Marches Care and has been drafted in to help this winter. Mandy Thorn, the managing director of Marches Care and vice-chair of the National Care Association (NCA), which is made up of small-and medium-sized care providers says: “If care homes were more involved in local winter planning, which is actually a year-round issue, we would probably see less of a problem with DToC." She believes this would be possible if they are "engaged early enough and sensible and respectful contract discussions take place – around block contracts at a price that reflects the additional support that short-term admissions require.” She says when it comes to care homes being used to address winter pressures it's "a patchy picture across the country". "Smaller independent providers are not always considered when local authorities and CCGs get together to discuss their response to winter pressures. When health and care professionals get together to respond to hospital bed pressures, not every local area takes into account the residential and nursing beds that may be available." According to figures from the Institute of Public Care, from April 2012 and April 2017, the number of care home beds available fell by 3,769. Add to this a major staff retention and recruitment problem in the care sector and the country’s ability to respond to a winter NHS crisis gets more challenging.
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