The Elderly Care Crisis

On June 13, 2002, 108-year-old Alice Knight finally starved herself to death. It was her protest, a protest against being moved from the care home she loved to one she did not recognise.

Mrs Knight had been at the private residential home Flordon House in Unthank Road, Norwich, for six years, but the home was forced to shut because the owners could not afford the modernisation costs to meet new regulatory standards.

Mrs Knight was moved to Laurel Lodge home in nearby Ipswich Road, but she refused to eat and would not let staff carry out medical examinations. She was dead within a month. Her death unleashed a massive backlash against the Government; the case was brought to the attention of Prime Minister Tony Blair. At the time, statistics showed private care homes were closing at a rate of 800 a year across the UK.

Figures showed that one in four elderly residents who moved died within a month of leaving; it accounted for the deaths of 12,000 residents across the country in the five years before 2002. Today there are 450,000 people in care homes in the UK.

Alice Knight became the face of the tragedy of the widespread closure of care homes and her death was important because for once it seemed it might change something. Now, four years later, the tragedy is the same, but the faces have changed. In September, 92-year-old Adelaide Lacey died three months after being moved from the care home where she had lived for 13 years.

Her story is the same as Mrs Knight’s and countless others. The night she was moved, Mrs Lacey actually fought her carers as they tried to take her away from the home in North Walsham. After that, she just gave up.

Speaking today, Diane Self, 62, the grand-daughter of Alice Knight, said: “When we heard that her residential home was going to close, we knew what was going to happen – and it did. She just gave up, she willed herself to death. The trauma of watching someone just give up and die was awful. I bumped into one of the ladies who used to work at Flordon House and she said apart from two, all the people who were moved from the home died soon afterwards. It was not that the people were not kind at the new homes, it was just the trauma of moving people at that age.”

Mrs Self, who lives in Easton, wrote to Tony Blair at the time of tragedy and the Government was eventually forced into an embarrassing climbdown.

Health Secretary Alan Milburn said legislation, enshrined in the National Care Standards Act, governing the size of rooms, the number of lifts and width of doors would no longer be statutory. But, though they may not be statutory, the standards are still making life difficult, sometimes impossible, for care homes.

Mrs Self said: “It was cruel and the system is still cruel to the old people. I think the situation has got worse, there does not seem to be as many care homes now. They have closed down so many homes in Norwich and mental health services have suffered as well. My mother is 83, she is fit and healthy, but in another 10 years things may change – where will she go? I’m 62, where will I go? They talk about care in the community, but you can only do that to a certain level.”

Betty Lacey, 64, the daughter of Adelaide Lacey, said her mother’s death was testament to the continued closures of care homes and their devastating effects.
She said: “The night they moved her she went totally berserk, she didn’t know what she was doing. She was fighting with carers, it was a terrible experience. That was the last day we were able to take her anywhere – it was just so cruel.”

It seems the problem has not gone away at all. The Mildred Duff care home in North Walsham, where Mrs Lacey was living, was forced to close because the owners could no longer afford to make improvements to meet the tough regulations set by the independent Commission for Social Inspection Care (CSCI). It was a happy home, but the corridors and doors were not wide enough and the bathrooms were ruled sub-standard. In total the CSCI has 39 standards for care homes to adhere to and they all cost money.

Care homes in Norfolk are closing at a rate of nearly three a month. Nearly 60 have closed in the past two years, taking the number from 329 to 270. Care homes say the cost of meeting the CSCI standards, soaring gas, electricity and water bills, staff wages and training fees are forcing them out of business. They say it costs up to £600 a week to care for an elderly person properly and that is what people who are paying privately have to pay, but the council pays only £378 for highly dependent elderly people, £329 for very dependent elderly people and £274 for elderly people. {mospagebreak}

It means they have to make savings by paying staff a salary bordering on the minimum wage, which leads to problems in finding good care workers – and keeping them. Therefore, care standards suffer. The problem is that about 75 per cent of the care homes used to provide care for elderly residents funded by social services are private.

Norfolk County Council is responsible for “making sure care needs are met” via its social services department. Elderly people going into care are assessed by the authority as to whether they can pay for their own care in full. A lifetime of paying taxes counts for nothing. Anyone with a property worth more than £21,000 is deemed rich enough to pay for their care in full, meaning thousands of homes are flogged off.

The heart-breaking sales rob elderly people of the houses they had worked their whole lives to own and hoped to pass on to their children. In return these people get a paltry £18.80 weekly allowance. But the councils are not using the money from the sale of the houses to line their pockets.

English authorities face a total deficit of £1.77 billion in social care. Pressures in the county council’s adult social services budget amount to £8.5 million in 2006/7 alone. Funding for services had to be frozen, savings were made.

The paucity of funding was criticised in the recently published Wanless Report, which called on the Government to treble its funding for elderly care. Its author Sir Derek Wanless hoped to stop so many people from losing their homes.

Care minister Liam Byre has vowed to take the findings of the report on board, but as yet, there are no promises of more cash. At present there are just 27 council-run care homes in Norfolk, and 15 nursing with care initiatives; it equates to one home per 4,000 of the county’s over-65s.

Although the private care homes take the lion’s share of the strain, they say they get about 10 per cent less in funding from local authorities compared to council-run counterparts. The council says the downturn in the number of care homes is a natural progression, as more people prefer to be cared for in their own homes.

Harold Bodmer, head of social services at the county council, said: “The traditional care homes will gradually – and I mean gradually – become more specialised and deal with areas such as dementia and respite care. A couple of years ago we consulted with people to see what strategy we should adopt. People said they wanted to live at home for as long as possible, and receive care in their own homes, and for specialist care, for people to be as independent as long as possible.”

As councils move towards keeping people in their own homes, private care homes struggling with costs predict the future will be large-scale 100-bed “granny farms”. Impersonal big businesses will swallow up the sector.

Lisa Rutter, manager of the 33-bed Redlands private care home in Reepham Road, Hellesdon, said: “It’s only those that care and want to do it that run care homes now, either that or they are large businesses. It is going to get harder and harder for the smaller private homes; it’s likely the future will be 100-bed housing units run by big businesses; they will be like mini-hospitals.”

Against this backdrop, the elderly continue to be failed. Help the Aged says 500,000 old people are falling victim to abuse. Inspectors from CSCI have revealed they have “significant concerns” over 23 care homes in Norfolk and will be targeting them this year.