Failing social care system leaving elderly and families to pick up pieces

Elderly people are bearing the brunt of cuts to social care, according to a new report, which also warned that increasing numbers of care homes would go bust.

The study, from the King’s Fund and Nuffield Trust, found the care and support older people received depended on where they lived and how rich they were rather than their level of need.

Reductions in how much local authorities pay care homes – or below inflation increases – means that some are on the brink of collapse, leaving vulnerable people at risk.

The cuts, combined with shortages of nurses and care workers, the introduction of the national living wage for staff and increasing reliance on people who can self-pay means many care homes are “under unprecedented pressure”, the report said.

It warned of future firms going bust, similar to the collapse of Southern Cross in 2011, and others leaving the market.

It said: “The possibility of large-scale provider failures is no longer of question of ‘if’ but ‘when’ and such a failure would jeopardise continuity of the care on which older people depend.”

Over the past five years, local authority spending on care for older and disabled people had fallen by 11% in real terms and the number of people who received state-funded help had fallen by around a quarter.

This meant growing numbers of people were now outside the system, struggling with basic needs such as washing, dressing or getting out of bed.

The report warned: “No-one has a full picture of what has happened to older people who are no longer entitled to publicly-funded care: the human and financial costs to them and those who care for them are mounting.”

Unpaid carers – such as family and friends – will be expected to do even more in future, the report added.

It said public spending on adult social care was set to fall to less than 1% of GDP by 2020, adding that councils “will struggle to meet basic statutory duties”.

The fact care is becoming more about what people can afford means those who are “relatively well off and well informed” will do better than the poorest, “who are reliant on an increasingly threadbare local authority safety net”.

The report also pointed to the rapid growth in delayed discharges from hospital – so-called bed-blocking, which is now at its highest ever level – as a symptom of issues with social care.

Richard Humphries, assistant director of policy at the King’s Fund, said: ”The failure of successive governments to reform social care has resulted in a failing system that leaves older people, their families and carers to pick up the pieces.

“Putting this right will be a key test of the Prime Minister’s promise of a more equal country that works for everyone – there is no more burning injustice in Britain today than older people being denied the care they need to live with independence and dignity.”

Ruth Thorlby, deputy director of policy at the Nuffield Trust, said: “No-one can predict whether they will have care needs later in life. But if they do find they need help with the basics – eating, washing, going to the toilet – most will discover that unlike a health problem where care is free, they somehow have to manage themselves.

“Our research found that local authorities have done their best to make savings while protecting funding for the poorest, but care providers are struggling on the low fees councils can afford.

“Shortages of home care staff and affordable care home places mean older people are often stuck in hospital, putting both their lives and vital NHS processes on hold.

“The number of older people needing care is increasing and yet we are continuing to put less money in.”

Figures show a 26% reduction in the numbers of older people receiving local authority-funded care – from more than 1.1 million in 2009 to 853,615 in 2013/14.

Phil McCarvill, deputy director of policy at the NHS Confederation, said: “Insufficient social care funding is now the most urgent threat to the NHS and the wider health and care system.”

Parliamentary and Health Service Ombudsman Julie Mellor added: “Our investigations have uncovered that older patients often fall through the cracks between health and social care when discharged from hospital, causing them and their families untold distress and suffering.

“The issues of funding and lack of integration between health and social care need to be addressed so that older people get the support they so desperately need.”

A Department of Health spokesman said: “We understand the social care system is under pressure, and this Government is committed to ensuring those in old age throughout the country can get affordable and dignified care.

“That’s why we have introduced landmark reforms to ensure no-one should have to sell their home to pay for care in their lifetime, and why we’re significantly increasing the amount of money local authorities have access to for social care, by up to £3.5 billion by 2020.

“Our Care Act gave new rights to carers and we will be publishing a new Carers Strategy shortly.”

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