Care Home Fees Conundrum

elsien

Many places are indeed closing.
Including one in my area, and another a relative was in, where the owner did very few of the things itemised above because it cut into his profit margins too much.
Businesses are there to make a profit, and it's very concerning at times to see just how the corners are being cut to do that. And some of that is down to greed, not funding cutbacks.

lisyloo

I agree with you terry towelling that the current system is not sustainable and not just long term either.

My FIL moved into home in March for a short period. We were very aware at that time that homes were closing in our area (Bristol). We were very lucky that a place came up where MIL is.

If there aren’t enough places then elderly people with bed block in hospital at great expense (I was told £3k per week for just bed) but that will also have a knock on effect to the rest of the NHS.

Nebulous2

lisyloo wrote: »

If there aren’t enough places then elderly people with bed block in hospital at great expense (I was told £3k per week for just bed) but that will also have a knock on effect to the rest of the NHS.

This is an interesting thread - though it has drifted a long way away from the original post.

We've moved from a society where most of the care was provided by family and friends to one where much of it is provided by the state. That is becoming increasingly complicated. The social compact which agreed to set up the welfare state has fractured, with many people concerned they aren't getting enough for their contribution.

The dilemma of a health service which is free at the point of delivery and social care which is means-tested, means that £3k bed costs the individual less than a £1k bed in a care home does.

lisyloo

with many people concerned they aren't getting enough for their contribution.

In most cases that is false.
60% of us are net takers (and yes there are links for that).
Some people (like my MIL) think they have paid all their life (which they have) on a supermarket checkout salary, but that doesn't go far when residential homes are £800 per week, hospital beds £3K per week and intensive care about £10K per night.


I don't think people realise the costs and those that do know the costs think that care homes are a rip-off as they don't appreciate what's involved.


There's a dis-connect between paying tax (which is seen as a bad thing) and wanting good services.


Also there's a resentment about those who get a free-ride.
I think the pendulum has swung the other way and whilst I totally see the need to see off free loaders the nasty party have made genuine cases struggle to make ends meet.

The dilemma of a health service which is free at the point of delivery and social care which is means-tested, means that £3k bed costs the individual less than a £1k bed in a care home does.

There is a system in place to put pressure on LAs (I know about this as both FIL and MIL were difficult cases) whereby they are fined for every day someone is bed blocking.
However it's clear that if there are no places available then putting pressure on isn't going to help people move.

Mojisola

It's a myth that people expected the National Health system to completely provide for them in their old age at the standard they would have had at home - the people who had more care needs than could be managed by relatives (or didn't have family who would take on the care) spent their last years in large wards with strict regimes, either in mental asylums for those with dementia or upgraded work houses.

There never was the money in the welfare system to provide accommodation and care to the standards we consider acceptable now.

Malthusian

elsien wrote: »

Businesses are there to make a profit, and it's very concerning at times to see just how the corners are being cut to do that. And some of that is down to greed, not funding cutbacks.

If I was greedy I would not enter an industry with tiny profit margins and a high level of regulation. If I was greedy and owned a care home I would close it, convert it into as many flats as I could cram in, and rent them out to itinerants and students.

GDB2222 wrote: »

Whilst I agree with you entirely, there have been societies (very successful ones at that) that took a very draconian approach to social welfare. The Spartans, for example.

Evidence is scanty but the Spartan social welfare system was almost certainly comparable with or better than its peers, given that universal education was available to both genders (in its neighbours it was boys-only), and both women and slaves had more rights than they did in other Greek city-states. It seems likely that anyone who did make it to old age was well cared-for by the standards of the time.

The tales of sickly Spartan babies being left on a hillside are likely to be exaggerated when you consider that most infants in poor health in 500BC would have died whether they were Spartan or not.

The problem with care homes is simple. Nobody wants to go into a care home. Therefore nobody wants to pay for it. As with the supposed "housing crisis", the "crisis" is a mish-mash of two different problems, which makes talking about "solutions" extremely difficult as there is no single solution which can solve two entirely different problems. The whole debate is akin to "9x + 2 = 20 and 5x - 7 = 13, solve for x".

Problem no. 1 is that those with the means to pay for their care don't want to. (And their kids don't want them to either as they want the money to go to them.) Problem no. 2 is that some people don't have the means to pay for their care and therefore have to be subsidised by others; the level of subsidy is currently too low to guarantee what we currently consider a decent level of care, which leads to shortages and poor quality provision.

The fundamental problem with the debate is that any attempt to discuss problem #2 on the national level is immediately hijacked by middle-class journalists and politicians who want to talk about problem #1, and make others subsidise their inheritance rather than people who don't have the money to pay for a decent standard of care.

The solution to problem #2 is straightforward: higher taxes or genuine, real cuts in other areas in order to subsidise more provision for those who don't own houses or other assets and can't pay for their own care. However those in influence, who do have the means to pay for their eventual care, refuse to contemplate a proposal for higher taxes unless it also includes some kind of provision to cap their own costs. Raising taxes in order to subsidise those with means is a total non-starter politically. A previous attempt to square this circle (the Dilnot report) has already failed. Hence no solution to problem #2 is politically possible because it won't also solve problem #1.

The latest pointless proposal for a "care ISA" is an illustration of this. The idea is that those who already have the means to pay for their own care should get a tax break. This solves nothing as those who already have the means to pay for their own care will still resent having to do so, tax break or not. Meanwhile not a single extra bed will be created for those who don't have ISAs. Yet a large number of people have already wasted thousands of hours drafting and debating this non-solution.

Shedman

lisyloo wrote: »

But if anyone thinks it's a money-spinner - then get into the business.

Well looking at several years accounts for the Care Home my MiL is in, which is one of the cheapest in area at £600-700 a week and is not part of one of the chains, it looks to me like they're making around £5k pa per resident net profit (around 25 residents so £125k total) so that ain't too shabby.

It's a good friendly home though and they provide good facilities & food, activities, etc. so they aren't scrimping...makes you wonder what profit levels the multi home chains like BUPA, Cinnamon, Gracewell etc make seeing as they charge between £1000 to over £1200 a week round here!

lisyloo

it looks to me like they're making around £5k pa per resident net profit (around 25 residents so £125k total) so that ain't too shabby

On what investment? What's the yield?
It's ok for investments to make profits and I am not claiming they don't (of course they do otherwise why would they be in business).


There is nothing wrong with making a decent profit, but if someone can make more from developing flats or investing it in shares or putting it in the bank then they would do that.


So can you tell us what yield that represents on the investment?

peterbaker

Mojisola wrote: »

It's a myth that people expected the National Health system to completely provide for them in their old age at the standard they would have had at home - the people who had more care needs than could be managed by relatives (or didn't have family who would take on the care) spent their last years in large wards with strict regimes, either in mental asylums for those with dementia or upgraded work houses.

There never was the money in the welfare system to provide accommodation and care to the standards we consider acceptable now.

There was money to pay for sanatoria all over the country for Tuberculosis treatments, and for treatment of polio, and huge mental institutions up and down the country, all of which cost a great deal of money to run and all of which are closed down and property sold off (flats and sundry BTL stocks again, lisyloo!) to fund the race to the bottom with tax cuts in recent decades.

There has continually been money to pay for the enormous costs of treating smoking related disease, alcohol related disease and obesity related disease. At one stage culturally I couldn't get away with saying to a heavy smoker that they were an idiot, even if I was having to breathe their smoke at work, or to a pot bellied nightly bar-propper that they looked a mess and were being stupid (probably wouldn't try that one even today - at least not in the pub itself!) nor even suggest that someone terribly obese probably had an overeating / dumb unhealthy diet/ lack of exercise / get up and go problem, if not a combination of the smoking and alcohol problems too!

Our UK culture has skewed the welfare system off track. It is woefully underfunded because of the short-sightedness and lack of world-alternative-view of the many who have been led to believe that low tax low wage for the masses is clever. It is incredibly stupid thinking and because that same stupidity is what successive HMGs have promoted, that means we as a country are too.

Mojisola

peterbaker wrote: »

There was money to pay for sanatoria all over the country for Tuberculosis treatments, and for treatment of polio, and huge mental institutions up and down the country, all of which cost a great deal of money to run

Probably less than the cost of current care homes where people expect individual rooms and a 'home from home' rather than the previous institutional ward system.