Rise in the number of care homes going bust

The number of care homes businesses going bust has increased from 35 in 2010 to 67 in 2012, according to accountancy firm, Wilkins Kennedy. Nearly 250 operators have closed in the last five years. Local authority cuts (referrals and rates) mean a number of care homes are struggling to maintain high standards of care and/or service debts taken out during the boom years. The Independent has estimated that approximately £5bn of debt has been built up by the larger care home operators prior to 2008. The regulatory standards within which care homes operate mean that they often have less flexibility to reduce costs to match falling revenues. The Government announced on 3 May 2013 that large private care providers will have their financial records regularly scrutinised in future to spot potential business problems.

Social care costs cap brought forward & the new Care Bill

The Government recently announced that its proposed overhaul of social care funding will be brought forward from 2017 to 2016. This reform is focused on removing the need for people to sell their own homes or lose their assets if they develop serious care needs rather than introducing more money into the system. The cap will only cover the social care costs (e.g. support for washing and dressing) and not the so-called "hotel" costs such as food and rent. In addition, the cap will not be calculated as a simple amount of money but will be done using the standard fee which the relevant local authority would pay for the care needed by that person. Any extra amount would have to be funded by the individual or their family. The Government have indicated that the rules will be changed to permit such "topping up".

The new Care Bill (to apply only to England) announced in the Queen's Speech did not refer to the amount of the cap (but the previous announcement said it would be set at £72,000). The new Bill will also give carers the legal right to support from their local council and everyone a legal entitlement to a personal care budget to spend as they wish. An Ofsted-style rating is also to be introduced for care homes. Residents of care homes and their families can currently rate care homes via the NHS Choices website: http://www.nhs.uk/Service-Search/Care-homes-and-care-at-home/LocationSearch/11 Research by the Association of Directors of Adult Social Services suggests that the social care budget is likely to be cut by £800m in the next 12 months (after a cut of nearly £2bn in the past 2 years) despite the likely increase in eligibility as a result of the cap, estimated at an extra 450,000 people. The previous announcement also indicated that the upper limit for care home residents in England will be raised to £123,000 whilst the lower limit is expected to be raised to £17,500. But no further details are yet available.

New law to jail care home bosses who mistreat the elderly

The Sunday Times recently reported that owners and directors of care homes where elderly people are abused could face jail under a new law making them accountable for neglect and mistreatment. Care homes that cover up incidents of neglect or mistreatment could also be prosecuted under the new "duty of candour" for staff. The new rules are expected to be outlined in a consultation by the Department of Health (DoH) in the forthcoming weeks. The Care Bill will also provide protection to people whose care provider goes out of business and create Health Education England and the Health Research Authority to prove additional training and support for health professionals in England.

Labour to launch a health and social care commission

Labour has announced that it will seek to establish an independent commission to investigate how best to integrate health and social care. Labour believes that, without such co-ordination, there will be a £29 billion gap in the health budget by 2020. The NHS currently meets medical care costs but social care costs are met by local authorities if private means are not available. This has led to "bed blocking" in some areas as local authorities have delayed taking responsibility for their care by leaving elderly patients in NHS beds. This split in responsibilities is historic but has led to concerns that the system is inefficient and wastes money and does not provide appropriate care and support for those most in need, particularly given the projected demographic changes.

Majority of Deprivation of Liberty cases unreported

A report by CQC has said that almost two thirds of applications to restrict a person's liberty under the Mental Capacity Act (MCA) were not reported to it as required by law. In some cases, patients had their freedom removed for months at a time. Lawyers representing people with mental disabilities suspect the numbers may be far higher because some care homes (and hospitals) are restraining people without using the safeguards.

Court of Protection

There have further complaints in the press about the secrecy surrounding the Court of Protection's role under MCA as the guardian of the interests of those deemed unfit to look after their own affairs. Wanda Maddocks was sentenced in her absence by the Court (and then jailed) for contempt of court because she removed her elderly father from a care home where he had been placed against the family's wished by local authority social workers. Details of her conviction were not made public for six months.

Dementia care - new NICE guide

The National Institution for Health and Care Excellence has recently produced its first social care guide - "Supporting People to Live Well with Dementia" - setting out the standards expected from care providers for dementia sufferers. It indicates that people with dementia should be involved in decisions about their care and must be helped to maintain relationships and to participate in their communities.

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