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Discussion in 'Dementia-related news and campaigns' started by nitram, Nov 7, 2015.
Could someone explain this? I am always astounded and dismayed by the weekly costs that have been discussed on many threads. I quite honestly don't understand how a company cannot manage when costs are £600, £700 and more a week.
There are two different types of homes here - retirement homes, which are very expensive (like your most expensive care homes - £1,000+ a week) and long term care facilities, usually referred to as nursing homes. Retirement homes do not offer specialized care and will actually turn people out if their needs become too much. A long term care facility is much more reasonably priced and receives government funding.
The expensive retirement homes manage very well. They are run for profit so I do not understand why British care homes charging similar fees cannot manage.
I'll give this a go from what I see:
We have care homes(CH) and nursing homes (NH). The nursing homes provide a higher level of care and charge a much higher fee, although often you would receive FNC but this is less than the difference.
If you are self funding you have to pay the homes 'rate' - if you are LA funded there is a max rate they will pay which is normally considerably lower.
I work for an accountants and so see the accounts of a few care homes, although many homes are run by large chains. The ones in nice areas charge a high fee and make a reasonable, although being honest, not excessive return for the owners, who have borrowed to buy the buildings so need to finance the loans as well as their wages. One which we dealt with in an area which was mainly LA funded, realistically was making a very low return, in old buildings which needed refurbishing and they couldn't afford a loan to finance this.
Obviously large chains will work on a different model, but many have borrowed when the interest rates were high and the banks will not renegotiate the loans to a lower rate.
I will just add that i personally know 3 care home owners and 2 care agency owners who are multi millionaires. They bought at a good time, made a stack of money and then quit. Lots of people jumped on the jolly wagon not because they are passionate about care but because they are besotted with £££££££s and now they are struggling because they have over borrowed and they are banking on being bailed out by the government. They can't make ends meet not because they are spending 50% of the fees on care because they are definitely NOT but because they are funding loans on properties and the cash cow has dried up
Thanks for the info jugglingmum and fizzie. I must say, it doesn't make for pretty reading.
There are no central government funded homes and very few local government funded CH/NH in the UK any more.
There are expensive (sometime very expensive CH/NH) that do run at a reasonable profit. However below that level it is not easy to make a "good" profit. Around 70/75% of all expense is on wages. Next year when the government living wage comes in that will go even higher and things will get worse unless there is a large increase in fees.
This crisis is frightening. Council-run care homes seemed to frequently be the worst in the past but I wish we could cut out the middle man and have homes run as not for profit organisations, instead of the councils feeding fat cat owners who then manage things so badly they go bust.
The independent care home my mother in has a 3 million pound deficit. You just wonder how they manage to get so far in debt.
creative accounting RaggedRobin and a huge mortgage on the property.
We have a range of care homes in our area 3-4 Local Authority, one not for profit run by the church and many private homes. In the past I would have expected the privately run homes to give better service, but have rapidly realized despite being modern and attractive- this is just not the case! They are businesses and businesses exist to make a profit. They will always put profit before people! Give me the local council or the not for profit every time.
I so agree Emac
I can only speak for the privately-run care home my mum was in. It was expensive, however the care was excellent and that was enough for me. I have no idea how much profit the owners made, and having never met a care home owner have no idea what their income is compared to other businesses.
All kinds of people earn their living from providing services we would rather not have to buy. It's not anyone's fault that my eyesight is so rubbish that my optician has to charge me a small fortune for my glasses and contact lenses. She's a business owner and no doubt has bills to pay like everyone else.
I have said it before on TP but will again. Good care costs and if we want carers to be paid a decent wage we either have to pay for it ourselves through the fees or be willing to pay higher taxes/NI during our working lives. There is no money tree.
With you all the way on this one. Looking down the road: hoping it is a long one. I have thought of a live in nurse/carer as an option. Hope it's a long way ahead but it seems an option worth considering. As you say there is no money tree. G L
Our taxes felt pretty hefty when we were younger....now we're old, and we're told the cupboard is bare...
Those are my thoughts too GL. It worked for some friends of ours.
I think we can tighten our belts; we've done it before. I can still remember being hungry in wartime, when Make Do and Mend was the motto. My mum would make dresses for me by cutting down her own. Probably that's why I get told off by my kids because I hoard things!
Be good to hear from those who have trodden this path before.
It's amazing what the differences can be between countries. Here in Ontario, the care in nursing homes is, in my opinion, superior to anything that can be found in retirement homes. That's because retirement homes are geared for the more cognitively intact people. The care is there but the price becomes astronomical. Heavy nursing care is not provided though. If a person living there has dementia and starts acting out, they will ask the family to move the person. It happened to someone I know.
I agree with this 100%. It amazes me how much the staff accomplish, even though the carer/resident is 1 to 10. But they manage and they keep everyone clean. My mother has been in a wheelchair for 9 years now and has not yet developed a pressure sore. A few times she's had pinkness but they have got onto it very quickly.
I've had my ups and downs with the home but overall, I recommend it to people I know. My disagreements have been mainly with management, not the actual care.
I have worked all my life and paid taxes and NI and actually used very little of the services I have paid into. I don't mind that but I do mind being asked to pay again in my old age when I thought that was a hefty chunk of what I was paying for in the years I have been working. I don't mind if they need to increase the NI but i do mind being told I can't have care.
Having seen the care on offer I am hoping that when my time comes i will have a combination of family and live in care to prop me up or else I'm off to Switzerland
They did, but so many factors play into that. For so many health problems, though sadly not yet for dementia, the treatments available now are to me miraculous. I remember the first heart transplant, now these are almost routine and certainly anyone with an illness requiring a transplant would feel short-changed if not able to have one. People who would have died much earlier in life now survive to a much greater age as the life expectancy figures show.
One of the problems with free at point of use is that we do not know how much our treatments and prescriptions actually cost, so I don't think we appreciate how the costs of treatment are continually rising. I have not so far needed to make much use of the services I have contributed for, but to me that is fortunate. I have paid for house insurance for many years too, and am grateful that my house has never burned down rather than feeling it's unfair that I have never been able to make a claim.
Pickles, I very much like your attitude. It's 'glass have full' thinking and you're right. Better to pay taxes and never use the services than not have have to pay for services. As you point out, we don't really know what the costs are, plus the treatments and procedures are far different to what they were when the NHS in the UK and our socialized medicine here were put in place.
To be fair what you were paying for was to have 30 bed wards of old people; no privacy, one TV at the end of the ward, hospital food at its worse, that's what the people who benefited from your (and my) tax years ago, I know I nursed some of them as did my wife.
These days many people don't like to share with one other person let alone 29 others with just a curtain pulled round for privacy.
Nowhere in the NHS was there ever a level of comfort to compare with what people expect (and receive) in care homes.