Cost of social care. Aibu

[Onlyifyouknewthetruth2026]

My son gets overnight respite 2 nights a month. Not a great amount but still respite. I have attached a pic showing the annual cost which is alot. Just for reference.

Got me thinking about social care and money.
With a aging population and more calls for social care no wonder it's on its knees
Im curious what others think about the cost.

my family member lives in assisted living, with onsite carers and facilities and activities etc. it’s not an asylum and it’s not a prison.

its not the 70s anymore. There are other ways of doing things and it doesn’t even require that much imagination.

the constant default hysteria about insane asylums doesn’t help anyone. any effort for longer term provision in the community for the decades of adulthood is not an asylum. Being cooped up the house with ageing parents and limited socialisation isn’t the only option.

I work with disabled people, I get paid as a specialist £40 per hour by the council, £52 for overtime. The costs are unsustainable as the level of them keeps increasing each year. Taxis to and from specialists schools are one reason Birmingham council overspent one year. PIP can be equivalent to someone’s actual salary so there’s no incentive to work. My brother and sister and father live off their pip quite comfortably. All of it is unsustainable as they aren’t paying in but taking out of the cofffers so to speak. As the rates of disabilities continue to rise, so will the claimants. Something will happen to head for a restructure.

@Cheese55 this was in response to your comment to my post about AD.

There are still many people in the UK locked up in mh wards in horrific conditions because it's cheaper than care in the community.

https://www.learningdisabilitytoday.co.uk/debate/locked-up-stories-from-behind-doors/

Full PIP is £778 .4 every four weeks nobody is going to be living comfortably on that.

I may have misunderstood the 36 children, due to the way i read the reports definition of illegal.

however, everything I can find, secure units, children's homes, residential sen schools are still used by low numbers against the population of total available children. I have no doubt they are incredibly expensive but I just cant find any evidence that anywhere near 5% of the population need that level of support.

Do you really have 5% of your local areas children on these kind of packages?

Spending money is fine; if you have money to spend. The trick is to make sure you have money to spend… young people out of work, stagnant wages at all levels except the top means that the government and councils struggle to raise the money required. These are the things that need to be improved so we can spend the money where it’s needed; everyone is in agreement generally that we should have a good welfare system for all. Comparing care for older people is also not really that comparable in this context because most (?) of that group are people are contributors for some time before they then require care; it’s the common path of life. Everyone should have the right to care when they need it whatever the circumstances whether disability or old age. It’s everyone’s responsibility to vote at every opportunity to help build a system that we want. Making stupid or ignorant political choices is the biggest mistake a population can make. Things like social care and welfare spending are where these behaviors show up.

Quite often the parents are actually trying to hold down jobs or have other caring responsibilities that mean they can't be in 2 places at once.

Some people seem to complain about disabled children needing transport to get to the nearest suitable school in one breath and then complain about their parents being on benefits instead of working on another. They want this utopia where they pay less or no tax and only get the services that they personally need. It's clear from this threat that some even advocate killing those who have the nerve to be expensive to care for. It's grim.

Horrible isnt it?

The answer isn’t to means test it, it’s to have far tighter checks on access. It’s supposed to be for people who need help to carry out everyday tasks. And the higher rate is for people who need night time care.

I'm constantly amazed by the number of people who still cling to this "unsustainable" myth.

The UK is the 5th largest economy on the planet, GDP is 4.25 Trillion.

There is nothing whatsoever "unsustainable" about either the UK's Care or Welfare bills.

"Unsustainable" has been deliberately and mendaciously used as a substitute for "I'm ideologically opposed to spending in these areas, and would rather the money was spent elsewhere, or even better - I just paid less tax", and yet it's been picked up and run with. 😐

Because a person is disabled they can get £842 pip, universal credit and UC health element payment which can equal £1484 per month. Or £1,697.50 with the higher UC element. If they are renting then UC can cover that cost. There is also a reduction in council tax, so yes they can live comfortably. I’m not saying we shouldn’t pay them anything! Just saying it’s not sustainable long term and needs a restructure.

There used to be Remploy factories in every city, run by the council for disabled workers. I knew many from the community who worked there. There was no DLA (PIP) for disabled people who could still work. Now everyone claims no matter if they can work. Many from the community are simply advised to take benefits and aren’t encouraged to look for work. I understand some of them could not work at all but most of them really could.

Agreed, assisted living are perfectly nice places. There is a lovely one near me and friendly staff who take the residents out and organise activities. Disabled people are treated well there. There are some disabled people in asylums but that’s because they cannot be left alone at all, usually mental health reasons. The nearest asylum is very professional but very cold and clinical because the residents cannot be trusted with objects unfortunately. Severely disabled people are always placed appropriately.

Just to say, PIP alpme will not qualify for reduced council tax - most, if not all councils have stopped that, unless very specific disabilities apply. Can't speak to UC though.

The only thing PIP might automatically help with is a blue badge, but again, only if the right number of points are scored in the right area. It really isn't the gravy train people like to pretend it is...

The OP explains that it is one person who covers two patients for the time.
So it is 22 hours. At the NMW this will work out at around £300 for someone over 21. 22 hrs that is.
Even less for someone under 21.
I doubt they pay more than the NMW.
Which leaves about £1000 to account for. Multiply that over many patients.
Considering they have many people the building only needs heating once for all of them.
Care centres exist because there is profit in them. But when that profit is extortionate I think someone should take a closer look.

Exactly. We aren't talking assisted living or scandi style dementia villages, which are absolutely wonderful.

It's clear from this thread some people have no clue how significantly disabled the people we are talking about are. And why would they if they haven't seen it.

These places often don't have large numbers, maybe 4 or 5. They often cover a lot of different needs so will have a nurse on staff as well, a cook etc. And respite placements have more voids than straight up resi care, so are more expensive to run because they won't often be at max capacity. But children's care is different to adult care, and adult care is considerably less profitable because people are more comfortable with adults being treated badly.

They may well be small. There may additional staff, perhaps part time. Although I suspect they will buy in food to reheat as a hospital does rather than employ a full time cook.
The costs need looking at.

I work in a private retirement home and our residents pay around £6000 a month each. It sounds a lot, but when you take into account insurance, wages, heating, food and maintenance for the building, it isn't really that much. I don't think the costs are actually that high considering the care and overheads involved.
Of course no one should be left destitute or without support, but not only do we have an aging population we also have an increasing disabled population. Medical advances are keeping people alive who may have otherwise passed away even 20-30 years ago. When you consider that some people need round the clock care for years and they will most likely never pay into the system themselves, we've obviously got a crisis on our hands.

Sorry but it is a vast sum. If say you have only ten people that is £60,000 a month. Every single month.
Many staff are on NMW. And earn about £2,000 a month. Heating is one building. Food will be purchased in. A nurse might be part time or on call.
I would hope the building is able to be maintained on that amount per month.

Is it no surprise to me to find that some big retirement care home owners are millionaires. Gordon Sanders, Cliff Cook, Barchester Healthcare owners .
Gordon Sanders is estimated to be worth £485 million.
Cliff Cook estimated to be worth £373 million

There will be corporations that invest and own care homes that earn a good deal and pay out to their shareholders.
But they pay staff a NMW. And charge residents and the taxpayers a fortune.
It needs looking at.

As Sen transport cost Birmingham city council £51 million out of gross expenditure of £4.8 billion one year, it was 1.06% of expenditure. It would only play a very small part in Birmingham’s financial problems. It sounds like local tax payers got heated over that, as part of this whole right wing ableist narrative as pp has said - that no one wants to see money spent on services for anyone, but themselves?

One answer to SEN transport is more local special schools, but governments have refused to allow that, as it’s cheaper to keep children in mainstream schools, where they can disrupt the education of the rest of the class, which has no cost to the government, but also has the rest of the parents up in arms! What do parents want, because they can’t have it all ways? Complain about SEN transport and expect SEN parents to be in two places at once, or complain they live on benefits; complain about children with SEN disrupting their child’s classes (and which costs adult social care more in the long run imo, because they have developed behavioural problems in an environment, where they can’t cope) ; but don’t want to spend money on special schools?

The costs are not unsustainable. It’s another right wing ideology, with no basis in facts. Welfare spending is still lower than it was, before the Conservatives came to power in 2010 and implemented Austerity. The government is giving £25 billion pa to Ukraine - that money would transform the social care system.

@ExtraHotDoubleShot - where is your evidence for economies of scale in “disabled villages”, when the biggest cost is staffing, and care staff are already on low wages (less than at the local Aldi usually), and the food is the cheapest? Have you ever spent time in one of these places?

Nobody gets £50,000 pcm in therapy. Have you calculated how many hours a month that would be for one person?

There will be corporations that invest and own care homes that earn a good deal and pay out to their shareholders.
But they pay staff a NMW. And charge residents and the taxpayers a fortune.
It needs looking at

This is the nub of the insanity of privatising essential services, and then expecting profit-making ventures to run them efficiently and maintain their obligation to provide an adequate service to the end user, all while ignoring the fact that their prime motivator is profit, and they way they derive that is to cut overheads. And yet proponents of this lunacy still pretend that the service shouldn't suffer as a result! 🤣

I have a relative paying nearly 100k p.a. as a private resident. What do they get for being out of pocket to this sum over and above what a resident whose care is paid for by the L.A.? Absolutely nothing, because the care home provides absolutely nothing beyond what they are legally obliged to. The food is still disgraceful, social events and trips never materialise because they will not pay for upkeep of the necessary vehicles, the interior decor is in a pitiful state because it's just not seen as necessary to pay for something which is considered merely cosmetic. This is what you get when £££ is the bottom line and not the actual care and wellbeing of the residents.

I actually don't know an older adult care home that doesn't employ a cook and buys food in as you describe. Possibly the smaller ones (under 10 people), but for the bigger ones it's a false economy - 3 meals a day for 30 residents, taking in to account dietary needs. It's cheaper for someone to buy food from Asda and cook it, than buy in that many pre-prepared meals.

The £6k a month will be for private residents, any funded by the council won't be on that, though will often have a top up as council rates are so low. I used to work somewhere with a lot of places that took council rates - that was still £3300 a month.

Plus someone minimum wage costs almost £30k a year to employ when all is taken in to consideration.

I think we have verged between small respite care facilities as the OP described and gone into large residential care homes.
All very different.
For a bigger one, I would not bank on there not being a cook. Hospitals buy in food and essentially heat them up.
Some might hire a cook. A lot will not.
£6,000 per month is a lot. An awful lot. Paid by private means or the taxpayer. They will not be able to stay for free.
Minimum wage per year is just under £25,000. But, if there are enough beds raking in 6,000 per month I would hope they can afford that.
Even if some are on a reduced rate that the taxpayer pays, the home with say 30 people will on about £150,000 in takings every single month.
Every single month.
They will not spend that on staff, heating or food or bedlinen. Even if they tried hard.

There is a big difference between care homes for the elderly, and those for children or working age adults. Posters should stop trying to conflate the two - it’s like comparing apples and oranges!

The elderly may well live in large care homes; but the CQC wants to see working age adults in houses for 6 - 12. The set up and staffing ratios are quite different! A large care home can employ cooks. A house for 6 people does not ime have a cook - one of the care staff gets the meals. Care homes for the elderly may have a staffing ratio of 1:8 - it’s hard to imagine 1:8 for people with severe learning disabilities in a care home for 6?