This article titled “English care home closures are leaving vulnerable people at risk, says watchdog” was written by Denis Campbell Health policy editor, for The Guardian on Tuesday 11th October 2016 20.20 UTC
The quality and safety of social care services received by elderly and disabled people in England are in danger, as care homes close and providers pull out because they can no longer make enough money, the care watchdog has warned.
In a bleak assessment of the future of vital services that support millions of people, the Care Quality Commission (CQC) voiced alarm that the care sector as a whole is “at risk”.
Providers are in trouble because their costs have increased by up to 30% in the past year while their profit margins have fallen by more than 40%, it warned. It pinpoints the national living wage (NLW) and the inability of cash-strapped local councils to pay higher fees for these services as the main causes of a growing problem.
The number of care homes overall in England has fallen from 18,068 in September 2010 to 16,614 in July this year, at a time of growing need linked to the ageing population, according to figures released by the CQC.
The total number of beds available in care homes also fell between 2010 and 2016 from 255,289 to 235,799 this summer – a fall of 19,490. While the number of nursing homes increased slightly, from 4,387 to 4,623 in that time, more than one in 10 residential homes – for elderly, often frail, people – have closed. The total of those available has fallen from 13,681 to 11,991 – a drop of 1,690.
The many people who rely on care homes and receiving help in their own homes with washing, dressing and eating could be affected if more and more of the private companies that dominate the market go out of business, the CQC fears.
Andrea Sutcliffe, the CQC’s chief inspector of adult social care, was responding to the leak to the BBC of a recent internal briefing document that spells out how rises in providers’ costs and the squeeze on local councils’ budgets are leaving care services in an unsustainable position.
“We know that the adult social care sector faces many financial pressures which, worryingly, could undermine the quality and safety of care that people receive and rely upon every day,” said Sutcliffe.
She confirmed that information from care providers detailed in the CQC document “does highlight a concern that the long-term sustainability of high-quality care within this sector could be at risk. Given the impact this would have on people’s lives, it is important that we continue to monitor these trends closely.”
The document emerged less than 48 hours before the CQC, which is the NHS and social care watchdog for England, is due to present its annual report on performance and emerging issues, called State of Care, to parliament on Thursday. It is expected to highlight how worsening problems in social care are having a serious impact on the NHS, for example, by leading to patients who are fit to go being trapped in hospital because no package of social care support is available to allow that.
The regulator is worried that more and more home closures could leave needy, vulnerable older and disabled people with nowhere to go.
Its analysis document says that with care homes the “market position is undoubtedly hardening – increasing the pace of home closures”.
The CQC’s anxieties echo those voiced with increasing urgency in recent years by old people’s charities such as Age UK, the Local Government Association, health thinktanks and MPs that deep cuts to town hall budgets since 2011 have led to a major deterioration in social care at the same time as demand for it was increasing.
The CQC document, called “adult social care market insight” and based on data received from 39 major providers, states that: “This is a local authority-funded service user problem. Notwithstanding recent fee increases, the historic level of underfunding remains and in some cases has probably increased as a result of [the] national living wage.”
On the fees that councils pay providers either to care for individuals in a home or to help meet their basic needs while they are still living in their own home, it says: “Fees – At what point will the ongoing focus on fees adversely impact the quality of service being purchased?”
The CQC also warns that businesses have been left out of pocket by having to pay staff more because of the national living wage. It adds: “NLW – Provider sentiment suggests fee increases have generally not covered the cost of NLW. This position is unsustainable.”
It is also worried that the same pressures could push providers of domiciliary care to the wall. “Provider exit and large-scale contract handbacks demonstrate the fragility of this market. At what point can the replacement providers only make the returns work by compromising on the quality of care?” the briefing paper asks.
Barbara Keeley, Labour’s shadow minister for social care, said: “These figures are an alarming reminder of the desperate state of care services in this country. Despite all the spin from ministers, the Tories have left social care on the brink of collapse, with thousands of people’s care at risk as a result. It’s not enough to turn a blind eye to this crisis. We need ministers to step up and guarantee that they will properly fund care services. Anything less will be a betrayal to the most vulnerable in our society.”
Norman Lamb MP, a Liberal Democrat former health minister in the coalition government, urged ministers to prop up social care before the system collapses. “This briefing confirms that the care system is teetering on the brink of collapse. The government has known this for some considerable time yet still they refuse to act. The whole system is now living on borrowed time as more and more providers contemplate leaving publicly funded care and face going out of business because the sums don’t add up,” he told the Guardian.
“The real scandal is that we are rapidly moving to a position where you will be able to get great care if you can afford to pay privately – but if you can’t you will be left with nothing or substandard care. That situation is intolerable and a stain on our country. It would be grossly negligent and morally wrong for the government not to act now. There is an urgent need for additional emergency funding.”
guardian.co.uk © Guardian News & Media Limited 2010