I read in the media today with some dismay about the plight of care homes and domiciliary care services. The Care Quality Commission are raising the stakes giving warning that the sector as a whole is at risk as providers of care for elderly and disabled people pull out over rising costs and cuts to council budgets.
Providers are in trouble because their costs have increased by up to 30% in the past year while their profit margins have fallen by more than 40%, it warned. It pinpoints the national living wage (NLW) and the inability of cash-strapped local councils to pay higher fees for these services as the main causes of a growing problem.
It is alarming to learn that the number of care homes overall in England has fallen from 18,068 in September 2010 to 16,614 in July this year, at a time of growing need linked to the ageing population, according to figures released by the CQC.
The total number of beds available in care homes also fell between 2010 and 2016 from 255,289 to 235,799 this summer – a fall of 19,490. While the number of nursing homes increased slightly, from 4,387 to 4,623 in that time, more than one in 10 residential homes – for elderly, often frail, people – have closed. The total of those available has fallen from 13,681 to 11,991 – a drop of 1,690.
CQC are also worried that the same pressures could push providers of domiciliary care to the wall. “Provider exit and large-scale contract handbacks demonstrate the fragility of this market. At what point can the replacement providers only make the returns work by compromising on the quality of care?” the briefing paper asks.
To many people who rely on care homes and domiciliary care for help in their own homes with washing, dressing and eating, the effect of contraction to services could become greater if more and more of the private companies that dominate the market go out of business, the CQC fears.
Andrea Sutcliffe, the CQC’s chief inspector of adult social care, was responding to the leak to the BBC of a recent internal briefing document that spells out how rises in providers’ costs and the squeeze on local councils’ budgets are leaving care services in an unsustainable position.
“We know that the adult social care sector faces many financial pressures which, worryingly, could undermine the quality and safety of care that people receive and rely upon every day,” said Sutcliffe.
She confirmed that information from care providers detailed in the CQC document “does highlight a concern that the long-term sustainability of high-quality care within this sector could be at risk. Given the impact this would have on people’s lives; it is important that we continue to monitor these trends closely.”
To those who work in the care sector, myself included, this is a degradation of duty on behalf of government and local councils. If the end product of buck passing between the 2 parties where on the one hand insufficient funding has been made available to provide quality care. On the other there has been no requirement on local authorities to ring-fence funding specifically designated for use in the social care sector.
This situation as we all know is exasperated by NHS bed blocking where packages of care designed to accommodate people’s needs in the community, would not only be the choice of patients but save money for a cash strapped National Health Service.
Barbara Keeley, Labour’s shadow minister for social care, said: “These figures are an alarming reminder of the desperate state of care services in this country. Despite all the spin from ministers, the Tories have left social care on the brink of collapse, with thousands of people’s care at risk as a result. It’s not enough to turn a blind eye to this crisis. We need ministers to step up and guarantee that they will properly fund care services. Anything less will be a betrayal to the most vulnerable in our society.” I would add that labour when in power could not agree a funding strategy for care with the Tories and Liberals.
Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute
Bettal Quality Consultancy