One in three nursing homes has failed its official inspection in results described by the care watchdog as worrying and by the government’s care minister as “completely unacceptable”.
The Care Quality Commission said that of 4,000 nursing homes, which care for the most vulnerable people at the end of their lives, 32% have been rated inadequate or require improvement and 37% have been told they must improve safety. Of more than 1,800 inspected more than once since 2014, 26% were subsequently relegated to “requires improvement” or even “inadequate” after initially gaining a rating of “good”.
Inspectors making unannounced visits to care homes found medicines being administered unsafely, alarm calls going unanswered and residents not getting help to eat or use the toilet. Some residents were found to have been woken up by night-shift care workers, washed and then put back to bed, apparently to make life easier for staff. The inspection results suggest that thing have got even worse for people with dementia in recent years.
Andrea Sutcliffe, chief inspector of adult social care at the Care Quality Commission, which carried out the inspections, said such practice showed a fundamental lack of dignity and respect. She admitted disappointment that only one in 50 of all care services had managed to achieve the top rating of “outstanding”.
The picture for nursing homes was the most worrying, Sutcliffe said. “Many of these homes are struggling to recruit and retain well-qualified nursing staff and that means that this is having an impact on delivering good service, she said. The commission would shut down failing homes that refused to improve and try to improve training and recruitment.
On top of this there is a growing crisis in the national nursing workforce, which is shrinking amid discontent over pay and workloads . State spending on social care, has been cut by a cumulative £6bn in England since 2010.
By size, small care homes and homecare services emerge far better than large ones – three times as many large care homes, with 50 or more beds, being judged inadequate or requiring improvement than small ones with up to 10. Smaller homes are often better at the personal touch and at retaining experienced staff. Without adequate funding, it was no surprise that care providers are being forced to cut corners.
My comment: For a long time I was responsible, with my wife, for the care of. an elderly second cousin who reached 90 and who had had cerebral palsy all her life. We managed to keep her in her home, and at that time, could ask the local council to send teams of two in every day to get up, give her breakfast, lunch and dinner, and make her comfortable and put her to bed. Amazing service. That system no longer survives. Today she would be in a none- too-clean, sparse nursing home, sitting all day with the TV blaring, and with little, or no attention. These homes are run by untrained people who seem to take the unwelcome job in desperation. Many are immigrants with no other options. Others are bullies, or at least unsympathetic with the elderly.
If the sign of a civilised country is how it treats its elderly then we are failing. It doesn’t help to hear the drumbeat of criticism from the younger generation that the elderley are sopping up the government resources at their expense. It’s a fair criticism, but are they advocating ignoring the old and infirm who are ailing and have no one else to care for them? In the old days the aged were cared for by the family, all the family, young and middle-aged. That was unfortunately in the very old days. Are we too engrossed in social media and don’t, deep down, have empathy for those who cannot care for themselves? I just don’t know.
I’ve got no doubt that the state of social care in Britain in appalling, and that underfunding contributes to the problem. But the problem with underfunding is fundamentally one of attitudes, not neoliberal ideology. On the one hand, people don’t like paying taxes, which is why a proposed increase in the amount of National Insurance (the British payroll tax) was received so badly. But on the other hand, they don’t want to pay for their care themselves, particularly if it means selling their houses. The Conservative proposal to make people pay for their own care if expenses go above £100 000 sounds reasonable, but was wildly unpopular and had to be ditched. People don’t want to spend what would be the inheritance of their children on their own care. Until the public grows up and realises how expensive the cost of care really is, the problem will continue.
Which leads on to the shortage of care workers, which is partly caused by the profession being so poorly paid. It will get worse if the Brexiteers get their way and immigration is considerably reduced. Everyone seems to want a reduction in immigration, yet no can name an industry that should face a labour shortage.
Finally, the only young people I’ve met who want to reduce state spending on the elderly are ideological conservatives, who have a principled objection to excessive state spending for both the young and old. I’ve never known anyone to advocate increasing spending on the young by cutting the spending on the old. Most young people lean left on economic issues, and thus voted Labour. For the most part, they defend the current spending on the old. They just want spending on the young as well, and only resent the older generation for cutting spending on the young while preserving spending for the old. Equally, I’ve never met any young person who lacks empathy for those who cannot take care of themselves. Again, the only people I’ve met who don’t support state spending for the infirm are conservatives. They would emphasise the role strong families ought to play in taking care of their elders. For conservatives, the rise of the welfare state has abdicated the responsibilities to the older generation the youth otherwise would’ve beared. For good or for ill, I doubt the old days of intergenerational responsibility are coming back. The welfare state is too popular, and people value the freedom that comes from not having to spend large amounts of time taking care of other people.