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 ?

Lack of funding is a problem if you consider the only solution to be pay more money and employ more people and that providing care should be a solely paid for service.

It is.

It doesn't help.

maybe it would help if people would realise that not all people in care homes are old.

No idea why anyone would suggest we should reduce social care for learning disabled adults when a large proportion of them already live with family.

"In 2017 to 2018, the most common living situation for adults with learning disabilities aged 18 to 64 years getting long-term social care support was settled living with family/friends (48,165 people, 36.7% of all working age adults with learning disabilities getting long-term social care). 29,975 people were living in some form of supported accommodation, 21,145 people in registered care homes, and 16,640 people in tenancies with local authorities, housing associations or registered social landlords."

www.gov.uk/government/publications/people-with-learning-disabilities-in-england/chapter-5-adult-social-care

Seems similar issue everywhere. Patients with LD/mental health with behaviours that may be perceived as challenging stuck in units as there are no placements for them. I've been attacked numerous times at work as have colleagues, many subjected to quite significant assaults.
Working in NHS we get sick pay etc, social care you are working long hours, minimal pay, no sick pay & can often be alone with quite aggressive patients.
The staff then leave, go off sick, package breaks down & patient ends up back in IPCU or similar.
No idea how this can be resolved, documentaries slating NHS for having patients for years are unhelpful. Lots of patients are fit for discharge but there is no where to discharge them too.

I would criminalize absent parents (ie fathers) so the state doesn’t have to support their offspring. Every person who breeds should be fully responsible for their progeny until they’re through school. Why should the state support single mothers? Where are the men who helped create these children? Make them pay and then all that money that is saved goes towards social care funding. Simples!

I think we have unrealistic and unreasonable expectations when it comes to life expectancy. I cared for someone in a care home who had dementia. They'd been unable to care for themselves for around 15 years before they died. The care they received - much of which was on the NHS continuing care basis came to almost half a million pounds. For one person. No quality of life during that time - in bed or a recliner chair, unable to communicate, unable to make any choices, contracted limbs, chest infections, fearful and in pain.

We need to start having some uncomfortable conversations I think.

The same could be said for severely disabled babies . Just because medical science can doesn't mean it should .
It's not a conversation I can ever see happening tbh

@thebellagio

All good points but we also cannot risk putting people off doing care work because qualifications are not their strong point, already the case with nurses. Not everyone is good at book learning. My ex mil was a cater for over 20 years and couldn't pass any written exams but a very capable carer.

The general public valuing care would be a starting point, people look down at carers currently. It's not just the pay (I earn very little but get lots of respect)

I also think there should be a stamp duty relief system for the over 70's / disabled moving to accessible accommodation

I also think there should be a stamp duty relief system for the over 70's / disabled moving to accessible accommodation

This is a great idea. Let's try using the carrot.

Of course the same could be said

and should be said. If someone is due to or having no quality of life the cost balance of their care should be weighed up. Sounds cruel but as the population grows, and medical costs and technology grow - these tough conversations need to be had.

unfortunately, for the last 20+ years, our government has almost exclusively used the "future tax payers will pay for it" as a technique. PFI etc was the start.

It started long before that. My generation was paying WW2 debt until 2006. It was always the premise for paying state pensions. Children born now will be paying off covid debt.

We use to have social housing bungalows and flats with a 24 hour warden(live in). Now it’s a cord around neck like a lanyard. Which you have to pay for.
We could build new builds, bungalows with live in warden. That you pay for, must be cheaper than now. Staff only have one workplace.

@PerfectlyPreservedQuagaarWarrior

Added bonus is is frees up family housing.

There's a lot of money tied up in housing so the equity released can be used to pay for in home care, I know a few people who have live in care, it's cheaper than a care home, but we also have 3 people at work who are stuck in hospital because there's no care agency staff available and/or home needs adaptations. Working for the church this is most of my working week dealing with these issues (most wouldn't realise this)

@PeachPies

Sometimes it also goes against a persons wishes. I bumped into a cater in town who was wheeling a middle aged man who was clearly severely mentally and physically damaged , she was telling me how desperate his situation because he was a successful self employed landscaper who had a catastrophic car accident leaving him with no hope of recovery . His family had said he always told them if this befell him to let him go as he wouldn't cope with the loss of dignity and would not want to live like this . Obviously his wishes can't / won't be upheld .

Re the 'I've paid my lot in' attitude...

You're talking about the very people you can't get to work as carers, teaching assistants, nurses, young teachers, etc because the pay is so rubbish while the job demands are insanely demanding. It's why so many aren't interested in these roles any more.

People who work in these jobs have paid their lot in in terms of job demands, energy demands, time demands, etc ... and they should have been paid more to do them and would have paid more in taxes along the way had they been.

Carers need to be paid more.

Covid taught us nothing about what's important ... these jobs are important ... and we still pay people who do them like crap. We deserve what we get.

Carer

I work in care - domicile. I'm leaving. Childcare is a joke in its lack of availability and my manager talks down to me. Definitely no pay between calls, nor for paperwork notes rarely for training nor for sll the times I'm asked to 'drop in' to the office (20 min drive each way). I really adore my clients but running a car, being constantly without back up, no time to decompress the emotions between calls (eg 3 hours with someone bipolar then straight to a call for someone receiving palliative care).

I do agree with this.

But very few want to admit they feel this way IRL, especially when it would upset real people that they know who are carers for family members like those you've described.

Sometimes it also goes against a persons wishes. I bumped into a cater in town who was wheeling a middle aged man who was clearly severely mentally and physically damaged , she was telling me how desperate his situation because he was a successful self employed landscaper who had a catastrophic car accident leaving him with no hope of recovery . His family had said he always told them if this befell him to let him go as he wouldn't cope with the loss of dignity and would not want to live like this . Obviously his wishes can't / won't be upheld

Yes, I think we need a societal conversation about presumed consent in cases like this. I know people can get advance directives, but the reality is they don't because humans are terrible at planning for this kind of thing. Look how many of us don't have wills, when one of the few certainties in life is death. There are people being kept alive in situations like this who never agreed to it.

I think employers could do quite a lot to improve the job for carers even setting pay aside.

There seems to be a culture of having to be available for rotas which are drawn up at random and contracted for a low amount of hours even for people that need full time work.

Imagine if employers tried to work with carers considering their needs to cover the whole care package needed like pieces of a jigsaw.

E.g. if a parent wanted to work only mornings Mon-Fri so they can do the school pick up (partner/grandparent/childminder does drop off) they probably can't get a job in care easily. I think it would be great if they could - then there would be someone else contracted mon-fri afternoons/evenings who could do their school drop offs. Students/parents with partners that work long hours might want weekends. If weekends are hard to cover pay more for weekend shifts until it balances out.

A 24/7 service should be an opportunity for all kinds of flexibility but instead the culture is expecting people to be available at all times of the day and sometimes night making it very family unfriendly.

People who need full time work being under employed on part time hours have to constantly scrabble for overtime or struggle. Not surprising they leave if they see something full time.

That is not to mention that you can earn more per hour in your first day in retail or hospitality at the moment than after a decade of working with/learning about and training for your complex client group.

Re: euthanasing disabled babies: is more than difficult conversations. Its barbaric decisions. Who makes them? How/ when is this value judgement on the worthiness of someone's life made? What's the cut off of acceptable/ unacceptable disability? At what point into childhood/ adulthood is this carried out. What about accidents/ injury/ degenerative disorders? Would you accept one of your children left with a neurological injury as being unworthy and thus unviable in the world.

There are plenty of people written off at birth leading happy, fulfilling lives. They are never going to contribute to society though. Do they need purging too?

All v v different considerations to a person making their own living will about what should happen to them in the event of a catastrophic accident/ illness

The media likes to portray hospitals as holding the patients hostage. It's not true we have people waiting for beds but can't take them due to waiting for placements to take them.

So true, patients get admitted for assessment & treatment, hospital does its job, they are then fit for discharge. In meantime community care package gets pulled or family can not cope with them returning home. Then there is literally no where to discharge them to. Soul destroying for staff as well as patients.