Clo­sures chal­lenge us all over cost of care for the el­derly

The Herald - - FRONT PAGE -

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.

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