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Frank Hovis

Care crisis: this has been coming

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I used to have dealings with the council on this and about six years ago they slashed the hourly payment they make from £18 - £20 to £13.50.  This pays for actual contact time, when a carer is travelling the council doesn't pay anything.  It's gone up to £16.20 since but realistically you need £18 and it's nowhere near that.

What this has meant is that the firms still taking council contracts, which set the market rate, have had to pare costs to an absolute minimum.

So care salaries are at or marginally above minimum wage and the carers have an extremely tight schedule to keep to, no time for a chat or allowance for traffic jams.

The situation is worsened in very rural areas like east Cornwall / west Devon because the travel times are longer so the effective hourly rate paid by the council can drop to half the headline rate.

Add in the high housing costs of the area and being a carer has become a route to high stress poverty. So people don't want to do it any more.

The solution is that the council undoes the damage it did six years ago by slashing the rate it pays.  The actual solution is likely to be the usual one of importing cheap labour.

Meantime people can't get carers, which is exactly what everyone said would happen when they cut the rate six years ago.

Note the typical BBC spin in the article below; the problem in this story is in Cornwall yet it says "SW Councils pay the highest average rate".

From the BBC's own website: Cornwall £16.20, Somerset £17.60, Devon not available. As I noted above £18 is the sort of level you need so Somerset is nearly there but Cornwall is £1.80 below what's required.  And that is the area being covered by the story so that other councils pay higher rates in the region is irrelevant.

http://www.bbc.co.uk/news/health-37307856

From the Devon & Cornwall breaking news BBC page:

Just not enough care workers in Cornwall, say providers

BBC Spotlight

Posted at8:04

Care providers in Cornwall say there's a crisis in the care of elderly and disabled people at weekends because there are just not enough workers.

One relative called every care agency in Cornwall but could not get weekend help for her grandfather.

South West councils pay the highest average hourly rate in the country, but its still not enough to attract new carers.

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8 minutes ago, Frank Hovis said:

I used to have dealings with the council on this and about six years ago they slashed the hourly payment they make from £18 - £20 to £13.50.  This pays for actual contact time, when a carer is travelling the council doesn't pay anything.  It's gone up to £16.20 since but realistically you need £18 and it's nowhere near that.

What this has meant is that the firms still taking council contracts, which set the market rate, have had to pare costs to an absolute minimum.

So care salaries are at or marginally above minimum wage and the carers have an extremely tight schedule to keep to, no time for a chat or allowance for traffic jams.

The situation is worsened in very rural areas like east Cornwall / west Devon because the travel times are longer so the effective hourly rate paid by the council can drop to half the headline rate.

Add in the high housing costs of the area and being a carer has become a route to high stress poverty. So people don't want to do it any more.

The solution is that the council undoes the damage it did six years ago by slashing the rate it pays.  The actual solution is likely to be the usual one of importing cheap labour.

Meantime people can't get carers, which is exactly what everyone said would happen when they cut the rate six years ago.

Note the typical BBC spin in the article below; the problem in this story is in Cornwall yet it says "SW Councils pay the highest average rate".

From the BBC's own website: Cornwall £16.20, Somerset £17.60, Devon not available. As I noted above £18 is the sort of level you need so Somerset is nearly there but Cornwall is £1.80 below what's required.  And that is the area being covered by the story so that other councils pay higher rates in the region is irrelevant.

http://www.bbc.co.uk/news/health-37307856

From the Devon & Cornwall breaking news BBC page:

Just not enough care workers in Cornwall, say providers

BBC Spotlight

Posted at8:04

Care providers in Cornwall say there's a crisis in the care of elderly and disabled people at weekends because there are just not enough workers.

One relative called every care agency in Cornwall but could not get weekend help for her grandfather.

South West councils pay the highest average hourly rate in the country, but its still not enough to attract new carers.

Get that sort of stuff in North Yorkshire.

The hourly rate looks good at first glance. Then when you factor in running a car it becomes impossible.

One solution is that care providers need to provide a fully expensed car to carers.

Another bit that would help would be the OAP stubbing up a contribution.

In NY you get a lot of OAPs moving to the area, pushing housing cost up and taking services.

Sadly, I think the only solution is for OAPs who need care to move to areas where there is cheaper local carers. i.e move into town where the service can be provided.

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every year, we hear the same thing.  Care is very short of staff.

Some of the jobs are very nice indeed.  Others not so. depends on the client.

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So what's the cost of keeping people in their own homes when they're spread out so far away

And does it reduce if you move people closer together. If they're all on one street (think vertical street maybe) then the travel time is minimal. 


 

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I know of someone in rural north yorks who was working as a carer.  They were not paid for the time it took to travel between clients.  This brought the hourly rate down well below the minimum wage. Pay was so poor that they could not afford to run a car so spent a vast amount of unpaid time walking between villages on the north York moors. Slave labour. 

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To add. A friend in London is looking for nursing care for a relative and thinks that sheltered housing is the most suitable arrangement. However, the council will only provide this if moving from another council property. 

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2 minutes ago, paulokes said:

I think we might actually see a reversal of the great 'home care' revolution of the 90s Sarah.

Moves back towards large hospitals, institutions and care homes.

Either that or a massive reduction in the quality and availability of care services. 

P


We need some purpose built, nice quality flats that are fully disabled friendly, with great shared facilities like a cafe, a shop, and some leisure facility. People could group by age (not everyone needing care is old).
The problem is always cost though. The ideal solution is going to be expensive but it's going to be such a problem we need to seriously consider what options there are.
- as is, completely unsatisfactory for carers and cared for
- moving people into independent living so carers have less travel
- move people into residential care - 
- soylent green

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More seriously, the knock-on effect of councils being unable to provide care is bed-blocking in hospitals. Elderly people who are ready for discharge having to stay in hospital because they don't have a "care package" in place. 

This has the the effect of preventing emergency admissions from Emergency Departments and admissions for elective procedures. This results in patients waiting for hours on trolleys for a bed to become available, queues of ambulances outside EDs waiting to discharge patients and people waiting hours for ambulances  this is not sustainable  

In the days when the NHS had the aftercare budget, this happened less often. Since councils took over, the communications between hospital and community care are poor in places and patients suffer. Some councils appear to have have raided the budget to make up unrelated shortfalls in other areas. The whole thing is a bu66er's muddle. 

And while I'm ranting, the NHS could do without the purchaser/provider split. It would be able to save manpower, ridiculously high salaries and wasting time and money that would be better spent in direct patient care. 

Since nursing training became university-based, the loss of helpful student nurses on the wards hasn't been properly covered by healthcare assistants. That was when staffing levels in the clinical environment dropped to unsustainable levels. Since then the NHS has been in inexorable decline, further exacerbated by the reductions in Junior Doctors' hours. 

Rant over. <<Puts soapbox away>>

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6 minutes ago, SarahBell said:


We need some purpose built, nice quality flats that are fully disabled friendly, with great shared facilities like a cafe, a shop, and some leisure facility. People could group by age (not everyone needing care is old).
The problem is always cost though. The ideal solution is going to be expensive but it's going to be such a problem we need to seriously consider what options there are.
- as is, completely unsatisfactory for carers and cared for
- moving people into independent living so carers have less travel
- move people into residential care - 
- soylent green

We have a lot of these "schemes" here in Colchester. Indeed, there are many of them countrywide.  But there are many elderly and infirm who just cannot leave their homes, and need help with cooking, getting in and out of bed, toileting. So care is allocated following an assessment, so maybe once a week, once a day to 4 times a day or even from dawn till dusk with a carer sitting in the flat with the person all day.

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14 minutes ago, paulokes said:

I think we might actually see a reversal of the great 'home care' revolution of the 90s Sarah.

Moves back towards large hospitals, institutions and care homes.

Either that or a massive reduction in the quality and availability of care services. 

P

That be the answer, PO. 

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Build "care farms" in places like Tunisia and Morocco and ship any elderly requiring care out there where care costs are about 2 / 3 quid per hour. Put in skype so they can chat to relatives.

We'd save on heating and care costs, provide work for the north africans (we could send some back to work there) and free up housing in the UK.

I've even mocked up the brochure cover picture

retiring-in-morocco.jpg

Do you dream of a safe, secure retirement in somewhere that isn't damp and raining 9 months of the year where you are left to wallow in your own poo for hours on end? Then check in to the Soylentcare retirement homes of the Maghreb

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15 minutes ago, davidg said:

Build "care farms" in places like Tunisia and Morocco and ship any elderly requiring care out there where care costs are about 2 / 3 quid per hour. Put in skype so they can chat to relatives.

We'd save on heating and care costs, provide work for the north africans (we could send some back to work there) and free up housing in the UK.

I've even mocked up the brochure cover picture

retiring-in-morocco.jpg

Do you dream of a safe, secure retirement in somewhere that isn't damp and raining 9 months of the year where you are left to wallow in your own poo for hours on end? Then check in to the Soylentcare retirement homes of the Maghreb

Where do I put my mother's name down?  

 

Not sure the old old dears would feel safe amongst all these arabs!!

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I recall we had a thread working out how much you had to charge for a cleaner if you were running an agency  - it was around £21 per hour IIRC.

I think the time has come where we have to start asking people for a contribution towards these costs - to be paid upon death. A sort of 'pay by use' inheritance tax top up.

True, the relatives will whinge about losing some entitlement, but if they are that concerned that can do the caring themselves.

 

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The other thing is the cost spent on preventing 80+ from dying.

You end up with aged cabbages getting 200k on medical care being spent on them.

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5 minutes ago, CunningPlan said:

True, the relatives will whinge about losing some entitlement, but if they are that concerned that can do the caring themselves.

 

 

+1

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You currently do have to pay for elderly care and its means tested , if you own a house or have savings they will get used up

"f you have more than £23,250 (£23,750 in Wales and £25,250 in Scotland) you’ll have to pay for care. Below this, you’ll contribute with the amount based on means-testing. This includes savings, income, and your property may be counted as capital after 12 weeks if you move into a care home on a long-term basis."

How are people not aware of this ?

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1 minute ago, t1234 said:

You currently do have to pay for elderly care and its means tested , if you own a house or have savings they will get used up

"f you have more than £23,250 (£23,750 in Wales and £25,250 in Scotland) you’ll have to pay for care. Below this, you’ll contribute with the amount based on means-testing. This includes savings, income, and your property may be counted as capital after 12 weeks if you move into a care home on a long-term basis."

How are people not aware of this ?

I was aware this was the case for care homes. Is it also true for home care?

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Just now, t1234 said:

You currently do have to pay for elderly care and its means tested , if you own a house or have savings they will get used up

"f you have more than £23,250 (£23,750 in Wales and £25,250 in Scotland) you’ll have to pay for care. Below this, you’ll contribute with the amount based on means-testing. This includes savings, income, and your property may be counted as capital after 12 weeks if you move into a care home on a long-term basis."

How are people not aware of this ?

Funding your own care at home – other things to think about

There are a number of options if you have to self-fund home care services including:

  • an Immediate Need Care Fee Payment Plan
  • insurance policies you or a spouse may have purchased a long time ago
  • an appropriate equity-release scheme (if you’re a homeowner)
  • downsizing to a smaller home like a bungalow <<< LOL bungalows are really dear!

https://www.moneyadviceservice.org.uk/en/articles/care-services-to-help-you-stay-in-your-own-home#paying-for-long-term-care-at-home

 

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2 minutes ago, SarahBell said:

Funding your own care at home – other things to think about

There are a number of options if you have to self-fund home care services including:

  • an Immediate Need Care Fee Payment Plan
  • insurance policies you or a spouse may have purchased a long time ago
  • an appropriate equity-release scheme (if you’re a homeowner)
  • downsizing to a smaller home like a bungalow <<< LOL bungalows are really dear!

https://www.moneyadvi?ceservice.org.uk/en/articles/care-services-to-help-you-stay-in-your-own-home#paying-for-long-term-care-at-home

 

Apart from everything else, why is the savings threshold £2k higher in Scotland?

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33 minutes ago, t1234 said:

You currently do have to pay for elderly care and its means tested , if you own a house or have savings they will get used up

"f you have more than £23,250 (£23,750 in Wales and £25,250 in Scotland) you’ll have to pay for care. Below this, you’ll contribute with the amount based on means-testing. This includes savings, income, and your property may be counted as capital after 12 weeks if you move into a care home on a long-term basis."

How are people not aware of this ?

I thought people were; you have to be skint and in a bad way - requiring help to do two things - before you qualify for free care. 

The problem is that the free care rate paid by the council is setting the market rate and the pay rate.  If they went back to paying £20 per hour rather than the current £16 then probem solved as companies will pay carers more in order to retain them.

Similar issue in care homes where they actually make a loss on council placements; if you have an elderly relative going into a home make sure they don't take council contracts or you (or they) will be subsidising the council placement rather than paying for your relative.

IIRC 40% of care home companies have sub 100% interest cover.  That'll work <_<

 

32 minutes ago, CunningPlan said:

I was aware this was the case for care homes. Is it also true for home care?

Yes.

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The hime help care is akso v cheap compared to care from nominally medical staff.

NMW vs 400/day for someone with very much extrain wsy of training, and whose training will do fckall for the persons state i.e being old.

There needs to be a de-medical ness of oap care. None of the treatments really work. Its just pissing money awày.

 

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