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Care homes crisis: Judith Martin responds

Why do patients have to be moved, with the upheaval and distress caused by Ill-planned or casually implemented closures and relocations which are stressful and linked to adverse outcomes in terms of symptoms, health and survival?

A 2006 article refers to one of many reports on involuntary relocation: Prof David Jolley, a consultant psychiatrist specialising in old age, said that it was “an inescapable truism that relocation is a stressful event [for frail elderly people] and can precipitate problems of mental health, physical health and even bring forward death”. Another psychiatrist, Dr Peter Jeffreys, rates it as “only marginally less significant than the death of a spouse”.

Local authorities could take ownership and take on the running of the establishment. The Bristol building is not beautiful but Bristol is an expensive city. The home could be wound down under the local authority, not taking any extra patients but keeping staff members, then eventually the site could be sold for redevelopment to recoup costs.

The local authority could commission decent design for the follow-on homes (“think of the Maggie’s cancer centres conceived by the late Charles Jencks”), which would be run without the burden of debt or expectation of profit.

As Gill Plimmer notes, many more local authority-run homes are rated good or outstanding – according to a LaingBuisson analysis of regulatory reports last August – than those owned by hedge funds or other for-profit bodies.

Based on Judith Martin’s letter in the Financial Times.

 

 

 

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Yet another Thatcher-privatised-off-shored-debt-laden industry is seeking subsidies

Most UK care homes were managed by local authorities until Margaret Thatcher ‘reformed’ the system in the 1980s; now just 8% are said to be under state control.

In April, the shadow minister for social care and mental health said, There are major concerns about the debt-driven business models of some companies in the care sector and the role of foreign private equity firms and hedge funds in deciding the future care arrangements for large numbers of vulnerable people. The real price of this instability and underfunding is now being paid by the 17,000 older people in Four Seasons care homes and their families who face an uncertain future”.

The Bracknell care home and Kingsmills care home (above) are two of more than 300 owned by Four Seasons Health Care. In May, administrators were called in by the firm which has struggled to repay its debts.

All four of Britain’s biggest care-home businesses have been up for sale in the past year and have failed to secure deals.

recent report by the Association of Directors of Adult Social Services reported that almost half of councils have seen the closure of domestic home care providers in their area in the past year and a third had seen residential care homes closed, collectively affecting more than 8,000 clients and residents.

Gill Plimmer reports an estimate by Care England, which represents the independent providers, that around £4bn is needed from the government to stabilise the sector.

In addition to sharp cuts to social care budgets due to the government’s austerity policy, private care providers have had to deal with an increase in the minimum wage and rising food costs.

Ms Plimmer comments that understanding where taxpayers’ money is going is essential if Britain is to resolve the funding crisis in elderly care, adding, “This is made difficult by the companies’ complex, multi-layered offshore private equity structures”.

Nick Hood, debt restructuring adviser at Opus, the social-care analysts, said, “We don’t know whether taxpayers’ money is going to the private equity owners or the financiers, or indeed how much is being paid in cash and how much rolled up on the debt”.

He pointed out that the care companies’ debt interest payments which average £4,800 per bed per year, contributed to overall losses at the companies of £900m from 2015 to 2017, adding:

“The figures showed that the “debt-laden model, which demands an unsustainable level of return, is completely inappropriate for social care. Hundreds of millions of pounds that could be going into improving facilities and care are being sucked out of the industry every year to fund the debt”.

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and reality

Some question the whole concept of residential care as inspections by the Care Quality Commission, which oversees provision of social care, find that some homes shamefully neglect residents – citing here an establishment owned and controlled by a US property investment group.

 

 

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