodation
schoolcare accommodation
secure care units
As per-My Gov.Scot
If you prefer to find a care home by yourself
The Care Inspectorate inspects and grades care homes in Scotland. You can check with them that a care home you’re looking at meets a high standard.

The Care Inspectorate can also tell you what type of care each care home gives. This includes what type of special care they can offer, if needed.
As you can see John there are constitutional differences to the regulation of care homes north & south of the border Health & Social Care is not deferred to Westminster .
Read-
https://www.theguardian.com/uk-news/2018/may/07/scotland-lead-way-cradle-grave-care-uk-devolved-tax-increase.
May I add not one person/family moving from England to Scotland complains about this most are happy with it. Its actually Scottish Tories that want it aligned with England not English people moving north.

Member

Beryl, under the care homes act it is iillegal to operate without a license if you know of any home operating without a license you should report it immeadeatly to the CQC and the Local Authoriity and ro Safegaurding at the L A .as far as I am aware there are no exceptions to this rule..
Part of the Regisration procedure includes Building Regulation , Fire Certificates , Health and Safety etc. Etc. I am amazed that the LAs you refer to could be party to whar you suggest,maybe you could start some action to get this matter sorted.

Member

John, if the CQC can’t trace them I think that is proof enough. There is sooooo much stuff coming out of the woodwork now the law is involved its reprehensible.

Member

Everyone should read this article as it fully explains the funding situation under the latest Care Homes Act
most people are basing their ideas under the old Act

Use of funding panels to decide on all adult social care packages ‘not lawful’
Legal expert says that using funding panels to make decisions on all adult social care packages is not in accordance with Care Act statutory guidance
by Sarah Dennis on May 4, 2018 in AdultsEveryp

https://www.communitycare.co.uk/2018/05/04/use-funding-panels-decide-adult-social-care-packages-lawful/?utm_content=Use%20of%20funding%20panels%20to%20decide%20on%20all%20adult%20social%20care%20packages%20%E2%80%98not%20lawful%E2%80%99&utm_campaign=Independent%20Age%20-%20291018&utm_source=Community%20Care&utm_medium=adestra_email&utm_term=https%3A%2F%2Fwww.communitycare.co.uk%2F2018%2F05%2F04%2Fuse-funding-panels-decide-adult-social-care-packages-lawful%2F

Member
Patrick Taylor says:
2 November 2018

Interesting article. And comments are useful:
” Saying this is not lawful will not change situation, as far as I can remember it was not lawful 10 years ago when I worked for another authority, however the expectation to meet and manage outrageous care costs of individuals, care packages for some individuals around £700,000 a year has meant that there has been a lot of arguing at all levels over what is the minimal we can get away with ,to meet the client’s needs in a safe and appropriate manner, not about what family demand is their right.

We are responsible to some degree to the public purse through our actions and ensuring that provision of service for other people may be just as needy, have their needs met not whittled down by people perceiving they have a right for this expenditure. Normal dichotomy too much need and not enough money.”

Perhaps the political promise of a cradle to grave coverage needs to changes slightly to include family and their resources. Sooner or later we as a society need to accept that there are practical limits and we need to start the argu mnet soonest rather than later. Medicine marches forward prolonging physical life but not necessarily a fulfilling life.

Member

And “how its done in children,s Private “care ” homes –

https://www.buzzfeed.com/richholmes/care-price
Have a good read of this don’t just “skim the surface” so you will see Private business “methodology “.

Member

Unlike you Duncan I do not get involved in topics of which I have little knowledge.I do have some idea however on how to run a business, startingas II did in 1964 and I can differentiate between improving effeiciency in management and reducing costs of service as explained by the MD .
Whilst on the topic of Child Care do you know what has been done by Councils and Police to stop child slavery and prostitution being perpetrated on Children in Care.Maybe Which? Could do a Campaign on this ?

Member

Your post does not deserve a reply from me Gerald .

Member

Duncan , I got what I expected, thank you

Member

I never gave you the “thumbs down ” Gerald .

Member

I’ve reversed it. But please let’s discuss the topic 🙂

Member

I realise that the profit private care homes make is “a secret ” and comment has been made as to the inability to gather more info on this so I used a different approach .
I checked out US – UK- EU- Australian websites relating to running them for the entrepreneur costed by business accountants , while the initial financial layout is high in every case the actual gross profit ranged from 26 % to over 30 % and the bigger the number of beds the bigger profit.

I have made it my duty to keep on trying till I get actual figures no matter what opposition is presented to me as I am being challenged, disgracefully in my opinion, well that just makes me more determined and strengthens my resolve , some will learn I never give up and intent to pursue this to the bitter end the one thing that gives me strength is the suffering of human beings.

Member

I have already posted a large conglomerate bought up a care home organisation in Scotland I think a £billion was quoted but for those that are taken in by “we cant afford the costs so are closing down ” in the care home business have a read of how off-shore large organisations operate and maybe you wont feel -oh those poor care home owners .

Read Australia as the Guardian publicises and you will see they are taking a leaf out of the books of companies like Amazon –

https://www.theguardian.com/australia-news/2018/may/02/australian-nursing-home-giants-shifting-millions-in-profits-offshore-report-finds

Member

Here are some bits of information that might be useful. More important, links to the documents they are extracted from that contain a lot more information that might be of interest.

”The care homes sector is worth around £15.9 billion a year in the UK, with around 410,000 residents.3 We calculate that there are around 5,500 different providers in the UK operating 11,300 care homes for the elderly.4 Around 95% of their beds are provided by the independent sector (both for-profit and charitable providers). LAsgenerally commission care services from independent care providers. We estimate that the average cost for a self-funder in 2016 was £846 per week (nearly £44,000 per year), while LAs on average paid £621 per week.”!

https://www.gov.uk/government/publications/care-homes-market-study-summary-of-final-report/care-homes-market-study-summary-of-final-report

According to accountancy firm Moore Stephens, one in six UK care homes is at risk of failure.
http://www.caresolve.org.uk/british-care-homes-facing-collapse/

• Economic profits 43. The industry, including the local authority and self-funded segments together, has been close to break-even levels of economic profitability between 2010 and 2015 (see Figure 2). We also observe that the local authority segment has generated significantly lower operating profits than the self-funded segment (see paragraph 39). Therefore, it is reasonable to infer that, in aggregate, the local authority segment would have generated economic losses and the self-funded segment would have generated economic profits.
https://assets.publishing.service.gov.uk/media/59b2bb0ae5274a5cfcda2d18/financial_analysis_working_paper.pdf

Member

Very interesting reading MALCOLM ,it is very clear that without the Private Sector there would be many Council Funded clients who would not find places in Residential Care ,the resultant would be even more bed blocking in the Hospitals at a massive increase in NHS costs and problems.
The front line NHS staff have been struggling with this problem for years but the Local Authorities have continually ignored their pleas Quoting shortage of funding (the LA started thisin 1993 the first year of this scheme) . We have known Councils that have underspent .

Member

Scotland, Australia ,America, etc.etc. For some relevant info Duncan refer to MALCOLM below.

Member

The 2018 Budget is providing a further £400 million to local adult social care authorities to assist in funding placements in residential care homes [among other things]. My initial reaction is that this will barely scratch the surface and there is a real risk of it being misappropriated and not finding its way into the economics of the business.

Member

I wonder how much this has also helped?
”What is the ‘Adult Social Care precept’?
In 2015 the government created the Adults Social Care Precept, which allowed Councils which provide Social Care to Adults to increase their share of Council Tax by up to an extra 2%. In 2016 they announced that for the 3 years from 2017/18 to 2019/20 Councils would be allowed to increase this by up to 3% in any given year, but no more than 6% in total over those years.

The Government has said that this precept must be shown as a separate charge on all council tax bills. The income generated from this charge is ring-fenced, meaning it can only be used for Adult Social Care services.

Member

That should have helped, Malcolm, but I wonder how much has trickled through to the front line in terms of better staffing, higher standards, and safer care.

I suspect that for commercial reasons there is an excess of places in residential care homes over the normal requirement. This makes it difficult for the operators to squeeze more out of the local authorities but it also means there is a widening gap between what they charge a self-funding resident and one assisted by the state.

It really is about time the government published its much-vaunted and long-promised Green Paper on the funding of adult social care. There will never be a good time – they might as well get it out and under discussion before the Autumn is over. Another casualty of the Brexit hoo-ha, I suppose.

Member
Gerald says:
5 November 2018

The Government of the day tried ring fencing etc in 1993 cer tain Councils actually underspent or diverted funding and actually returned money to Nat Gov. (we were kept informed by a Member of the Public Accountants Association after his parents were denine funding).To understand this blatant misuse of funding one must remember that prior to The Private Sector the main Providers were the Local Authorities and certain Authorities have been penalised for abusing power to promote their own homes at the expense of others including Charities, Housing Associations, Voluntary Sector.
In spite of being caught out this this by the Ombudsman this practise still continues as old habits are rd to break it appears. Can we really see people such as BT or Railtrack etc ever treating anyone threatening their power “fairly” and just imagine them being given funding to distribute “fairly” – NO CHANCE . Unfortunately it is the service user that suffers in the end and then guess who gets the blame ??
The funding needs to go back on a National level as before and be administered by politically unbiased Public Servants as before ,Medical Assessments need to also return to medically qualified staff (DOCTORS & GPs) who are trained to prescribe and not left in the hands of unqualified pen pushers

Member
Gerald says:
5 November 2018

Once again John I find myself agreeing with you ,according to Which? own figures there is already a shortfall of £1.4billion .Ever since the Councils have taken over this task they have been found Guilty of misappropriation on numerous instances and I have personally had to deal with the Counsellors who have openly condoned this action .While ever this money is administered by One of the largest providers of Care do we really believe they they will not usurp their power We just need to refer to certain participants in this conversation to get an informed answer.

Member

The registration and inspection of Residential Care homes used to be done by the Local Authorities under the Old Act this actually included the LAs own properties .The task for Nursing Care Homes was delegated to the Area Health Authorities and for many years we suffered a total confusion of standards and attitudes with each County having conflicting and differing attitudes towards different types of providers .
With the introduction of localised funding ( for residential and Nursing) and the introduction of the new Act the Goverment of the day decided that having a separate National Authority Authority (CQC) wouldbe a fairer and clearer National scheme. Anyone operating over County boundaries have found the new scheme much easier to understand, obviously any task of this magnitude needs time to settle , personally having worked in both systems I find the CQC far more Proffesional .
Just a point of interest funding from the Local Authorities was always deemed by the Government as “a contribution” towards any fees and it should be up to the Patient (Client) to decide where they wish to reside and what fee they decide to pay, this freedom seems to have been lost in some Authorities.

Member
Patrick Taylor says:
4 November 2018

Thanks for the elucidation GH. I can understand the logictical cleanliness in dealing with a consistent set of requirements.

However I also think it was more likely that local people having a pop at local councillors might have been more responsive to abusive or weak homes management. Whatever else we know is that there is abuse and has been abuse and that staff reporting it have been victimised. This has to be changed.

Member
Gerald says:
5 November 2018

Hi Patrick glad to be of assistance unfortunately the Councillors you are referring to were party to the underfunding which I have referred to and therefore not uniformly acceptable to criticism. In practise we do find that the whole system is working better for everyone Private, Public Sector Charities etc. Health Authorities, Less Politics, more needs awareness applied across ALL Sectors.