Why the elderly care crisis is here to stay

Who gets what care

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Another day, another story about old age care.

The report from the Care Quality Commission that a quarter of home care services are not meeting all the quality and safety standards makes depressing reading.

Evidence of rushed appointments, botched assessment and revolving door of carers suggests the system is on its knees.

The temptation is to think that will all change with the introduction of the cap on costs that the government announced on Monday.

But sadly that is not the case.

The complex nature of the system means the reforms should help reduce the need for people to sell their homes to pay for care.

But they do little - perhaps nothing - to improve the quality of services on offer.

The last decade has seen services squeezed until the pips squeak.

In fact, they have got so bad that just over a year ago the Equality and Human Rights Commission said some services were "breaching human rights".

'More for less'

Much of the system - both care homes and home care - is provided by private firms or voluntary sector organisations.

They look after a mix of self-funders - about 500,000 - and those who get state help from councils - just over one million.

Talk to them and they will describe how local authorities have been wanting more for less.

Research by the UK Homecare Association, which represents the firms providing carers to help the elderly with basic tasks such as washing, eating and dressing, shows that councils have been putting pressure on them to reduce the length of visits.

Three quarters are now less than 30 minutes in duration, including 10% which are less than 15 minutes.

Start Quote

Without an urgent injection of money to meet rising demand in the short term things will continue to get worse”

End Quote Councillor David Rogers Local Government Association

Those paying for their own care are not immune - agencies have pared back on their visits to cover costs.

Councils understandably point out that they are doing the best they can.

They have been ploughing more and more into the system as a proportion of their resources at the expense of other areas such as leisure centres and libraries.

Social care, including services for younger disabled adults, now accounts for nearly half of their spending.

But the total pot for care is still shrinking as the huge cuts in government funding for councils - it is falling by over a quarter this parliament - means local authorities have been unable to protect the sector entirely.

The budget for social care stands at just over £14bn - a £1bn cut in real terms. If that happened in the NHS there would be outrage.

Councils have responded by rationing access to care so only the most needy can get it.

It means despite the ageing population the numbers getting help has actually fallen in the past five years, leaving an estimated one million without any help.

In years gone by these people would have been looked after by younger relatives. But with families more dispersed and the children of the elderly often pensioners themselves this is not always possible.

Stephen Burke, director of the United for All Ages charity and author of the Good Care Guide, is scathing.

He believes the government has pulled a "con of the worst sorts" by giving the impression it has solved the problem of old age care.

Other are more generous.

Councillor David Rogers, from the Local Government Association, has welcomed the cap as an important step forward, but says more needs to be done to tackle the quality issue.

"Without an urgent injection of money to meet rising demand in the short term things will continue to get worse."

With the over 65 population expected to rise by 50% over the next 25 years, expect to hear much more about the care crisis.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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