The government appears to be in denial about the impact of an ageing population on care services. That's why a new Commission is urgently reviewing how residential provision needs to adapt and change
Last year, a Lords committee set out to review the implications of demographic change on all aspects of life within the UK – from health and care to pensions, work and housing. They had some stark numbers to work with: England will see a 51 per cent rise in those aged 65 plus and a 101 per cent increase in those aged 85 plus from 2010 to 2030. Instances of dementia will increase by 80 per cent by then. Arthritis, coronary heart disease and stroke – all up by over 50 per cent.
After 10 months of gathering evidence, a 100-page report was produced detailing every aspect of life likely to change and what we’d need to do about it. Its opening line didn’t pull any punches: ‘The UK population is ageing rapidly, but we have concluded that the government and our society are woefully underprepared.’
One might have expected a swift response from the government, answering the committee’s urgent call for a white paper outlining how vital reforms would be pushed through.
However, a leisurely four months later, and issued amongst a pile of other documents on the last day before MPs cleared their desks for summer recess, the government’s muted response to the report gave no new policy details and no promise of a white paper.
In a play on the first line of the report his committee produced, Lord Filkin expressed his frustration by commenting that the government was now ‘wilfully’ under-prepared: it now had evidence of the seriousness of the situation and recommendations for policy solutions which could help, and yet chose not to act upon this.
But then, an ageing society isn’t good news for the NHS (misdirected); social care (under-resourced); housing (the wrong type) or pensions (not enough) and it takes a brave party, less than two years from the next election, to tell voters they have to work longer, save more and pay more for their care in later life.
But while the Coalition and Opposition dodge the uncomfortable truths the Lords took pains to set out, those on the front line of the services affected by our ageing population can’t afford to put their heads in the sand. Thousands of home carers, social workers, housing officers, GPs (not to mention pensions providers, insurers and employers) across the country are all struggling to keep pace with problems being thrown up by a growth in the numbers of older people and the public’s mental block when it comes to preparing for old age.
But many are not waiting for political leaders to get their acts together. Bottom-up, innovative solutions to many of these challenges are popping up locally – you don’t have to go far to find a Dementia Café these days or an alumni club for retired employees. But spreading this knowledge and having the courage and leadership to do things differently and to make this the norm is another matter.
Demos is working on several fronts to help with this – looking into how housing equity might be used to fund social care; assembling the arguments for a proper downsizing policy for older people; and, last week, launching the Commission on Residential Care, headed by Paul Burstow MP.
Residential care homes are at the coal face of demographic change – over half of residents already have dementia, and the average age (and care needs) of their residents increases year-on-year. Demands and expectations of residential care are also increasing, as wider NHS and social care reforms promote choice, independence and personalised services; but years of under-funding in social care has led to local authorities paying under-market prices for care beds and bankruptcies are a way of life in the sector.
The number of private providers declaring insolvency rose by 12 per cent in 2012 with 67 companies going out of business. The annual rate of failures has more than doubled in the last five years from 28 in 2008, meaning nearly 250 operators – many of them running chains of several homes – have disappeared.
To make matters worse, recent high profile abuse scandals has exacerbated the social stigma surrounding care homes, making them a feared last resort for many older people who would in fact benefit hugely from the wrap-around care and social opportunities a good care home can offer.
It is for this reason that we have launched the Commission. By 2030 there will be an extra 239,000 people over 85 needing 24/7 care. It would be foolish of us to think this entire group can be – or wants to be – catered for by carers coming into their own homes. It’s clear that the residential sector has to not only grow, but innovate, as this new cohort is more culturally diverse, with more challenging needs, and higher expectations.
How can it do this when bearing the burden of financial pressures and social stigma? It’s an unsupportable mix for the average care home provider and something must give.
Rather than wait for policy makers to provide solutions from above, the Commission believes the sector should lead the charge from the bottom up. It wants to help by identifying the pioneering models both here and abroad and share this practice. Gathering evidence of how care homes are finding their niche in a modern care system and speaking to the next generation of care home users to find out what they want and expect will, we hope, give insights that the entire sector can use.
It’s time for the sector to grasp the nettle of our ageing society, even if our political leaders aren’t willing to.
Claudia Wood is deputy director at Demos. This post first appeared on the Demos website
