Years of cuts see elderly struggle to get help with care

Six consecutive years of cuts to local authority budgets have seen 26 per cent fewer people get help with care, says a report highlighting the 'bleak' state of social care services for England’s older people.

The number of people receiving help with care from their council has fallen by 26 per cent in the four years to 2014, reveals the report ‘Social Care for Older People, Home Truths’, published by the independent health charities The King’s Fund and the Nuffield Trust.

'Care depends on what people can afford not what they need'

‘Many social care providers are surviving by relying increasingly on people who can fund their own care, but those dependent on local authority contracts are in difficulty’, the report stated.

The care older people receive increasingly depends on 'what people can afford, and where they live, rather than on what they need', it stated.

The document also said more than 40 per cent of the money paid to care homes comes from people paying for themselves.

Doubts about ‘sustainability of care provider market’

Reductions in fees paid by local authorities and other cost pressures such as the National Living Wage are ‘squeezing the incomes of residential and home care providers’ and the report said an increasing number are now likely to leave the market or go out of business.

‘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’, the report said.

Martin Green, the chief executive of Care England said: “Without adequate resources the sector will simply crumble.

“Providers are willing to work with politicians and commissioners, but this goodwill needs to extend to action in order that those in our care can continue to rely on the availability of the high quality care that they need and deserve.”

’Increasingly threadbare’ safety net

The report said the squeeze on the budgets of care providers is ‘prompting some providers in affluent areas to step back from providing care for people funded by local authorities, leaving those who depend on council funding reliant on an increasingly threadbare safety net.’

Davina Ludlow, director of carehome.co.uk, said: “High quality care is not something that can be delivered ‘on the cheap’, and often as a result, care homes find themselves forced to charge privately funded residents more in order to subsidise the fees paid by local authority-funded residents.”

’Battling the system’

The ‘Real Lives’ report is a companion report to Home Truths, and captures the social care experiences of the over 65s. Older people told researchers they had difficulties accessing high-quality care. Researchers said this was because councils are raising eligibility criteria and increasing fees and charges, and the strain this places on individuals and carers who can end up feeling like they are ‘battling the system’.

Susan George, who lives in London and cares for her husband Bruce, who has dementia and Parkinson’s disease, said: 'Just before we got the help with care it was making me very ill. I had infections and I was very low – lying on the sofa wondering how I was going to cope with the rest of the day.

'It has been a long battle from having no care. You feel like you want to scream sometimes when trying to find help – it is out there but finding it is like a maze.'

People trapped in hospital beds awaiting care packages

A ‘continued failure' to integrate health and social care 'leaves people trapped in hospital beds awaiting social care packages’ when they are medically fit to go home.

When Bruce was admitted to hospital with a trapped nerve, he remained there several days after he was medically fit to go home, while health and social care professionals organised a new care package to meet his increased needs.

Susan George said: “Nobody was speaking to anyone else, social workers weren’t speaking to the care agency, and neither of them were speaking to me. They blamed each other.”

The report stated: 'Care homes described making renewed offers to Clinical Commissioning Groups and acute trusts to assist with admission and delayed transfer of care pressures. They often saw themselves as offering a less intense environment than an acute inpatient ward, which could replace a shrinking NHS intermediate care offer, essentially acting as additional NHS capacity for older people.'

In response to the report, Martin Green, chief executive of Care England said: "It is dangerous to underestimate the potential role and capacity of the independent sector in supporting NHS sustainability and reducing delayed discharge numbers, which continue to rise."

The report also said under-funded NHS services are undermining the policy objective of keeping people independent and out of residential care. Despite the Care Act 2014 creating new demands and expectations, it said most local authorities “will soon be unable to meet basic statutory duties”.

One local authority interviewee described how this financial year’s savings target of just under £15 million could not be met without breaching the council’s legal duties under the Care Act 2014 to assess and meet eligible needs.

£2.8 billion funding gap by 2019/20

The report highlights a huge funding gap which will reach at least £2.8 billion by 2019/20 as public spending on adult social care shrinks to less than one per cent of GDP.

The Government has reduced its funding to local government by 37 per cent in real terms between 2010/11 and 2015/16 (National Audit Office 2014).

’A perfect storm’

The report concludes: 'Six consecutive years of budget reductions to publicly-funded care, increasing demand, increasingly acute levels of need, workforce pressures, provider failure and market exit are all converging to create the perfect storm.

'The net effect of these pressures is now clear: social care in its current form is not sustainable and requires both immediate investment and long-term reform to prevent crisis and meet the aspirations of the Care Act 2014.'

’A key test for the prime minister’

Richard Humphries, assistant director of policy at The King’s Fund said of the findings: ‘‘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.”

“Not ‘a country that works for everybody’ when older people miss out

Research for the report was undertaken between September 2015 and June 2016 and involved analysis of national data, interviews with health and social care commissioners, providers and interviews with older people.

“A Government that wants to create ‘a country which works for everyone’ should not tolerate the oldest and most vulnerable falling into a social care system riddled with holes”, said Ruth Thorlby, deputy director of policy at the Nuffield Trust.

To read the Social Care for Older People, Home Truths report visit:

www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Social_care_older_people_Kings_Fund_Sep_2016.pdf