‘This is a damning indictment of a social care system that is failing older people’, Age Concern’s Director General, Gordon Lishman, said on Wednesday.
He was responding to the just-published State of Social Care in England 2005/06, a comprehensive annual overview of the entire social care sector, from the Commission for Social Care Inspection (CSCI).
This found that elderly and disabled individuals and families across England are increasingly having to find and pay for their own social care, as councils restrict services to people with the highest levels of need.
The report finds that more services are meeting minimum standards, but despite spending more, councils are tightening local rules about who qualifies for state-funded social care.
This means that more and more older and disabled people either have to find and pay for their own private care or rely on family members or friends.
The CSCI says: ‘As local councils support fewer people, informal carers have to fill in the gaps, with inadequate support structures to help them and no system in many areas to help people find the services they need.’
Those who have no one to rely on may have to make do without support until their situation becomes critical.
The lack of ‘respite’ help for people who have caring responsibilities can affect their ability to hold down a job, fulfil other family responsibilities such as looking after children, and may damage their own long-term health and emotional well being.
CSCI Chair Dame Denise Platt said: ‘Social care services in England are gradually getting better, but only for those people who manage to qualify for help.
‘As councils face an increase in the number of older and disabled people and in the costs of care, many have responded by raising the threshold people have to pass before they are entitled to a council-funded service.
‘As a result, irrespective of the quality of social care services, fewer people are receiving services.
‘Those who do qualify for care have a high level of need.
‘The options for people who do not meet the criteria set by their local council are limited.
‘In some cases, people rely on friends and family members. In others, they pay for their own care. Some people have no option but to do without.
‘It is also clear that external pressures on the sector are hindering progress in making services better for the people who use them.
‘In particular, NHS budget deficits in some areas are putting a strain on relationships at local level and potentially undermining essential partnerships in both adult and children’s services.’
The proportion of people in England who are over 65 is growing.
Recent projections indicate a rise of 53 per cent in the number of older people with some care needs over the next 20 years; and a rise of 54 per cent in older people with a high level of need.
The number of young disabled people is also increasing.
The number of children under the age of 16 with disabilities rose by 62 per cent between 1975 and 2002.
Many of those children will continue to require help and support as they reach adulthood in order to live their lives to their full potential.
The report also sets out details of improvements in the quality of services, such as care homes and home care agencies, which are registered and regulated by CSCI.
CSCI Chief Inspector Paul Snell said: ‘People who use social care services deserve the best possible care.
‘People tell us they want services that offer them privacy, choice and dignity, and we have seen a year-on-year improvement in these standards.
‘For example, the number of care homes for older people meeting all the national minimum standards has gone up by 20 per cent in the last three years to 79 per cent.
‘However, more still needs to be done to ensure that medicine is properly administered in care homes and that processes for recruiting staff are robust.’
Some of the key findings of the report are:
‘Social care services for both adults and children in England are gradually modernising and getting better.
‘Some services exceed minimum standards and provide very good levels of care. There has been a small increase in the number of places in children’s homes, and fostering agencies are now on average meeting the majority of national minimum standards.
‘But progress is gradual. Some services still do not meet national minimum standards and do not offer people choice and control.
‘For example, people often have little choice as to who provides care in their home and when; and some children in care are moved frequently, denying them the stability that would improve their life chances.
‘Progress in achieving government’s policy ambitions is being hampered by financial and other pressures in the social care and health systems.
‘The market-place for social care providers is underdeveloped, there are continuing recruitment and retention problems for high quality qualified staff, and organisational turbulence in the NHS and councils’ structures for children’s and adults’ services.
‘Local council officials who purchase or commission services have to balance the need to economise while at the same time meeting public expectations of high quality services.
‘There is a shift away from services funded and arranged by the state to more responsibilities being placed on individuals.
‘Fewer people qualify to receive care services due to ever-tightening eligibility criteria.
‘Some services still do not meet national minimum standards and/or do not offer the sort of choice and control that people should have a right to in determining how they live their lives.’
Age Concern’s Lishman added: ‘The government has said it wants more care delivered at home – but this report just highlights that fewer and fewer people have been receiving social care in recent years.’
Calling for a debate on what the state will provide, Lishman said: ‘Unfortunately this report just confirms the experiences of older people.
‘Those receiving care at home have seen services withdrawn and prices increased, while those in care homes and their families often find themselves subsidising the pitiful amounts local authorities pay for care.
‘Older people are also let down by the quality of care delivered in care homes.
‘It is unacceptable that 61 per cent of care homes don’t meet minimum standards of managing medication safely and 57 per cent don’t ensure there is an appropriate care plan for its older residents.’
Mervyn Kohler, Head of Public Affairs at Help the Aged said: ‘It comes as no surprise that the current social care system is still in a profound mess, and the portents for the future are even bleaker.’
He added: ‘This disturbing report shows how more older people are paying the price of a floundering system.
‘It is particularly alarming that only two thirds of care homes meet minimum standards relating to safe management of medication to residents.
‘There should no excuse for such lapses in provision of basic, yet critical care needs, but sure enough we’re still hearing of it.’
He said the government was reluctant to fund to care for the elderly and disabled.