How do we solve the social care crisis ?

[Worriedddd]

We have complex needs patients being stuck in hospital for up to 2 years. Some even more they are ready to leave just there's no social care placements and they can't get the right staff anyway. For minimum wage carers will have support people with very challenging needs. There is high risk of assault in many care settings employers don't offer the right training like de-escalation and breakway. . You could get more money working for Lidl and aldi. Even with immigration people leave and find another job. What's the solution to this ?

I'm not doubting you, but I'm a bit confused by the care home involvement here, they can't normally get involved too much, even with people who don't have family, I've worked in some not great places and yes, we've pushed for hospital admission for someone, but on the basis that they've developed needs that we cannot meet (they have nursing needs in a residential home where no nurse is present and community nursing isn't enough), and therefore it's not appropriate or safe for them to remain in our care, and it's urgently needed and unfortunately social services take so long to sort out anything like this the hospital's pick up the slack or people are at risk, and it's often ignored tbh, so I'm really surprised that the care home even had their opinions listened to regarding treatment options, because normally past 'Can you meet their needs' care homes have no say in what treatment someone has, they can advise families I guess, but other than that I didn't think they'd be given the opportunity to put their wants forward.

I do love “I’m not… but” phrases. Highly amusing as 99.9% the person goes on to do exactly what they said they would,

It’s what happens, in this case, when you live in a very small place and people are interlinked. So if the local GP is married to one of the care home managers, for example, they get more involved than they should.

it’s what happens when one person convinces themselves, and everyone around, that they know the patient better than anyone else.

In my opinion it was all to do with money. The inspection put it down to over-enthusiasm. Basically slated them, but it had an air of “they cared too much” which is bollocks.

IME care homes don't get involved in treatment because it's not deemed appropriate (as shown by the CQC not being happy about what happened to your relative) in fact I've had trouble getting relevant information, that we needed to care for someone properly, out of hospitals before regarding the person's condition or treatment, or planning for them returning or ongoing treatment etc because we're not NOK and have no legal rights really to that information or so I've been told (even though obviously it's needed in order to actually care for someone effectively) it's where involved relatives are a Godsend because they tell you what you need to know.
And I've also experienced being utterly dismissed by medical staff when I have relevant information that could help with treatment or wishes etc, so I am surprised that what the care home had to say was given any time or attention.

That this was allowed to happen was a failing on more than just the GP and care home manager, but of the hospital too imo, because as you pointed out, there's a financial interest that can't be denied at play (and I have no way of knowing) but I'd hazard a guess your relative was self funded - they usually pay more than state funded. It is unusual though.

I actually added the "I'm not doubting you" bit because I typed the rest and realised it sounded exactly like that was what I was doing, and in reality I wasn't, so no need for the snippy response really.

Social change. Families should take a greater responsibility in looking after their elders.

I hate the distinction between medical needs and social needs. Frankly if you support the idea of the nhs in full you should support care as needed being given. This isnt about an old lady getting company to go to the supermarket (family job really) but if you are demented and incontinent the fact you are sat in your own piss is really medical and should be treated as such.

The problem with care is that it has all been privatised. My mother had carers through an agency (whilst living at home as her needs went beyond social needs) - they got minimum wage whilst the agency chargdd them out to us at £30 an hour. Barely trained, i found my mum stripped completely naked with no dignity or cover whatsoever for a wash on her bed once. She had a full service wetroom and plenty of robes etc. There is plenty of money for care - its all just dripping into private hands.

We need more local authority care homes and they need to be staffed by people who are educated properly and paid properly. It should not be a profit industry.

Where’s the money coming from?

The problem is when you say this is you mean women. That’s who is ends up falling onto.
Also the reality is DH moved 300 miles away from home to work. He helped his mother enormously when she was unwell but he had work and tiny children. His brother did almost nothing despite living 10 minutes away.

in the past people didn’t live as long, didn’t have the medical interventions keeping them alive so long, and women didn’t work and probably they all lived closer. Society has changed too much.

I don't know how wishing back a different era or romanticising different cultures really helps here. Families don't have live near each other and both men and women have jobs. We can't just recreate some idealised version of the 1950s.

And yes by family it's almost always women doing the work.

@cantba not everybody has family.

Those who do have families how do you know they are in a postition to help? Families are stretched keeping their own heads above water, young children to care for, debts to pay off, distance to travel, more and more only children or just two children.

We need a decent system, not be relying of family, which may or may not exist or be able to pitch in

Absolutely. Lockdown proved that society hasn't changed in this regard. When education, childcare and other services were cut back, it was women who bore the brunt of it.

If you put the responsibility back on families, you're essentially putting it back on women and, in extreme cases, driving them out of the workforce. Replacing their paid work with unpaid work, undermining their autonomy and independence and making them more vulnerable.