Crisis In Care: Follow The Money. Panorama, Tonight 7.30pm.

[Victor Meldrew]

I'm pretty sure there is significant overcharging. My dad was paying £1150 a week for his 'care' three years ago.

 

He had Alzheimers so we didn't really have a lot of places to choose from at the time and, after visiting lots of homes over a wide area, we were incredibly relieved to find him a place in a CareUK home in his home town. Up until having a small stroke he'd been at home but had spent many weeks in Stepping Hill Hospital getting poor care from the NHS and they were putting a lot of pressure on us to remove him. My step-mum wanted to try to look after him at home but we all agreed she could no longer really cope with his unpredictable behaviour and and he really needed specialist care.

 

The problem is you walk into these arrangements full of hope and, dare I say, desperation. You've no real idea what it'll be like for them and what 'care' your loved on will get.  So you believe everything they tell you. It doesn't take long for the penny to drop though. Literally. Because they had some savings and owned their small house he was charged the full whack, which we soon came to realise was subsidising the majority of the other residents whose finances were below the limit. Many of these 'poorer' residents had much better rooms and were treated more favourably because their 'impediments' were less pronounced making them nicer to be around.

 

They tried to present a 'caring' facade whenever we visited but when you consistently find loads of dirt under his very long finger nails and his teeth never having been cleaned and him wearing odd socks and someone else's jumper you soon realise he's not getting well looked after. They didn't even have their own kitchens but simply heated up pre-packed delivered meals of which there was limited choice. We used to take him sandwiches and cake in and he wolfed them down.

 

Virtually all the residents were over 70 and yet the loud radio in the lounge was constantly tuned to a pop station because that's what the carers wanted to listen to. We used to remove him from the main lounge and take him into a small room where we had a picnic and played him his classical music. He was so grateful.

 

The problem is you can't complain in case it backfires onto them and makes their care even worse. I still feel guilty and have nightmares about how he was treated when we weren't there. You really have to live through this scenario before you can make any informed judgement of the care system.  I just hope I die before I get to that stage!

 

 

[ECCOnoob]

So just doing a fag packet breakdown of the two examples provided above.  Carbuncle refers to the Alzheimer's patient who required 24/7 care for around 3 years which gave just under half a million pounds before the money ran out.

 

That broke down to a charge of around £9.80 per hour for their care. Is it really so outrageous? Compare it to the national minimum wage rate let alone costs accommodation, food and supplies.

 

In the second example from Victor Meldrew that so called 'overcharging' of £1150 per week breaks down to just under £165 per day.  Taking a step back, and thinking about what exactly that needs to cover, is it really so outrageous?   Of course we know the company is making profit,  they are after all a business. But what exactly is that profit margin and just how 'unreasonable' is it.  What sort of comparatives are applied by the man and women in the street in their 'outrage'  and is it realistic    After all one cannot simply Premier Inn charges X so why do we have to pay Y for a care home.   

 

Perceptions and the harsh reality are very different.  Goes well beyond the just looking at the cumulative totals without context.  It's easy to say or feel or think the rates are too high but persuasively demonstrating that it is a wholly different thing.

[Carbuncle]

16 minutes ago, ECCOnoob said:

So just doing a fag packet breakdown of the two examples provided above.  Carbuncle refers to the Alzheimer's patient who required 24/7 care for around 3 years which gave just under half a million pounds before the money ran out.

 

That broke down to a charge of around £9.80 per hour for their care. Is it really so outrageous? Compare it to the national minimum wage rate let alone costs accommodation, food and supplies.

I don't think it is outrageous ... although I did say just over rather than under half a million (because I could not remember the exact number given).

[Anna B]

2 hours ago, Carbuncle said:

Sorry, I managed to leave out the word 'didn't' in my last post. I do not think we are in agreement. I would like to know whether widespread overcharging is occurring. It's plausible but I did not know before watching the programme and do not know now.

Of course overcharging is happening. You pay an average of £900 per person per week for a place, some places charge extra on top for housekeeping. That's getting on for £4,000 a month per person. or 48,000 per year (For comparison a relative caring for a loved one in their own home 24/7, (which may have required them to give up a good job,) get a paltry £60 a week carers  allowance - which also reduces the loved one's benefits...) 

 

In the care home, the facilities aren't great, the care isn't great, the food isn't great, certainly not good enough to warrant those sorts of costs.  

 

The hard working care workers, who do the lion's share of the work and on whom the happiness of the clients depend, are on minimum wage, and there are usually not enough of them, to go round to allow them enough time to spend with their clients to  give real job satisfaction. There's also a manager and usually a nurse too, and that's it. Food is often bought in rather than cooked on the premises, similar to school meals, and probably don't cost much more.

 

That's a broad generalisation on an average home for an average cost. Some are better, some worse.  

£4,000 a month worth?  Value for money? I don't think so.  As the programme pointed out. 

 

The council pay about £450 towards the cost, the rest has to be paid for by the client, or their fammily, which often necessitates them selling their home to pay for it. The average stay in a care home is 4 years, enough to wipe out the entire life times savings and value of the client's home.  

 

[Anna B]

43 minutes ago, Carbuncle said:

I don't think it is outrageous ... although I did say just over rather than under half a million (because I could not remember the exact number given).

It was actually just over half a million. 

[Carbuncle]

2 hours ago, Anna B said:

Of course overcharging is happening. You pay an average of £900 per person per week for a place, some places charge extra on top for housekeeping. That's getting on for £4,000 a month per person. or 48,000 per year (For comparison a relative caring for a loved one in their own home 24/7, (which may have required them to give up a good job,) get a paltry £60 a week carers  allowance - which also reduces the loved one's benefits...) 

 

In the care home, the facilities aren't great, the care isn't great, the food isn't great, certainly not good enough to warrant those sorts of costs.  

 

The hard working care workers, who do the lion's share of the work and on whom the happiness of the clients depend, are on minimum wage, and there are usually not enough of them, to go round to allow them enough time to spend with their clients to  give real job satisfaction. There's also a manager and usually a nurse too, and that's it. Food is often bought in rather than cooked on the premises, similar to school meals, and probably don't cost much more.

 

That's a broad generalisation on an average home for an average cost. Some are better, some worse.  

£4,000 a month worth?  Value for money? I don't think so.  As the programme pointed out. 

 

The council pay about £450 towards the cost, the rest has to be paid for by the client, or their fammily, which often necessitates them selling their home to pay for it. The average stay in a care home is 4 years, enough to wipe out the entire life times savings and value of the client's home.  

I found this: https://www.payingforcare.org/how-much-does-care-cost/ which seems to be quoting what looks like a reliable source - the reliable source itself is expensive to access. As you say the average UK cost for nursing care in a care home is about £900 per week. I am struggling to know whether that is a lot or a little because the amount of care needed will vary hugely.

 

Do you have any way of getting at what £900 per week buys? I am interested but looking for something which is not built out of anecdotes. It's probably a hard question.

[harvey19]

12 hours ago, Annie Bynnol said:

There are many types of 'care home' with a wide range of provision.

Most do not support residents that need nursing care.

Most do not admit people with dementia.

Some people are more 'dependent' on support than others.

We seem focused on older people and forget about adults with health and learning disabilities.

Most people in care homes are not ill, they are older, they are require little or no health care beyond what would be needed in a home of their own.

 

At what point should the needs of an individual be met by taxation? Who decides? How?

Should a young family finding it difficult to make ends meet have to pay(through NI etc) for people to live in a home?

The job of the NHS is to help people who are ill and do through a CHP(needs to be a lot better).

Why should people who choose to live in a 'care home' have everything paid for by those who choose not to? 

 

Not planning ahead for the possible outcomes of your own old age is very foolish indeed.

The idea of NHS operated care homes is frightening, not because of the what they could provide but what the Government would allow the NHS to provide.

 

 

 

 

 

 

 

 

Where there is a will there is a way.

[Anna B]

84% of beds come under the umbrella of just 3 parent companies: HC One, mentioned in the programme, Care UK, also mentioned, and H/2 Capital, (Four Seasons now newly aquired) by a USA based Hedge fund, (the other two are Private Equity firms.) All three are based in the Cayman Islands and pay no tax.  

 

Those three Companies are the parent company of some 5,500 subsidury companies such as Cygnet, Bupa and Barchester Healthcare etc. and they in turn have several separate healthcare branches including homes offering different services. So while there may seem to be competition and choice, they in fact are able to operate a cartel setting a price that people have no choice but to pay. They are also difficult to pin down, each able to hide behind each other another.

 

It isn't that no one can be bothered to untangle this web, it's designed that way quite deliberately so no one can untangle it. It's the modus operandi of many large corporate companies in order to reduce liabilities, negate responsibilities and avoid tax.

They are in it purely and simply to make money by any means, nothing else matters but profits. And we have no recourse but to pay it, with no voice and little alternative should things go wrong. 

I doubt it even registers with these masters of the universe that at the very bottom of the pyramid are the lives of some of our most vulnerable and. frail elderly people.

[Chekhov]

The present crisis in care has been far exacerbated by the requirement for all care home staff to be vaccinated, if you do not believe me ask anyone (particularly any manager desperately trying to find staff) in the business.

The fact the staff have to wear masks all day is another contributory factor, who would want to do that ?

I will leave the argument about whether any of this is needed (considering all care home residents are vaccinated, probably triple vaccinated by now) and just concentrate on the staff shortage point.

A close friend of mine works for the NHS in Sheffield and has been telling me for months the NHS in our area IS coming under pressure to the extent that staff are being redeployed, but one of the main reasons is that so many beds are blocked with older people who they cannot sort care packages for.

Brexit has also had an effect, getting staff from abroad is more problematic now.

 

Covid jab rule could deepen care home staffing crisis  ["could", who are they kidding ! ]

https://www.bbc.co.uk/news/health-59234880

 

Social care crisis: Woman, 92, waited four months to be discharged

https://www.bbc.co.uk/news/uk-wales-59010673

 

It was all totally predictable, at least to anyone with half a brain.

Edited December 8, 2021 by Chekhov

[Anna B]

15 hours ago, Carbuncle said:

I found this: https://www.payingforcare.org/how-much-does-care-cost/ which seems to be quoting what looks like a reliable source - the reliable source itself is expensive to access. As you say the average UK cost for nursing care in a care home is about £900 per week. I am struggling to know whether that is a lot or a little because the amount of care needed will vary hugely.

 

Do you have any way of getting at what £900 per week buys? I am interested but looking for something which is not built out of anecdotes. It's probably a hard question.

In my experience what care homes say they offer, and what they actually offer differ widely, so anecdotal evidence is what your left with. It also differs widely from home to home. A lot depends on the calibre and dedication of the staff which also varies, and a glossy brochure is nothing to go on. The surface appearance might look good (and pleasant surroundings are important,) but may hide a multitude of sins, also the cost may well be higher than the £900.

Personal reccommendation is important, and  anecdotal evidence matters, but bearing in mind that people are outspoken when things go wrong but less so when things are going well. 

 

Edited December 8, 2021 by Anna B