By Dennis Moore
A new report by the Citizens Advice Bureau (CAB) charity highlights the plight of many of the 433,000 elderly people in the UK living in care homes. In total, some four million older people—nearly half the over-65 population—require some form of care.
CAB carried out a mystery shopping exercise of 404 care homes across England, between November 4 and November 18 last year, utilising data and insights obtained from the CAB and another agency. The purpose of the study was to try to ascertain whether care home providers were taking advantage of their clients.
Elderly care is a growing industry in the UK, with many people living longer and requiring more complex provision. The number of people aged 85 or above is set to double in the next 20 years. At present one in six people over the age of 85 lives in a care home. Recent research predicts that there will be a 15 percent increase in demand for residential care between 2015 and 2020.
The UK elderly care market is estimated to be worth £15.9 billion, with £12.1 billion taken by for-profit providers. There are 17,000 care homes in England and approximately 80 percent are for profit, with most of the rest run by voluntary, charitable organisations, and only a small number still run by the local authority. The majority of older people in care homes have to pay something toward their costs, with nearly 41 percent paying for their costs in full.
Many care home residents are vulnerable due to mental health problems and often suffer with dementia. It is difficult for someone to be able to know what their rights are in such a state.
The CAB supported nearly 27,000 advice queries regarding social care last year, a rise of 7 percent on the previous year. The number of queries concerning residential care increased by 12 percent over the same period.
The report pointed to the short notice period in which many elderly people are informed of fee increases. Nearly one in 10 care homes give only a week’s notice – possibly affecting 22,000 older people. Two thirds of care homes give four weeks’ notice or less. Just 18 percent give up to a year’s notice. The short notice period does not allow time for a resident to query the increase and challenge its legitimacy. This leaves the resident with very little choice but to accept the increase.
Fees rose on average by £900 last year, an increase of 2.7 percent, while in the East of England residential care home fees rose on average by £2,184, an increase of 6.8 percent. Failure to arrange for fee increases can mean the resident being forced to move. This process is often distressing and can exacerbate existing health problems.
Almost all (96 percent) care homes do not pass on savings to residents when they were away from the home for as long as four weeks. While care homes have constant running costs, variable costs such as, food, electricity and laundry costs are avoided when a resident is absent.
The elderly face other massive expenses. It can be difficult for costs of chiropody and carer support to be ascertained before moving into a home. In the case of having to attend hospital on a weekly basis, requiring two hours of care provider time, this could end up costing the resident up to £5,200 a year.
The CAB reported that it has had to assist residents who have received unexpected phone bills of £1,000 and unspecified entertainment charges.
The payment of care fees has been a contentious issue for many elderly people and their families who feel the system is unfair. In 2014, the Daily Mail reported that between 30,000-40,000 people had to sell their homes to be able to pay for their residential care costs. This worked out at 100 elderly people a week having their homes seized because local councils refused to pay.
In the decade from 2004 to 2014, state funding for care of the elderly plunged by a third from £8.1 billion to £5.4 billion. This cut of over £3 billion has meant the loss of thousands of jobs and front-line services being cut back to a minimum.
Due to strict eligibility criteria, only 850,000 of the elderly who require care services qualify for state help. Many elderly people are forced to hand over their entire life savings and assets to pay for their care.
One in 10 who enter the care system end up paying over £100,000 in fees. This state-sanctioned robbery is set to continue. Last year the government delayed the introduction of its still expensive cap of £72,000 on the amount residents can be charged for care homes. This was scheduled to be in place by 2020.
There is much evidence that cuts to services for those over 65 are leading to mounting pressure on the National Health Service, with over 400,000 extra elderly individuals subject to emergency admissions to hospital.
For hundreds of thousands of pensioners living outside of care homes, the situation is no better. A survey, using the Freedom of Information law, found that last year three quarters of councils in the UK had commissioned care visits of just 15 minutes. The visits by nursing staff were so brief and rushed that nursing staff did not have the time to speak to the people they were visiting, and care givers would not even have the time to take someone to the toilet, or help them to wash. For many elderly people, such visits could be the only human contact they have in a week.
The Local Government Association, representing 370 local authorities across England and Wales, warns that due to funding cuts home care for the elderly in some of the poorest areas of the country will have to be scrapped or only provided for those in the most desperate need.
Local authorities are now allowed to raise revenue via increases in Council Tax of 2 percent, as long as the money is spent on social care. This will benefit more affluent areas of the country disproportionately, as property prices are higher, leaving poorer areas with less money. It places the cost of care on the local population, while rationing services for the most needy.
The elderly are seen as consumers of services in a market, like any other consumer who purchases a product. It speaks volumes about the failure of capitalism that elderly people, who have worked all their lives and contributed through their taxes to the building up of the National Health Service, are robbed of everything they have to pay for care.
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