Closures challenge us all over cost of care for the elderly
IT is widely accepted that the stress of a move, particularly an unwanted or unexpected one, can be harmful for an elderly person. So the decision by Bield Housing and Care to close all 12 of its residential homes for older people in Scotland is serious and significant.
The company doesn’t shy away from this. Its chief executive Brian Logan says the decision was very difficult and a last resort. Bield insists it will work to minimise the impact on around 160 residents and help them make alternative arrangements.
It is nevertheless depressing to see the company writing to the people living in its homes to tell them they cannot remain open because they are too large and too high quality. “Quality is only one aspect of a service,” the charity says. Councils facing funding deficits can no longer afford to pay more for a better service, so homes have been losing money.
Many care homes – not just Bield’s – subsidise places paid for by local authorities with higher fees for those who self-fund. This practice in itself is dubious in terms of fairness.
But providers also face rising costs on a number of fronts that they can’t control. These range from improvements demanded by care inspectors, to the Scottish Government’s care worker living wage, to the cost of catering to a population which is increasingly in need of more expensive health care and support. That is on top of rising food and fuel costs.
A national agreement sets the amount councils will pay for those who need care but who cannot fund themselves. Industry bodies have said for some time this amount is not enough. They want to provide quality services, they just can’t do it for what councils are able to pay.
Bield’s decision is significant not just for its own staff and residents, however. It is unlikely to be the last care firm to take this route. Should others in the private or third sectors follow Bield’s lead – and there is already talk that more may do so– the public sector will increasingly be left with those needing the most care.
For years councils have secured care on the cheap, while the model for tendering care out has delivered a sector with a low-paid workforce, in insecure employment, and employers who have difficulty funding extras such as dementia training. Yet this is not a situation where we can simply blame the charity, or even hard-pressed local councils. The reason councils are paying so little for care is because we have not yet faced up as a society to what caring for an increasing elderly population will cost.
The recent UK General Election showed the electorate’s hostility to the idea that people should be required to fund their own care through the sale of their own homes. If that option is off the table, older people and their families will need to consider other ways in which to plan and fund for the future in case they fall ill or need care.
Expecting the state to fill the gap is not realistic, at least if we want care which is high quality, individualised, and modern.