Solve the social care crisis

[Explaintome]

As I understand it, the lack of social care is causing a lot of the problems in hospitals and therefore the ambulance service. People can't be discharged because of lack of care, so block beds.

Carework is unattractive because of the poor pay.

Despite the poor pay, care still costs the taxpayer £££

The now cancelled NI increase was supposed to help fund social care, but disproportionately affected the low paid and didn't affect retirees or the wealthy with unearned income at all.

My solution. Accept that people need to pay for their own care where they can, including from the sale of their houses, even if that's retrospectively because they or their spouse were living in them at the time.

Increase inheritance tax.

To me it makes perfect sense that people who have the means pay what are essentially their own living costs and that those people with means who are fortunate enough not to need care constitute to a pot to pay for care for those who don't have their own money.

I don't understand why "we" are so hung up on the idea that parents have a right to pass on (largely unearned/untaxed) property gains to children.

IHT taxes people who no longer have any need for the money, it seems a painless tax to me.

FWIW I am the child of boomers who worry about IHT so this would cost me, but I think if there's that much money going "free" there should be substantial tax paid on it.

A lot of Elderly frail people used to be cared for by the NHS in elderly care wards. The NHS closed many of the wards and transferred people to privately owned care homes which a lot of people pay for. Some people choose to be cared for at home (a good thing). The NHS will fund end of life or continuing healthcare needs but often refuse to fund continuing healthcare. This means that the burden of caring for very frail and elderly has moved from NHS healthcare to social care - into the hands of private companies or with social care paying carers with ‘Direct Payments’ the cost often creeps upwards as people deteriorate. It’s a mess but one that has been many years in the making.

It makes zero difference what people pay for their care, there are no staff, I work in this sector & can't get patients discharged from hospital, funding etc all agreed but the providers have no staff. They are constantly recruiting, some adverts have no people applying.

Surely there are no staff because the work is unattractive for the pay? If it paid better there would be staff.

I have a friend who's worked in a carehome for nearly 20 years. She loves her work, is so demonstrably fond of "her" old people, exactly the person you want in the job. She earns minimum wage, not a penny more. She could earn mlre doing anything else. DS1 earned more in McDonalds, DS2 earned more in his first school leaver's job at 16. It needs to be better paid, but that needs to be paid for. Hence my IHT solution.

Only a tiny fraction of estates pay iht so an increase there isn't going to be much help.

The thing is that everyone wants to know they will be taken care of when they are old, but no one really wants to do the work so it's really difficult for the care companies to recruit staff and the job is very unpleasant.

Some of the burden could be reduced by encouraging the over 50s to join in to mutual "care cooperative" charitable organisations where people build up credit towards their own future care needs by providing for the needs of others in the cooperative. You spend 20 minutes a day helping others for as many decades as you are able, but when you start needing care yourself you can rely on others doing likewise. It couldn't be a universal solution because obviously some people are not going to be accepted as members of such cooperatives if they are for any reason not a safe or trustworthy provider of care. But it would mean that the paid-for services could have a lot less pressure on them.

That's why I'd change the threshold. More estates should pay IMO.

agree, there are no staff
covid,
bad reputation
bad employers
looked down on occupation
unrealistic hours
bad pay
i did community caring but gave up in 2020, would not go back, the price of petrol enough to outweigh any benefit!

would you be a carer op?

I think that some sort of halfway house would help - somewhere those medically fit to be discharged from hospital can go to, but where they would still receive nursing and social care while they convalesce. This would buy them some time for a proper package of onward care to be put together and perhaps prevent some re-admissions to hospital too.

Not under current conditions, but I'd certainly swap e.g. shop or cafe work for it if it was better paid than they are.

That's my point. Currently McDonalds pays better than caring.

perhaps the discharge shouldnt be to their homes, but to an actual purpose built care home
that woudl cure the housing crisis for one thing

Vaccinating even.

mcdonalds may pay better but a poster upthread said but no one really wants to do the work so it's really difficult for the care companies to recruit staff and the job is very unpleasant

so not only is the pay not good enough many many people feel the job is unpleasant

In the long term, it has to be a mix.

people are living longer so IMHO people have to take more responsibility for their own care, dealing with obesity through diet & exercise. We need a major push to get the 50s and 60s into better self care, which will reduce need.
Then people need to contribute to their own social care. And medical care is provided by the nhs.
my dm lived at home but as she became more frail we provided a gardener, cleaner, home hairdresser, eye & foot care, farm food delivery at home. All for an hour or two a week and each on a different day so she was never lonely for long. We did weekends. Cost to us towards the end was about £150 a week. Much cheaper than residential care and dm was much happier. I think people need to plan and adapt more.
I think the demand for home services will grow.
Developers need to be forced to build more
housing suitable for pensioners rather than endless exec 5 beds so people can remain in communities.

whatever their pay, carers are looked down on

perhaps if there were more training oppournitists, a better job title, for instance, that might encourage staff

If it was better paid, the kind of salary people aspire to, they'd be less so?

That's interesting. My dad's golf course has just had planning granted for retirement bungalows. The local council refused initially on the basis that yes, the area needs retirement housing, but these bungalows will be unaffordable for the people in their Borough who need the housing, so will effectively bring wealthy retirees from more affluent areas, who will see an opportunity to release equity and subsequently use our local health care facilities, whilst doing nothing to solve the local problem.

The Secretary of state has over ruled and planning has been granted.

Agree with Fanny.

MIL has funds to pay for care but it’s almost impossible to get it due to staff shortages.

We certainly do not pay care staff anywhere near enough, but in our experience the main problem with adult social care isa total lack of communication between the different sectors.

Olds have lots of things wrong. MIL has:-

Alzheimers and vascular dementia
A serious heart condition
A tumour in her bladder
Very poor mobility
Sores on her feet

She won’t go into a care home and lives alone with carers and us going in several times a day. However, each one of these problems is dealt with by a different department, they never talk to each other, and the only people who try to co ordinate all this stuff is us.

When she went into hospital for a heart operation they didn’t know she had Alzheimer’s because it wasn’t on her notes.

The pharmacist at our surgery rang about one of her drugs and he didn’t know if she was seeing the community dementia team. He asked us, why isn’t it in her notes?

The GP prescribed extra aspirin for blood thinners he didn’t know about the tumour.

The district nurse has been out twice on a wasted visit because no one had told her MIL was in hospital.

And on and on, these are only a few examples. Until this is sorted and the different sectors communicate nothing will improve, throwing more money at it will not in itself change much.

The issue is that our lives our longer but quality of lufe hasn't caught up.
Humans are designed to breed, rear their young and die. Having a fulfilling life has been a very recent thing in our history.

Immigration. There are thousands and thousands of people in the world who would jump at the chance for a 2 year contract working in a care home in the UK. I don't know why the government is so reluctant to implement this in a way that gets the manpower the country needs whilst also satisfying people's wish for no immigration as such. What we have where I live is specific visas for low paid jobs that are attached to an employer. The time spent in the country on this visa doesn't count towards permanent residency stay requirements or eligibility for benefits. The employer houses the employee, pays for their medical insurance and also pays a levee to the government for each worker they bring in. Why couldn't we do something similar?

OP, many people do pay for their own care. In this family alone we’ve had 3 entirely self-funded relatives in care homes - all because of advancing dementia that had come to need 24/7 care and supervision. In every case the sale of the house had to pay much of the fees.

As for paying for care retrospectively, via sale of a house, this does happen already. A lovely old bloke who visited his wife daily in my DM’s care home, told me that her costs were being ‘rolled up’ until he either died or had to go into care himself - when the proceeds of the house sale would go to the council. That (excellent) CH accepted both council- and self-funded residents - the SF did of course subsidise the others.

Not sure Nursing homes in the Uk would have the capacity to house employees ? Nor community care agencies. There is no spare housing.

They should also put a stop to people who put their homes in their kids names to avoid half the house being used for care. How on earth do they get away with this? I am fully resigned to my dad living to a great age as his mum did before him and not getting any inheritance because of the house may need to be sold to pay for care. I would always try and care for him in his own home though if I could as I know this is what he would want. Carers allowance and associated benefits need to be increased to allow more people to care for their elderly relatives if they wish to. I do think if it was increased there should be more checks that people do actually do some caring though.

I always find myself almost hoping that the DC's marriage breaks down and the cunning plan to avoid tax results in half the house going to SIL/DIL. It's not a plan without risk.