Forum Topic

Social Care

Having seen the system close up for older people’s social care, I was astounded by a story on the news tonight of someone paying £7,000 per month for care.  Alongside the proposals for raising more money, I would like to see charges investigated and more accountability of where the money is being spent.  Carehomes should be opened up to the Freedom of Information Act.

Martine Guy ● 1379d50 Comments

"10%!!!!!  I thought it was 1.5%!!!!"As with all percentages it depends what the denominator is.There is an additional 1.25 percentage point rise in National Insurance. Although the current true rate is not 12% because it doesn't start at 0!So that is misleading too!"12% of your earnings between £9,568 and £50,270. You'll pay 2% on any earnings above £50,270."

Ed Robinson ● 1377d

10%!!!!!  I thought it was 1.5%!!!!But it would have been fairer to increase the 2% for people earning over nearly £5000 per week and not the 12% of those below it.

Ivonne Holliday ● 1377d

Hello Ivonne :)I didn't say 'owning a house means you are incredibly wealthy' either, i'm just saying that the property price rises are unearned income.I'm not saying all the money in a house needs to be used, I totally agree that this would be unfair, i'm just saying a percentage. You have an advantage that likely the majority of young people will never have and yet they have been slapped with a 10% increase in NI to pay for the care of the elderly. Hardly sounds fair to me.Also, I rent.

Matt Palmer ● 1377d

Hello Matt,No, you did not and I apologise for this.  But you did agree with a post that did...  My mistake!!  I am sorry!!But bricks and mortar have always been a very good investment!  We moved into our house in 2001 and have just finished paying the mortgage we took out over 20 years; we both worked and worked hard to achieve this.  The value of our house is not near £1million (but there are houses on Roehampton Gate being sold at £10m!)So, I do resent people saying that, because you own a house, you are incredibly wealthy.  Tell me the price band of your house and then we shall see. And yes, I would love to leave an inheritance to our son. Anything wrong with that?  Perhaps that is the way he will get on the housing ladder?I wholeheartedly hope I will not need a care home in my old age.  One point I wish to make is that my husband's daughter from his first marriage has just bought herself a house in Cornwall.  She is a nurse and used to be a care worker.  When she finishes paying her mortgage in 20 odd years time, does she really have to pay for her old age care?

Ivonne Holliday ● 1377d

I never said anything about 1 million pound houses, i'm just saying the value in a house is unearned. People who are coming to the point of needing care now benefitted from extremely low house prices and then subsequent huge price rises. Why shouldnt some of that unearned income be used to finance their care?This is something that todays young people will unlikely ever be able to do, my 12 year old son will be a lifelong renter i imagine.

Matt Palmer ● 1377d

Yes, although almost any small business will do so as Amazon basically don't pay any tax at all.

Matt Palmer ● 1377d

Ooops!!  Forgot about this.  Did you mentioned you paid more corporation tax than Amazon?

Ivonne Holliday ● 1377d

Hello Matt,I think the triple lock has been delayed for a year?Also, the reason why the triple lock came into existence was that pensioners were complaining to Cameron, when seeking votes for premiership, that they could not survive on £57 per week.It is also true that, for many pensioners, the "nest egg" is in the value of their property and nothing else. And to think that all pensioners own properties of £1+ million is really ridiculous!Of course the young must be helped but pensioners should not be penalized for it.  There are an enormous amount of incredibly rich people that avoid (evade?) paying tax.  The name Rees-Mogg comes to mind, do not know why.....

Ivonne Holliday ● 1377d

Fully agree. There's no doubt people need help and a bit of tax is a reasonable way to do it.However you are talking about people who benefited greatly in the house price boom(s) and that extra value is unearned wealth. Surely its reasonable that a proportion of that is used to pay.Pensioners already get a really good deal with the triple lock etc, it's about time the young got some help.

Matt Palmer ● 1377d

When we were looking at carehomes for a permanent place, I did wonder if some homes preferred council funded clients.  One home was very basic in another Borough, and we turned it down.  The other two we saw were actually very nicely decorated and clean, and on appearance you couldn’t fault them.  The one I liked the best turned us down unfortunately.  
When we first used respite about 10 years ago, the home we were offered was the absolutely wonderful Viera Gray House in Barnes.  This was the best carehome I saw anywhere.  However the funding changed and Wandsworth Council stopped using it.  After that the respite homes we were offered were never in the same league. If Barnes Hospital had still been in use, it would have been available for respite.

Martine Guy ● 1377d

IvonneYes they all do deserve looking after in old age, if they require it. And indeed they are. The council has a legal obligation to do so. However, it's funds are limited and the rates which councils are prepared to pay for care are at the low end. Thus council-funded homes are, on average,not so nicce as privately funded ones (there are homes which have a mix of both council-funded and private "customers") so the position is a little complicated.This is really the point I was getting at - if we are all being asked to pay a bit more tax so that those in council-funded care beds have a better quality of life, I'm all for that, but if the extra tax is going to go on helping people keep 90% of the value of their £1m houses to leave to their children, I am not so keen on the idea.

Michael Winstanley ● 1377d

Councils don't fund the home, they fund the individual. If someone needs to go into a home and has no income or assets, the council has to pay for them. There is a set rate which the council is prepared to pay and there are homes specialising in council-funded "customers". They tend to be cheaper and lower quality as cash-strapped councils are unable to spend tax-payers' money on frills.

Michael Winstanley ● 1377d

Thanks for these replies, Philippa.  
Throwing money at the care system isn’t going to fix it.  The Government has to start talking to families.  Why are the care home providers complaining about a crisis when they are being given mega amounts of money?  (Don’t know why the underlining happened!) It isn’t just care homes in crisis, I really didn’t like dealing with Social Services, it was so stressful at times.  E.g. Going on holiday to France, I asked Wandsworth Social Services to organise respite care for us.  With about 2 weeks to go, nothing had been done.  I said but it’s urgent, we are going abroad.  The person in social services came up with a home on the other side of Richmond and we went to see if it was suitable.  Social services knew my mother smoked but the first thing the home told us when we got there was it was non-smoking.  My children were very young at that point and it was so stressful to have this wasted journey.  We got very close to our departure date before a suitable care homes was found.  This situation was so awful, the phone calls, the time wasted, plus still caring for my mum.  The care situation is dire, it really is.

Martine Guy ● 1377d

NI increase will presumably cost lower paid workers as well as their employers. Will this lead to more workers in the gig economy?  More fragmentation of systems?  Unions grew up to stand up for poorly paid and exploited workers.  Perhaps they then or some of them then became too powerful but it is a shame that they were necessary in the first place.  I've often wondered if workers are now kept overworked and poorly paid so that they can't afford union dues.

Philippa Bond ● 1377d

The value of friends who will sit in and allow you to go out and do something eg have a flu jab cannot be overestimated!  I understand that sometimes members of the Salvation Army do this.

Philippa Bond ● 1377d

So completely agree.  I cannot tell you how tired I became.  When someone naps several times during the day then they can stay awake for longer in the evening and don't want to go to bed when the carer arrives!  So we had to compromise if I was there but even so I had been up since first thing to let the morning carer in.  If I'd have been on my own it would have been much tougher.  With my mother I remember finding her in the sitting room dressed when I got up and I think she had two breakfasts that day.We used the care home while building works were carried out and for respite and paid but it was a major event getting ready and going there.  Once they had closed when we were due to use it because if they have more than a couple of people ill with something they close to visitors and new people.Many (most?) councils no longer offer respite care.

Philippa Bond ● 1377d

Martine  Maybe you've not heard about this?I had problems getting in touch with a friend of FIL who was in a care home.  We had seen him fairly recently with his family but he moved homes and although he had told us where he was going it was impossible.  I had the Data Protection Act quoted as the reason why we couldn't speak to him, why they couldn't give him a message and why they couldn't ask his family about.  This was misuse of the Data Protection Act and I'm afraid I did not follow up.  (BTW the friend was OK.)When you are in your late 90s you don't have as may old friends as you used to so it was wonderful to have chats but neither of them was very good with phones.  Neither FIL or MIL ever got to grips with a mobile although we tried.  Getting in touch with people in care homes can be difficult. Although we were told we could have a phone when there (we were used to speaking each evening) we were later told there weren't enough lines.  The only portable phone was also used for calling ambulances and ordering medication. Of course we did not want to interfere with this.  However they were very good and welcoming where family and visitors were concerned and they did try with entertainment although I know it was quite difficult to encourage people to leave their rooms sometimes.  Nowadays everyone has their own TV in their rooms. Being blind FIL wanted people to talk to. There was better chat around the table at mealtimes (so something to be allowed to linger over) than in the sitting room.

Philippa Bond ● 1377d

I think that one thing that would really help people stay in their own homes and give a break to carers, is more respite care.  As I said above, there needs to be a complete re-think of the social care system.  We found the cost of respite care was pretty expensive, but it was much needed, especially when we were going on holiday.  
I want to see carehomes built and run by the state.  We need hospitals for the elderly, parts of which could be used for respite.  I am not suggesting respite care would be free, and we would definitely have paid for it, but more available and easier to obtain respite would allow people to live in their own homes for longer.

Martine Guy ● 1377d

There was an excellent letter to The Editor in The Times yesterday from a GP in Devon “Care for the Elderly”.  She calls for a reimagining of hospital care and for the building of hospitals dedicated to elderly care.  “Many elderly patients receive unnecessary scans, surgery and other extortionate treatments in our hospitals, when all they really needed was space, time, nursing and compassion.  Totally 100% agree with this. (We did once have a fantastic hospital for older people with mental health problems and that was Barnes Hospital.  I think it has never completely closed but Richmond Council want to build houses on the site.  If anyone know what happened to Barnes Hospital, please let me know, I can’t understand what’s going on. The Care system doesn’t just need money, it needs a complete overhaul, a new beginning. 

Martine Guy ● 1377d

My biggest client is a company that runs private care homes, i know they are having horrific staffing issues at the moment. Primarily down to two factors1) Brexit and immigration rules changes - like it or not the fact is that a lot of care workers are foreign and have gone home or simply cannot come here.2) mandatory vaccination - a lot of staff are walking off the job over the rule about vaccines. Not helped by the fact that the same rule doesnt cover all NHS workers, so they can easily go get a job there.

Matt Palmer ● 1377d

How so?  The system we have doesn't work.  The Scandinavians have a brilliant system but high taxes.  I think I once read about Denmark? I definitely don't think that US systems are the way forward for many things.  We shouldn't all have to worry about it and we would spend more savings if we had them and not be so worried about old age care if we knew that we would not have to suffer some of the terrible conditions that we hear about.  NI is a ridiculous tax anyway as it is not ringfenced it just goes into general taxation.  Some people are working but not paying NI because of the cut off at the old retirement age.  Many women haven't paid enough in because caring responsibilities (of the young, old and ill) have interrupted their working lives and Govt failed (and it was ruled so) that they were not adequately informed or informed at all of a change in retirement age.  It was a will it/won't it situation for ages.  It would be sensible if there was a more flexible way of paying NI and if it was used in the way it was perhaps originally intended.  It is also ridiculous that there are those who are well off who can afford to and will avoid taxes that everyone else has to pay.  Everybody should be paying something.  Perhaps like some other countries what everybody pays should be more transparent?

Philippa Bond ● 1378d

Philippa, you have misread my message.

Ivonne Holliday ● 1378d

Every so often we hear a little about better systems.  I wish we could hear more.  Nobody realises how bad it can be unless they have experienced it for themselves.

Philippa Bond ● 1378d

https://chpi.org.uk/papers/reports/plugging-the-leaks-in-the-uk-care-home-industry/

Philippa Bond ● 1378d

Hello Michael W,I have not experienced caring for somebody with dementia but friends here and family abroad have.  It is depressing, distressing as well as exhausting.  Particularly so if you do not have much guidance on "best practices".Personally, I would prefer a Scandinavian style of care than the American one.  Yes, the Scandinavians pay enormous amounts in taxes (eye-wateringly so?) but the services they get are amazing. As you say, social care needs proper funding.  Privatising it, in part or totally, is not the answer. I am not left-wing by any stretch of the imagination.  But I believe, very strongly, in fairness.  There are a myriad of jobs that do not pay very well, particularly in the last decade or so.  What about nurses, teachers, emergency services personnel, armed forces even road sweepers and rubbish collectors, to name but a few though representative jobs, do they not deserve looking after in old age? 

Ivonne Holliday ● 1378d

Just some additional points to note:Some homes only take those paying for care privately so if you run out of money you will need to move to a care home your council has a contract with.It is possible to by an annuity, usually are two years fees  that is a lump sum payment and the care home fees are paid until death. ((Apparently the majority of people die in under two years in a care home, my mother died after almost exactly two years in one.)Some councils will, if their social services deem one should go into a care home, will pay the fees and then recharge the person in care. One still pays but you pay the cheaper council rate rather than the private rate.

Michael Ixer ● 1378d

I remember council care homes being privatised and sold off to buyers from abroad and then asset stripped because the land is worth more than the businesses (especially if you run down the businesses).It must be quite difficult to organise redecoration of single rooms at a time before a new occupant takes residence.Just as in hospitals and in the home-care sectors there tends to be a shortage of staff.  Looking after people who need two people at the same time to help them and turn them so that they don't get bed sores or to help them have a bath or shower is labour intensive and so expensive.  Elderly and less mobile people do not like to be and shouldn't be hurried along - so require more time.  Despite all the en suite bathrooms advertised your loved one may not get that bath or shower because of a staff shortage. (This aspect still haunts me as it was a selling point and yet it never happened in our case.)The number of qualified nurses is very low and many carers may not have had a lot if any training.  I believe it has to be a qualified nurse who has to be in charge and who doles out the medication - which nowadays can be very complicated.  I was surprised at how quickly the ambulance service was called for if there was a problem.I read the other day that carers were going to work for Amazon rather than work in the care sector - and I thought that their rates of pay weren't good.Please visit your friends and relations if you can!  A good care home welcomes visitors to their residents and it also means that they have more time to talk to those who have no visitors.https://www.theguardian.com/society/2021/mar/01/hc-one-uk-largest-care-home-provider-sell-off-52-covid-crisis-threatens-viability

Philippa Bond ● 1378d

Thanks, Barbara. The situation you are describing is what we have mentioned above.  If you have to go into full time care, then the local authority takes into account all your savings including the value of your home.  Anything in excess of about £25,000 is used to pay for care.  For example if your savings and value of your home comes to £300,000, then the local authority can use £275,000 to pay for the cost of care.  With the yearly cost of care from about £50,000 upwards, it will take about 5-6 years to use up £275,000. If you have savings under the approx £25,000 and don’t have a home to sell, you pay nothing.  As I understand it, some benefits stop when you go into care, but I can’t remember which.  
Some people can still keep their homes and savings and don’t have to pay for care.  These are people who qualify for NHS Continuing Care or who are Sectioned under the Mental Health Act.  It is incredibly difficult to get help under NHS Continuing Care.

Martine Guy ● 1378d

Yes Andy it is, but I did read if you have paid so much and your left with a certain amount of money then the Government take over. My cousin and her husband paid thousands in a car home in Bournemouth, her husband died, then they had to speak to Social services who then take over the payments. But what I have also only found out last week, they take all her pension and she is only left with £50 for herself a month. So how do they buy clothes etc. This is disgusting. I hope Martine gets the answers she wants. Try writing to the House of Commons SW1.

Barbara Stevens ● 1378d

Lyle court is private sector as far as I can see  not Council run

Andy Pike ● 1378d

What I want to know is if taxation/N.I. increases to fund social care, how exactly is the extra money going to be spent in the system?  Is the money going to go straight into the hands of the carehome owners without any accountability.  Why isn’t the Labour Party questioning where and how the mega amounts of money are being spent in social care?

Martine Guy ● 1378d

Is Lyle House, Arabella Drive, on the Lennox Upper Richmond Road. I think you have to pay, until you can't pay anymore. Only read a bit. You can read on the site if this helps.

Barbara Stevens ● 1378d

Michael,are you confusing council owned sheltered accommodation with carehomes?  If you know a council owned carehome in Wandsworth, please can you name it? Personally, I would like to go into sheltered accommodation when the time comes that I can’t manage in my own home anymore.

Martine Guy ● 1379d

If carehomes are under state ownership, they will presumably have to have minimum standards and I think the Freedom of Information Act also applies in the state sector.   I am very concerned about the standard of social care received by older people, but let’s not forget children in the social care system too.   I think many people are willing to contribute to their own care, what they do not want is complete financial wipeout, after a lifetime of hard work to buy a modest family home.

Martine Guy ● 1379d

This does seem low. There is a conflict between a desire for people to be able to pass on to heirs what they have saved and a desire that people pay their way. The average UK house now costs £250k. If the £25k went up a bit, what of it? Maybe it does no harm. Bear in mind that a lot of oap's don't have a house, don't have £25k and live from week to week on their pensions. I'm far more concerned about the quality of social care they receive (currently really poor) than whether someone can leave £25k or £50k to their heirs.As regards nationalising the care home network, this rather goes against current trends in the UK, but services can either be publicly owned or privately owned and competitive - there is the perennial argument over transport services. It tends to be the regulation which is more important than the ownership, but if you are a staunch socialist, it is a point of view. After all, the NHS is publicly owned, though many of the services it provides come from private companies. If the care sector were "nationalised", it is most likely that the homes themselves would be contracted out to save money. Now I'm often (wrongly) accused of being a socialist - but that's my opinion for what it is worth.

Michael Winstanley ● 1379d

I don’t understand your point about council funded accommodation.  Do you mean there are council funded  carehomes in Wandsworth, if so please name one?

Martine Guy ● 1379d

Caring for a demented relative is a tough call. My remarks about looking after your own were aimed more particularly at older relatives still with their mental faculties. Nonetheless, I have dealt with a demented relative and actually found that until the later stages they could be looked after in their own home - indeed a profound change of surroundings accentuates the decline and should be avoided until it is unavoidable.The concept of "subsidising others" is really most apposite; either one pays for one's own care or others do. I'm very much of the view that someone should pay for their own. In later life, there isn't much reason for them to do otherwise - this is the only rainy day which is going to come. Private payers are charged more than those in council funded accommodation because the latter are not so nice. In fact they are really dire. That is why social care needs proper funding. I am worried about a confusion of objectives. Is the plan to make council-funded care less dire? Or is it to help people afford privately funded care funds whilst not paying the full cost and leaving their homes to their heirs.

Michael Winstanley ● 1379d

Ed, thank you. Talking to friends recently, one of whom is an ex-NHS worker, they said they thought the aim of the system is to put the elderly into private carehomes— the private carehomes are businesses.  The carehomes can operate how they like, imo. there is no check on how the money is spent. Where is the Labour Party on this?  Why aren’t they suggesting state run carehomes?

Martine Guy ● 1379d

Martine,This article is interesting and highlights your points:THE HIDDEN PROFITS BEHIND COLLAPSING CARE HOMEShttps://chpi.org.uk/blog/the-hidden-profits-behind-collapsing-care-homes/Can I suggest a radical proposal - that people try and spend and use up their assets while they can still enjoy them to the full while they can?

Ed Robinson ● 1379d

Lucille, I agree with you on this. If someone is really wealthy, they will usually have made provision some time in advance to protect their money.  The people who are hurting are the ones who own modest homes that they have worked hard all their lives to buy.  They will be left with about £25,000 after their home has been sold to pay for care.  I think that this limit is set too low, and needs to be raised to around £100,000.

Martine Guy ● 1379d

I haven't much of a clue what Labour's view is. From what I have seen in the papers, the Tories want to fund it from National Insurance - this is utterly ridiculous; potential beneficiaries like me pay no national insurance since we are not working. So from retirement age to 85 or whatever, when we have few outgoings - mortgage paid off and children long gone - we would pay nothing and reap the benefit. Younger, working people would pay.The Labour Party are muttering that there should be a wealth tax. Fine in principle - but wealth taxes are much harder to make fair and much more expensive to collect.I focus though on who  is to benefit from this new social care plan rather than who pays and both parties are at present very coy about this. If it is to be people who own substantial property wealth being let off the hook, then (a) that would be totally iniquitous; and (b) just let me show you where to send the cheque.Cats and dogs - you are not wrong. Nor donkeys!

Michael Winstanley ● 1379d

Have you looked after a close relative with dementia Michael? I wouldn't ask my nearest and dearest to do that for me. So a home it  will have to be but i resent that I am expected to subsidise others because I happen to own a home. Any money from selling it won't last long and will last even less because as a private payer I will be charged more than the council payee.

Lucille Grant ● 1379d

I did look after my mother for some time, and I have seen the social care system close up, whether it be full time care, respite care and day care.  Tonight on the news, I heard a care home owner say the system is about to explode.  Why is it?  Why isn’t £1,000 a week enough for basic needs, where is the money going?  Why isn’t the care system open to intense scrutiny? My view is nationalise the care homes. Make it a National Care System with every care home having to meet basic standards.  If people want private care, that will be their choice, like those who choose for private medical care. If you increase tax/N.I. and then just chuck the money at the private care homes, they will put up their fees, but I bet you won’t see an improvement in standards of care.

Martine Guy ● 1379d

"Tory party are going to offer, I will bite their hand off and the poor can go hang."I assume you will not be leaving your inheritance to a cat or dog charity? :)You are quite right Michael, our taxes are gradually by design or accident becoming more regressive.The strange thing is there doesn't appear to be any left voices on this. The voices I have heard against it for the reasons you out line have all been on the right. I guess Labour do not want to upset older house owners that increasing do not vote for them ???

Ed Robinson ● 1379d

You could do it yourself and look after your own elderly relatives. That is the practice in many other countries.Pay someone else to do it and it is expensive. Try to stay full-time in a budget hotel, without any personal care needs, and eat 3 meals a day - see what that costs.It is no surprise to me that a person with complex needs can cost £7k per month to look after. Indeed, the cost of caring for anyone with profound disabilities far exceeds this.I reallydo not understand what the target is for any new social care plan which the Tory government is threatening us with. If it is that those people requiring social care who aren't at present receiving adequate care because of inadequate budgets and some of us have to pay more tax to pay for it I'm all for it.If it is that people who own valuable houses should be able to keep them and leave them to their heirs whilst people without such houses (or with houses but with big mortgages) should have to pay extra taxes so that the aforementioned don't have to sell them to pay for their care I am very much opposed.At the end of the day, someone has to pay for this - I'm very happy to pay for myself (I own a house) - the idea that someone else should pay for me whilst I keep my house and leave it in my will to heirs is completely unfair and ridiculous. However, if that is what the Tory party are going to offer, I will bite their hand off and the poor can go hang.

Michael Winstanley ● 1379d

Yes that’s my understanding too and what causes so much upset and anger for families.  Local authorities, so I understand it, are able to negotiate a lower rate, whilst if you are self funding you pay more. By the way, when the private care home businesses know more money is going to be available because of tax/national insurance increases, then they will put up their charges — we will end up no better off when it comes to social care, but paying more money for it.  

Martine Guy ● 1379d

In care homes where there are both privately funded and state funded residents I understand that the privately funded ones subsidise the state funded.  It must depend on how much care is needed eg with dementia it will be greater.

Philippa Bond ● 1379d

Can I add, that if the government is going to raise taxes and/or National Insurance to fund social care, and if they are still expecting people to sell their homes to pay for care, then make the social care system open to scrutiny and subject to the Freedom of Information Act.  Where is the money going, why are people paying around £1,000 per week upwards and what care should you be getting for that:  24 hour care, a warm clean room, sufficient food and drink, adequate bed linen, exercise, and entertainment?

Martine Guy ● 1379d

If the care system was wonderful, you would think that’s a lot of money, but worth it.  But it isn’t, care can be so basic it makes you want to weep.  My mother slept with a single fitted sheet covering her mattress and a quilt and single pillow in her own home.  Simple and easy to use.  Her care home gave her a loose sheet that continually came off the mattress and crumpled up in the middle of the bed.  There were about 4 pillows on the single bed which she found incredibly difficult to deal with and there were a load of   blankets and a sheet, which also kept ending up in a heap in the bed.  I think I took in 4 duvets and begged them to use a one at a time with no other top layers of bedding.  An ambulance was called for her one day, and they issued a safeguarding notice, which I guessed was for the inadequate bedding.  I was always having to check on this. I didn’t see a lot of entertainment going on.  The only time this really happened was when I organised an entertainer and party for her 90th, which everybody was able to enjoy.Basically, it was just watching tv.  Something my mother needed help with was to switch on her t.v.  Again I had to keep on at them about it. The NHS chiropodist rarely seemed to visit and I paid for a private chiropodist to visit. My mother’s charges, paid for by the Council, were about £900 per week.  Value for money, I don’t think so.  Where is the money going, there is no accountability.

Martine Guy ● 1379d

7000 a month and they expect the taxpayer to organise and pay for their PPE !

Andy Pike ● 1379d