Charity focus: how do we make care work for the elderly?

A small team from Kreston Reeves and Brachers were privileged to sit down with a few key charity leaders working in the elderly care sector. The aim was to consider the challenges that are faced and maybe start the rocky road to finding a solution – we can all dream!

Let us start by setting the scene.

Elderly care in the UK is in crisis. No government wants to deal with the issue as it is in the ‘too hard’ box. They do, however, have a big box of sticky plasters. It looks like they have bought the cheap version and the stickiness is diminishing.

As a sector, we are part of the Government’s box of plasters. But it is not sustainable. What can we do? It would be great if we could solve the problem, but as we get older, we are becoming more realistic rather than idealistic. However, there is something we can do and that is developing and growing the narrative. Think outside the box and start leading the fight: don’t wait for a system of government that only deals with the short term.

A key challenge identified is society’s attitude. The public will not engage until it affects them personally, e.g. when a loved one needs support. In their mind, the NHS is there from birth to grave, so it is an NHS issue. However, the NHS is funded by us, the taxpayer, and hence it is our issue. The Government’s proposal of introducing a levy to fund social care is just increasing taxes. A hard cost to bear for those already struggling in a ‘cost of living’ crisis or paying increased mortgage payments on ever-increasing house costs.

Valuing the cost of care

Houses are a difficult topic when looking at care homes. Should they be used to fund the care home or kept for the next generations’ inheritance? What is your home – do you view it as the place you live or an investment? How do your next of kin view it?

If it is the place you live in, when you move to a care home you are replacing one with the other, hence using your house to fund the care home is a natural progression. The care home provides a roof, three meals a day, washing, care and some entertainment. When you look at one’s home as an investment, the mindset is more to retain it.

Cost is an issue with care homes, but you need to put it into perspective. What would you pay to say in a hotel full board? Care staff are among our lowest paid employees. Due to the circumstances of some of our elderly people, they perform some very personal care for people and can be subject to a lot of abuse – verbal and physical. (Dementia is a challenging illness).

Families do not always want to (or cannot) do these tasks but are reluctant to pay a proper amount to pay carers a decent wage. As a society we do not promote the importance and value of this sector.

We should be promoting the values of a caring career. There should be a clear pathway when they come out of school to becoming a care worker. We are not advocating a qualification for qualification’s sake – and definitely not just a university route – but qualifications reflecting the important and difficult work they do.

What does ‘good’ policy and practice look like?

We have an ageing population but the policies in place are the same that existed many years ago. Thanks to the advancement in medicine and improved living standards, people are living longer. Unfortunately, there is a downside as living longer can bring more illnesses, including Dementia and Alzheimer’s.

The policies need to change but if you do not understand what is broken how can you fix it? Do we even know what ‘good’ is? Government tenure is short term; however, all parties should unite to instruct the civil service to consider a longer-term solution and policies that will outlast successive governments and make lasting change. Money and funding are a major part of this, but what does the outcome look like? What does the money actually do?

The Private Sector and charities have taken some of the initiative, the civil service needs to engage with them. The NHS, as an organisation, is becoming introvert and insular. Locally, it does an incredible job in difficult circumstances, but there is no overall strategic planning. A commercial organisation or charity would have gone bust many years ago without this.

There has been an increase in the number of retirement communities providing additional support. There are some very ‘young’ older people and hence the communities can be quite diverse. Some of these can be expensive and hence provision needs to be put into more affordable sites.

We hear a lot about bed blocking. Long stay geriatric wards have gone but should we consider replacing these with sites to care for people before they can go home or enable them to be assessed away from hospitals. Home assessments and follow up work needs to speed up.

Charities can help but pay them a reasonable sum to do this work. The NHS does not need to do everything. You often hear of conflicts on funding between local authorities and the NHS. Should this funding be independent of both?

A ‘whole community’ approach to elderly social care

There are a lot of independent organisations popping up to provide the older generation with activities and support. These are being initiated by the older community themselves. Learn from what they do and use their experiences to develop future strategy.

Signposting is the buzzword of the last twenty years, but it is crucial when you find yourself in a situation where you don’t know what to do. In life we do a lot of planning, but we don’t plan for later life. We can often do some simple adjustments in our own home to enable us to remain in them for longer, but we often leave it until it is too late. Knowing what benefits you are entitled to can be a minefield.

It is very easy to be critical of the Government, but this is a society issue and people need to engage more in looking for solutions. We all pay taxes but that only goes so far. The welfare state was created with no funds and hence we are always paying for the past. The welfare state has become more complex increasing in breadth and size, leaving the taxpayer with a bill which is insurmountable, akin to a credit card with outrageous APR. We need a strategy to pay for the present situation we find ourselves in, it is not going away.

Conclusions

What did we conclude from our discussions? Unfortunately, there is not an immediate solution but the current policy of tinkering and bury their head in the sand is not working. We need a longer-term strategy based on an understanding of the problem and not about votes. We need to value the skills required for working in social care and promote the values of a caring career. We need to value the support provided by unpaid carers. Society needs to take responsibility for the sort of country they want to live in.

Old age may be a long way off for some but hopefully we will live to see it and we can enjoy it in the way they would like to.

This guest post was authored by Susan Robinson, Accounts and Audit Partner and Head of Charities and Not for Profit at Kreston Reeves.

This content is correct at time of publication