Social care in crisis

Laura Bradley, a researcher at the Institute for Public Policy Research (ippr), reports on the Southern Cross Healthcare story, and looks at the crisis state of social care.

Laura Bradley is a researcher at the Institute for Public Policy Research (ippr)

Over the last few weeks, the financial future of residential care has been called into question. The financial woes of Southern Cross – which the company blames on a 14 per cent reduction in admissions from councils – had added to the sense of impending crisis.

Of course it is important that there are enough care home providers to meet the demand for quality care but surely the critical thing to be asking is: what is happening to the older people who are no longer being admitted by councils into care?

A recent poll revealed 16% of councils were increasing the level of need an older person has before they are entitled to free care, with most of the other councils already having the tightest criteria allowed under the Fair Access to Care Services criteria. Eligibility is getting tighter, while older people with high-level need are already being left behind.

With free care home places increasingly limited to older people with ‘significant’ or ‘critical’ need the affordability of home care services becomes even more important – but the same poll shows 88% of councils are planning to hike up the cost of the community services they commission for.

While the home care market offers an alternative source for care it is currently held back by problems in the way it is commissioned and the conditions it offers to potential recruits. Forthcoming research by ippr looks in more detail at the issues facing home care in their project on Older Londoners, funded by the City Bridge Trust.

It is unsurprising then that the NHS is filling the void left by inadequate council support. Bupa has recently warned of a surge in NHS bed blocking, due to increasing numbers of older people remaining in hospital because they lack a care alternative.

A recent poll found that 50 per cent of doctors already felt the problem of bed blocking was getting worse. With increasing strain this puts on the NHS budget it seems illogical to allow cuts to public services to leave older people with no alternative but to go without the care they need.

The Dilnot commission has an opportunity to ensure additional funding is injected into the system in a way that means people are able to use care at earlier stages and remain independent in their own homes. The newly announced role of Monitor in achieving consistent and closer integration of health and social care will also be critical to ensuring hospitals don’t end up becoming the last minute care option for older people left behind by the care system.

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