Why is the cost of care so high?

I work in a care home - there is no profit (it’s charity run) and the fees are as low as they can possibly be to cover the nurses, carers, laundry, cooks, food, heating, entertainment, maintenance etc

I was just looking at our local care / nursing home. The absolute cheapest room is 2300 per week, if you don’t need a high level of care. The fees included a manicure twice pm, hairdressing twice pm, wine with lunch and dinner, afternoon tea and cakes, concierge to book restaurants and shows, physio once per month. Trips out. In-house cinema etc.

Luckily we managed to look after my parents in their home until almost the end, then a wonderful hospice for the last weeks. As the ambulance crew were carrying my mum into the ambulance to take her into the hospice, someone finally called to arrange the requested support at home - too late!

In the case of dementia the cost of 247 at home or residential care can easily exceed £500k if self funded. I think a high cap of say £200k would win a lot of votes, still high but not a devastating amount.

I wonder how long it will be (not long presumably, as this govt really seems to have the elderly in its sights) until a charge is levelled against the estate of people receiving care in their own homes? I think Theresa May was proposing something like this and it helped cost her the Tories' majority in 2017. On the other hand it might make the bills less eyewatering for those who do need residential care, if the govt was able to subsidise it more effectively.

It does seem incredibly hard on people that local authorities can rinse an old person who lived alone for almost the complete value of their home, yet if they have a spouse or adult child over a certain age living in it, the home cannot be touched. It's a very unfair system as it stands in many ways.

Have a look at the care home car park when the owners are visiting to see where the money goes. Bentleys are popular. My stepdad did accounting for a local care home group, they were swimming in profits, not that any of that went back to the staff or residents. A very small group of people are making a lot of money from a lot of families down repeated generations, but it’s ok because most people don’t end up in care homes, despite dementia being the biggest killer in this country.

We looked into live-in care for an aunt of dh, but it would have worked out rather more expensive than a nice care home. She’d have needed help at night too, which would have meant more than one on shifts.
Plus there would be all the usual expenses of running a home on top.

Care homes - some of them don’t seem so bad when you think of someone on hand 24/7, help with washing/dressing etc., ALL meals and drinks, all laundry, and a LOT of heating. And then compare the daily cost to just B&B in say a 3 star hotel.

It's not binary, it's a sliding scale, but there is huge variation. Doesn't necessarily correlate with cost, though.

But, there has to be a ratio of self funders to council funded depending on the fees paid by the self funders. This is where it gets tricky if there aren't enough self funders paying full fees. If a self funder runs out of money the council funding won't be enough to keep them in an expensive home.

Yes self funders subsidise the council funded residents and yes there is a wide variety in quality and standards.
I have personal experience of supporting elderly relatives in 6 different homes and professional experience of visiting many more as a community nurse.

But are there good ones and not so good ones? Is it really a binary choice? Because from my own experience and from what many people have said on this website, generally speaking, the self-funders and the people funded by the state are living in the same homes.

Probably... but 23k would not go far in this situation.

They do if it is a good home and the local authority want to move the person to a cheaper home. Either your relative is moved or you find the money.

They can charge what they want because people have no choice but to pay and when people run out of money the LA pay. I know two people who own care homes and they are both phenomenally wealthy.

The OP said £5k per month, not per week.

Not nothing. The threshold is £23k.

£3-£4k per week? That must be top end of the ridiculously luxurious market. £800pw is about 50% of a typical rate and probably not far off the total labour costs including NI, pension contributions, holidays etc. Add property and equipment costs, food, laundry, insurance etc and £1500-£1800pw is not that eye watering.

Yes there will be 4 X shifts of staff, however the ratio of staff to residents isn't 1:1. It's about 1:4. So whilst it will always be very expensive to pay effectively 1 persons wage for care, NMW is only around £25k per annum. Let's add 50% and round up to £40k for antisocial hours. That's still only £800 per week (rounded up). Let's add another £200 per week for employer NI and pension contributions. Where's the other £3-4k per week going? Some of it will be utilities, food, equipment, insurance, salaries for additional staff (managers, caterers etc) but I would imagine a significant proportion is the care home being rinsed by excessive rental costs and private contractors (eg meal providers will charge extortionately for low quality food, agency costs, equipment may be hired at extortionate cost instead of purchased).

We should nationalise social care right down to R&D of equipment as much as possible - seeing as we are all having to pay (through the nose) for it in any case, whether we/our loved ones end up in care or not.

I think for LA to get involved there have to be, literally, nothing. On top of this, the process takes forever... One of my friends have been trying for about two years now.

If there is no money then the LA will pay. There may be little choice, but if home care is unsustainable and there is no money then social services do have an obligation to arrange something.

Everything about this situation is unfair, especially for the elderly people trapped in it.

Because the care sector is now totally privatised with no financial regulation. It’s an utter disgrace the amount of profiteering that now comes from so called “care” sector. The people doing the graft really do not get paid anywhere near enough.

Family can be asked to pay a top up, not made to. If they say no - or there is nobody to answer - social services will either (in rough ordernof preference) negotiate a lower rate with the existing home, find another home that will accept the standard local authority rate, or pay the extra themselves.

I too think it's really high, per week, the cost.

What happens if the the elderly person has no family (but does have the money to pay)?

It's really not a good idea to spend the capital of an elderly person with dementia etc, making the assumption that they don't have long left.

My ex's parents had a lot in savings, much of which they've given away to their children; the problem is that the FIL was diagnosed with dementia four years ago and it will be viewed as intentional deprivation.

MIL is 77 and has to look after him, he is incontinent and quite far gone, but he may live years yet - they have dug themselves into a hole when it comes to trying to obtain a care home placement, as the DOC will be flagged up straightaway.

Families don’t have to top up, do they?