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Funding crisis hits care homes

Discussion in 'Dementia-related news and campaigns' started by Wirralson, Sep 22, 2015.

  1. Wirralson

    Wirralson Account Closed

    May 30, 2012
    661
    I've not seen this posted elsewhere on TP. Some of the issue seems to be care home providers and their lobbying organisations attempting to force more money out of LAs, but the situation is unlikely to improve, and it is noteworthy that the CQC is raising the issue as well. One of the possible outcomes is home closures or sales to lower-cost operators, and another is that an increasing number of homes will decline to take LA-paid residents, or that the number of places available overall will diminish. The issue of cross-subsidy (of self-funders paying more than LA or NHS-funded residents) is unlikely to go away any time soon either.

    http://www.telegraph.co.uk/news/hea...rly-care-home-residents-face-uncertainty.html

    W
     
  2. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,668
    Salford
  3. Wirralson

    Wirralson Account Closed

    May 30, 2012
    661
    Warehouse care homes

    Hi Kevin,

    Many thanks for the link. This chimes with what I observed when my father and I were placing my mother in care. A couple of acquaintances ran/run family care homes in houses that had in some cases previously been converted to small hotels. But one acquaintance was involved in a more modern home which was significantly larger. Where my parents live(d) was an area where there was large houses could be had relatively cheaply as could the land, and the larger (though IMHO still not "warehouse"-sized) providers had moved in as their overheads were significantly lower. Some of the Telegraph article you post does look like special pleading by high-cost operators though. A high-cost operator in an older property where there possibly are H&S higher risks may find it difficult even to qualify for LA residents.

    W
     
  4. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,561
    North West
    I believe that this would have been an appropriate name for the vast huts full of beds in which people with dementia and other mental health conditions were 'cared for' in the fifties and sixties.

    Progress?:(
     
  5. Wirralson

    Wirralson Account Closed

    May 30, 2012
    661
    #5 Wirralson, Sep 23, 2015
    Last edited: Sep 23, 2015
    Warehouse care homes

    Stanley,

    Having childhood memories of a relative ending up spending the last 20 yeasr of her in one of the massive Victorian institutions you mention, they were in many ways awful, although they were an improvement on what went before. But one of the pressures resulting in their overall size was the same - reducing overhead costs. One attempt to reconcile the demands for concentrating services to keep costs down together with the need for smaller, more personalised care and more flexible units was the bulding of smaller blocks on one site - there are/were examples of these different approaches wihtin a few miles of each other in Hertfordshire at one stage. I wonder if that kind of campus approach might be revived, or if any TPers have examples of such approaches in UK or abroad?

    It is going to be increasingly difficult for smaller care homes in older buildings to meet the ongoing aand increasing requirements for safety, disabled access etc, and I'd expect new builds to become more common, espcially if the process of selling off homes on valuable land continues. Some homes also probably deserve the "warehouse" epithet with all its negative connotations, but I suspect staff atitudes and management leadership have a lot more to do with how user-friendly a home is. Small isn't necessarily always better, although I acknowledge it often can be.

    However, there appears to be over-capacity in the care home industry at the moment. This and the increasing patchiness of availability combined with difficulties in some areas in recruiting and retaining staff seem to me to be real areas for concern. It's pretty evident thqt large amounts of money aren't going to be directed that way any time soon. Most government pronouncements on dementia are couched in the rhetoric of care, but on analysis the subtext is often about finding methods (whether through research and drugs or management) of minimising the demand that chronic illnesses (including the dementias) make on public funds by slowing progress of the disease. While we'd all wish to see that, the care side of the equation doesn't seem to carry anything like the same weight.

    W
     
  6. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,561
    North West
    Yes, Wirralson. I agree that size isn't everything. The campus idea sounds like a possible compromise. The residents and their relatives do need to feel that they and there requirements are known, whatever the size of the facility.

    I agree entirely about government pronouncements. It is never clear exactly how they expect to make a difference and what resources they will actually commit.
     
  7. Wirralson

    Wirralson Account Closed

    May 30, 2012
    661
    #7 Wirralson, Sep 23, 2015
    Last edited: Sep 24, 2015
    Government pronouncements and their subtext

    Having spent thirty years where my responsibilities included writing such things, I can tell you that the one thing you almost never do is commit publicly to allocating resources (or even hint at doing so) unless the proposals have been agreed acros Government and with the Treasury and other stakeholders (the reasons for this are clear when you consider the debacle over the care cap). Most Government pronouncements on dementia are effecitvely exhortations to researchers and pharmaceutical companies (and to a lesser extent the care industry) with a subtext saying, in effect, "we take this seriously but we don't want/can't afford to meet public aspirations for care, so money will be available for research etc". All the concerns expressed about carers and persons with dementia is about emphasising the cost to them and the potential costs to the public purse.

    W
     
  8. Wirralson

    Wirralson Account Closed

    May 30, 2012
    661
    #8 Wirralson, Sep 23, 2015
    Last edited: Sep 24, 2015
    Government pronouncements and their subtext

    Deleted as post was a duplication of the previous one.
     

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