You are here: Persistent care shortages leave older people with few choices
Older people face an ongoing struggle to get the care they need, with 4.2 million people aged 75 and over living in areas that do not have enough care. This is one of the findings from our second annual Older People’s Care Survey, which asked local authorities and health and social care trusts across the UK about the care for older people in their area.
Our findings highlight failures in the care system to provide people with positive choices about their care in later life. Everyone should have the right to safe, comfortable and dignified care, and no one should have to be frightened about what will happen when they get old. Worryingly, our findings highlight that many people do not get to make positive choices about their care in later life.
Only a quarter of local authorities have enough care for everyone who needs it, meaning that for many people, where or even whether they access care is not up to them. What’s more, two fifths expect shortages to get worse in a year’s time. This patchy availability of care means older people sometimes have to move into residential care located far away from their home. This can make it harder for family and partners to visit, putting more pressure on families and threatening loneliness for those in care.
The point when families first start looking for care can be acutely stressful. It is often a time of crisis when health and independence are deteriorating. Family members will often rely on their local authority to help them navigate a complex care system, but may find that the information their local authority holds is too patchy to be adequately helpful. A fifth of local authorities don’t know whether or not they have enough care. This raises serious concerns about local authorities’ ability to support families – both to make sure that enough care is provided and to provide older people and their families with the timely and accessible information they need to plan their care.
The people who are most likely to struggle to find suitable care are those who are most vulnerable. Fewer than two in five local areas have enough specialist nursing care, leaving those with the highest support needs facing the least choice and longest wait. This often means that the only care available is a hospital bed.
There is also a large gap in the availability of home care, with fewer than half of local authorities reporting enough in their area. This can put impossible stress on family members who are forced to fill the gap, exacerbating pressures on their own health, finances, and ability to remain in full time employment. Some 8 per cent of the population are unpaid carers, a third of who provide over 100 hours of care per week. High quality home care can also play an important role in helping older people stay well and independent, reducing the need for more expensive residential care.
The survey reveals that the rate that local authorities pay to care providers has not increased significantly since last year, with authorities paying £556 per week for residential care. Inflation over the last year means that care providers face increasing costs, suggesting that many may be left with the choice between compromising on the quality of care or passing costs on to self-funders in the form of higher prices. Indeed, according to respondents, self-funders pay on average 14 per cent more than local authorities for residential care. There is a significant gap in information held by authorities on this, with nearly three in four unable to provide data on the rates that self-funders pay.
The rates paid by self-funders for care mean that it will take just six years to use up savings taken from the value of the average home on residential care. Lower property prices in the North East of England and Northern Ireland mean that this falls to just three years and two months for self-funders. When care is so expensive and choices so scant, many individuals are likely to opt for the cheapest option, rather than the most suitable.
Regions vary widely both in the price and the availability of care, meaning that whether or not an older person can access the care they need is likely to be down to where they happen to live. Similarly, funding arrangements such as third party top ups and deferred payment agreements are not used consistently across the UK, raising concerns that some older people have fewer choices than others about whether or not to use them.
It is clear that there is not enough care for older people. In large part, whether an older person is able to make genuine choices about their care is determined by where they live. This is unfair and puts immense pressure on families – often increasingly frail spouses – to fill the gap. We hope that the findings of the Older People’s Care Survey will highlight the urgent need to address these challenges, and to remind policy makers and politicians of the importance of this issue for older people, their families, and for society as a whole.
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