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Frank Hovis

Adult Social Care In Posh And Rural Areas - Kaboom

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Is beginning to collapse, as expected. This is care in people's own homes: washing, dressing, preparing meals etc.

People are paid the bare minimum because that's all that the council funding will support.

Then factor in that carers don't get paid travel time or costs for their first and last jobs so it's not worth their while taking a job any distance from home.

Then care firms find that they can't recruit for these jobs in areas of high rents and so can't provide the service for Adult Social Care as the one thing they don't have the funding for is to increase wages. One this morning pulled out of Fowey (high rents / prices town on south coast of Cornwall); this is one of many but it's all small scale so isn't headline news.

Result: no care, people need to go into care homes which costs a vast amount more.

Stupid policy.

In case people think it's greed by the care firms it isn't, margins are wafer thin these days and most providers pulled out when the hourly contact (i.e. not including travel) rate paid by the Council dropped from £20 to £13.

So if the carer is spending half their time travelling (not the case when dealing with blocks of sheltered housing, entirely the case in rural areas) then the care firm has £6.50 per hour to pay the carer, their travel time and fuel, and central costs.

I think those firms that haven't pulled out yet just haven't done their sums properly.

The next crisis of people being filthy and starving in their own homes has started, this then starts a flood of people into care homes. And once they go in they aren't going to go back to independent living.

And the council doesn't fund those places sufficiently, care homes cross-subsidise from private patients and some smaller homes are already refusing to take council-funded residents.

Plus a lot of the bigger private groups were taken over by equity firms and laden with debt so have been going bust because of the already tiny margins having to fund the debt burden.

So you have a accelerating rush of people into a declining number of care home places. It may be another two or three years before this becomes a national crisis that "no-one could have foreseen" but it's in the post so I thought I'd flag it up.

On a practical note if you are placing an elderly relative into a care home and self-funding do try to get them into one that doesn't take council-funded people. Not for class reasons but for financial ones; you will be cross-subsidising them and the more there are the faster your bills will rise without any benefit for your relative.

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It's much better to be cared for in your own home than have to go into a "home"! Surely this must be cheaper, and more pleasant?

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It's much better to be cared for in your own home than have to go into a "home"! Surely this must be cheaper, and more pleasant?

It is all of that Mr Pin.

Hence the ridiculousness of councils cutting the rate they pay for contact time to plainly uneconomic levels.

An older guy I worked with used to say that the best time to be old was passing and everybody agreed.

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It is all of that Mr Pin.

Hence the ridiculousness of councils cutting the rate they pay for contact time to plainly uneconomic levels.

An older guy I worked with used to say that the best time to be old was passing and everybody agreed.

I am of the suspicion that these "care home" owners know a few people on the council. It is a trade. My mum spent her last few months in one. It was quite nice, and the staff were very pleasant, and not on good wages. I imagine the directors paid themselves very well.

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I am of the suspicion that these "care home" owners know a few people on the council. It is a trade. My mum spent her last few months in one. It was quite nice, and the staff were very pleasant, and not on good wages. I imagine the directors paid themselves very well.

Not the case these days Mr Pin; they're creaking under the financial strain.

You would not be able to run a care home with only a council-funded contract as a source of income. You would lose money and go bust.

That is shocking to my mind; councils do not pay enough for their residents and the shortfall has to be met by increasing private fees. Which can only happen up to a point.

The councils are deliberately exploiting their market position to rip-off care homes who need their volumes to continue.

However there will be no new entrants to the market; the smaller home owners will just pack it in, and the debt burdened big providers will go bust.

Ultimately the councils will have to step in as direct providers which will cost an absolute fortune.

As short sighted as GP out of hours services being reduced (not worth their while any more) so that A&E gets swamped and the hospitals are on perpetual black alert.

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Struggling with this at the moment with father in law. One of those things that you don't really have dealings with, until of course, one day you do. Had no idea it would be so difficult.

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I hope I don't ever need that level of care when I am older. I'm OK at the moment, but you never know. I do pay my council tax, and one day I would hope to think I might get something back, but I doubt it. There's a smashing old lady (must be nearly 80) on a bicycle round here. She always tinkles her bell for me. :blink: What a lucky lady to be so fit at that age! So many are in electric wheelchairs. :blink: I do hope I never get there. My dad hasn't, but can't move so quick any more, and has to take it easy on the gardening. I expect he is out there today planting runner beans.

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Struggling with this at the moment with father in law. One of those things that you don't really have dealings with, until of course, one day you do. Had no idea it would be so difficult.

The advantage of having worked in the sector is that I know how variable homes are in price and quality and how the two have very little relationship to each other unless you pay an absolute fortune.

You have to do an extensive amount of research and not hit and hope. There are superb cheap homes out there, often independent ones run by voluntary trustees who are always looking for new trustees....

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It's much better to be cared for in your own home than have to go into a "home"! Surely this must be cheaper, and more pleasant?

The economics behind that rely on exploiting those care workers. Minimum wage and payment for travel time are hammerblows to that business model.

The old crocks need to be rationalised if care is to be offered. That doesn't mean high-dependency (full-zombie) care homes with the astronomic costs, it can just mean sheltered/warden assisted accommodation with a couple of £k/year for a service charge that includes warden and a slice of support staff time.

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the answer, sell the patients house.

That's exactly what happens!

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The economics behind that rely on exploiting those care workers. Minimum wage and payment for travel time are hammerblows to that business model.

The old crocks need to be rationalised if care is to be offered. That doesn't mean high-dependency (full-zombie) care homes with the astronomic costs, it can just mean sheltered/warden assisted accommodation with a couple of £k/year for a service charge that includes warden and a slice of support staff time.

Those wardens who are all mostly gone in the name of efficiency.

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Cameron/Osborne are insane.

No. But they are wildly irrepsonsible and make cuts and "reforms" without making the effort to think through the consequences.

The modification of the spare room allowance / bedroom tax to allow for a spare bedroom when a carer is required to stay overnight after mutiple court cases is a prime example. Whilst I wouldn't have thought of it practically any housing officer in the country could have told them that.

No research, no consultation, and most particularly no thought.

Reforms for disaiblity benefit, for example, were well overdue. But were brought in with a heavy-handed sanctioning regieme and an "act first, think later" attitude that has driven people at best to foodbanks and at worst to suicide.

So much of it has been absolutely moronic and whilst they think they're being brave and principled in bringing these in I think they're being blinkered and idiotic with the way that they're doing it. And I actually agree with their aims :mellow:

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No. But they are wildly irrepsonsible and make cuts and "reforms" without making the effort to think through the consequences.

The modification of the spare room allowance / bedroom tax to allow for a spare bedroom when a carer is required to stay overnight after mutiple court cases is a prime example. Whilst I wouldn't have thought of it practically any housing officer in the country could have told them that.

No research, no consultation, and most particularly no thought.

Reforms for disaiblity benefit, for example, were well overdue. But were brought in with a heavy-handed sanctioning regieme and an "act first, think later" attitude that has driven people at best to foodbanks and at worst to suicide.

So much of it has been absolutely moronic and whilst they think they're being brave and principled in bringing these in I think they're being blinkered and idiotic with the way that they're doing it. And I actually agree with their aims :mellow:

They believe & promote ideas which are palpably untrue & seek to inflict needless pain & suffering upon the elderly, infirm & demented. Thats close enough to insane for me but more than happy with "wildly irresponsible"

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It is all of that Mr Pin.

Hence the ridiculousness of councils cutting the rate they pay for contact time to plainly uneconomic levels.

An older guy I worked with used to say that the best time to be old was passing and everybody agreed.

Is it cheaper to travel round to 8 people rather than have them all in one place.

I have a friend who gets care several times a day. She is allocated shower time once a week. They do not brush her hair for her and have suggested many times she gets it cut short so it can be managed better.

Whilst everyone living independently would be lovely I don't think it makes any sense for having hundreds of workers rushing between them all.

The old lady who lived a few doors away was in a nappy because her three visits a day meant she was effectively bed bound. No benefit to live at home when you only see one room of it.

She was put to bed at about 6pm and got up about 10am.

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Is it cheaper to travel round to 8 people rather than have them all in one place.

It is when you compare low-to-moderate-intensity care (executed traditionally by volunteers) in the home to high-to-extreme-intensity care (led by qualified medical staff) in a home.

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Only if carers are available. I have heard of paraplegics being left in their wheelchairs all night in rural Hampshire because the carer that put him to bed didn't turn up - this happened more than once.

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Is it cheaper to travel round to 8 people rather than have them all in one place.

I have a friend who gets care several times a day. She is allocated shower time once a week. They do not brush her hair for her and have suggested many times she gets it cut short so it can be managed better.

Whilst everyone living independently would be lovely I don't think it makes any sense for having hundreds of workers rushing between them all.

The old lady who lived a few doors away was in a nappy because her three visits a day meant she was effectively bed bound. No benefit to live at home when you only see one room of it.

She was put to bed at about 6pm and got up about 10am.

It is definitely cheaper to have somebody stay in their home and receive care and much better for the person in general.

When it ceases to be effective then they have to go into a home.

It is cheaper again if they're all in a town centre rathe than across villages; but I wouldn't want to require somebody who needs half an hour of care a day to move if they want to get it.

Only if carers are available. I have heard of paraplegics being left in their wheelchairs all night in rural Hampshire because the carer that put him to bed didn't turn up - this happened more than once.

Carers are required to meet unrealistically tight schedules, no time for chat, no time for delays, and no cover if there's a problem. There is no contingency at all in this schedule so pretty much anything can throw it out.

So if their car breaks down, there's a traffic jam, or they have to sort out an emergency that's it, end of the round and no more visits.

I really wouldn't blame the carers, or even their companies who make them work to such tight margins. Blame the councils for cutting the money and forcing those few care companies that remain (Cornwall went down from over 20 to 4 companies when the big cuts came through; and I think those four remianing were naively optimistic) to operate like care sweatshops.

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the answer, sell the patients house.

They essentially do that now via a charging order to pay for care

As Frank states if you have assets you may be better of raising money on them yourself and buying purely private care rather than relying on the Council to choose it for you

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In fact more than sending you to Eton

But then who said governments did logic

I would like to go to Eton in my old age.That would be sensible. :(

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