Posted on 1/09/2017 by
Cracks in the social care system are starting to widen
SO, how old will you be in, say, ten years’ time? How old will your parents or grandparents be?
And what do you imagine your/their life will be like then?
Whatever the answers to those questions, there can be little doubt that what the future holds for our ageing population should be racing up the list of topics taking up our thinking space.
In the present climate, with a predicted social care funding gap of around £3 billion by the end of the decade, the best we can anticipate right now is a place in a lottery draw.
What have, until now, seemed like cracks in the system are starting to widen alarmingly.
An analysis by the Telegraph & Argus earlier this week showed that an increasing number of adult social care homes in the Bradford district are failing to meet national standards.
Ask anybody involved in social care – providers, staff, experts and councillors alike – why this is happening and the answer will always come back to one thing: money.
Inadequate funding means low wages, difficulties in recruiting and retaining care workers, poor maintenance, a lack of resource to improve facilities and, inevitably, a shortfall in the care, attention, compassion and dignity required by residents.
A survey carried out in June by Unison led them to call on the Government to take urgent action to tackle “severe” staff shortages in residential care homes after it found elderly and vulnerable people were being denied trips to the toilet and kept indoors for days on end.
General secretary Dave Prentis said: “The care system is failing the elderly and the vulnerable and those staff struggling to provide the best support possible.
“Elderly people should expect the best possible care, whether they are being looked after in their own accommodation, or in a care home.
“The Government must act now to fund social care properly and protect the most vulnerable in society.”
The claims were reinforced just three weeks ago by residents of nearly 200 care homes across England - including some in the Bradford district – when they were interviewed by patient watchdog Healthwatch about their experiences. The study revealed that even homes giving excellent care often aren’t getting the basics right.
Imelda Redmond, their national director, said: “It’s not easy running a care home, particularly as the sector as a whole is trying to get to grips with the dual challenge of managing rising demand with limited resources. But getting the basics right doesn’t have to cost the earth and should be the least we should all be able to expect for our loved ones and ourselves should we need care support.”
You would go a long way to find someone who doesn’t agree with that but successive governments have seemingly been unable to take a long-term view of our growing elderly population’s needs, with the result that our current system is cracking under the strain.
So, where is the vision to find a better way to care for our elderly? Should we be looking abroad?
We often hear that there’s a better way in the Far East, where looking after elderly relatives within the family can be seen as a matter of honour.
In China, for instance, elderly parents are traditionally looked after by their children. But with the fastest-ageing population in history, that model is rapidly deteriorating.
In some areas, Buddhist temples have effectively become care homes with elderly citizens living out their lives there. Most have been abandoned by their families because, in extremely poor communities, if they can no longer work they are seen as a burden.
A study in 2013 suggested that only 38 per cent of the over-60s currently live with their families, which has led to China now being seen as one of the worst countries in the world for the elderly, with a huge lack of hospice facilities and affordable health care.
It has led the authorities to experiment with a new model that combines government, community and family support to try to build a system to fit modern Chinese society, with the Communist Party warning that it is not enough to rely on the government alone.
There are echoes of that policy in Japan, long seen as an ideal society for elderly care.
Until 2000, there was no publicly-funded social care in Japan because caring for the elderly was seen entirely as a family responsibility.But, according to the Nuffield Trust, in recent years there has been a growth in reports of neglect and abuse, apparently due to the restrictions the system places on an increasingly mobile population, especially Japanese women who tend to be the main carers. There has also been a large growth in the number of older people spending long periods in hospital, not for medical reasons but because no-one else would look after them.
With over-65s making up a quarter of the population and this expected to grow to 40 per cent by 2060, the government has had little choice but to take radical action.
They introduced long-term care insurance, offering social care to those over 65 on the basis of needs alone. The system is part-funded by compulsory premiums for all those over the age of 40, and part-funded by national and local taxation.
Users are also expected to contribute a 10 per cent co-payment towards the cost of the service.
The system is so popular that the uptake of services has outstripped expectations and costs are soaring, with the result that the Japanese government has introduced higher co-payments for wealthier citizens.
What it shows us, though, is that we need to think outside the box and change our expectation that the state alone will look after us when we are unable to look after ourselves.
There has to be a better balance to the responsibility for social care and families and individuals need to be prepared to play a bigger part.
We can’t stop the rising tide of our ageing population and neither can we afford to look after it under our current system. That future is nearer for all of us than we like to think…