Why is the cost of care so high?

[Truetoself]

I think the average household income in UK is around £33K? I believe the cost of a care home is upwards of £5K a month and that of a live in carer us around £10k. I am trying ro work out how this makes sense because it is not proportionate to the income of an average household in the country.

It’s related to the cost of provision just like all services not to household income. A more typical cost for non nursing care would be around £4000 a month or £143 a day. Try finding a hotel providing three meals a day and care 24/7 to all of the residents for that. The problem isn’t it’s too expensive it’s that it’s too cheap with prices driven downwards by the biggest purchaser, local authorities.

MIL is in a St John's home. It is a not for profit organisation. Still £1600 a week.

My grandmother in law had 24/7 1:1 care for her safety and that of others, at £20 per hour that’s over £2k per week. Add the cost of essentially a basic hotel room, say £150 a day including 3 meals you can see why a high needs place will be many thousands per week. (There’s laundry, equipment, some tasks need two members of staff…)

Do you mean The Orders of St John Care Trust?

We couldn't get our Dad into the one in his town as he didn't have enough in the bank!

Because care homes are private businesses that have to make a profit after all their high overheads. Without a profit it is unviable. Therefore there isn’t any comparison between households income and care home fees. Also your care home fees are probably not typical amounts up North.

This is what gets me the most. Why is my relative, who saved to allow themself a comfortable old age, subsidising those who didn’t? It’s an absolute scandal and I don’t know why it hasn’t been the subject of a national outrage.

If someone needs 24/7 care that is the cost of themselves and another person. So you could take that 30k and multiply it by 2. That is what it is going to take to care for someone because the person doing the caring needs to pay for their own life. In reality that is split between the shifts of multiple carers, but you get the idea. So there you have 60k/12 =5k a month.

Now perhaps they don’t have one to one care every minute, but someone in care typically has additional expenses.

caregivers need to earn a living wage. Far too often as it is, their wages are topped up by benefits which just shows they are being underpaid. No business should be considered viable if it depends on the government to supplement salaries that way

I’m a carer and paid £18.53 an hour. Many clients require at least two carers per visit as is law for manual handling. Some clients need help with every aspect of their life from feeding to toileting so the hours mount up very quickly. Then there’s housekeeping and cleaning, food to be bought and prepared and heat, electric and insurance is astronomical, specialist equipment, training for staff etc etc. many need 24 hr care and care homes need to employ managers, medical staff, book keepers etc etc. yes it’s expensive but maybe we should all be doing more to look after each other writhing in our families like we used to and many cultures still do.

My grandfather was cared for at home until he died. However he had four daughters living nearby and none of them worked ft.Smaller families, people moving away for work and women working ft means it’s hard to provide this now. Note it was the daughters, not the three sons. In cultures where it’s prevalent, it is generally the women who provide care.

You could be paid twice as much and I wouldn't begrudge it but you have had training, you have shifts and an end to your day (although if you are anything like the carers my mum had that goes out the window if someone is dying or sick) wheres those of us who just tried to do our best to care for an elderly relative receive just over £ 10.00 per day with zero support, no special equipment and no idea if we are doing things right or making things worse. No holidays, no sick cover, 24/7. It's not lack of love that made me agree to my DM going into care, it was self preservation.

24 hours a day x 30 days a month x NMW (£12.21 from April) plus add on costs (Pension, NIC etc) is £8791.2 just in wages for 1:1 care at home.
You then have to add on things like insurance and employers costs, covering holidays and sick leave, training courses, dbs checks, safety and safety training, sometimes training in specific medical conditions, general first aid possibly, consumables like aprons, and gloves. Probably lots of other things I've not thought about.

It isn't difficult to see how it adds up.

We sold my parent's home to afford it. Interesting that our local council will pay a maximum of £700 per week for care home placement but as a full fee payer we have to pay over 1K so basically we're subsidising those funded by Adult Social care via the council makes me furious

Care home owners make a shed load of money. The carers still don't get paid as much as they deserve. But you only have to look at the big chains to see how much money they make. I mean it's a business at the end of the day, and they should of course make a profit, but there is undoubtedly a lot of money in it for those at the top. Much less so for the people who work there. We're looking at nearly 100k a year for my mother's care, and it's almost unfortunate that even with her house being sold, she's likely to outlive her money. She has a normal house, not one worth millions.

My mum didn't own a house so she was classed as fully funded by the local council. However on top of what the Council paid she had to pay nearly all of her pension apart from an allowance for "pocket money". So that would have been an extra £300 or so per week.

I really feel for you the personal expenses allowance of £30.15 is disgraceful and leaves family topping up for hairdressers chiropody etc and don't get me started on the third party top up

It is because it’s so labour intensive. I worked in a care home and staff outnumbered residents because you need to have a 24 hour rota of care. Caretakers, cleaners, cooks, manager, admin, physio it’s all expensive and bills are high as heating costs are £££s

Having carers at home is expensive as employees are entitled to sleep and downtime so need more than 1. I think family carers often burn out, especially when looking after people with dementia as they are essentially on call 24/7 and it’s not possible in the long term.

I am sick of the private care sector complaining about how they're barely covering themselves, and then reading about their profits. One group in Northern Ireland - a tiny country really - which runs 13 homes turned in a £20 million profit last year! And 'Barchester' homes which I think operate all over London have made billionaires out of the Irish business people who own it. They line their shareholders' pockets by paying staff buttons.

I feel I was in a better position than those whose families saved for their future. My parents did not have a good relationship with money. They were the kindest, most loving, most generous people and if they had something that help someone else they would never dream of selling or loaning - they just gave and gave. They sold us their house and set up an annex (all above board with the local authority etc over 30 years ago when they were still young and adventurous and in return we were happy to help out more and more as they got old.

Then DF died and I became DM's carer until her needs were so great she wasn't safe or happy in the annex. Personally, I don't feel bad that her place in the care home was funded by the local authority because I had already provided more than 10 years of care - shopping, dressing, cooking, laundry - for the two of them without claiming any benefits because I didn't know I was entitled to anything.

The £ 30.15 was enough to cover the odd chiropodist appointment and clothing - everything else, including toiletries, pads, the lot - was provided by the home. I don't know what the staff were paid but even if it was double it was not enough. They looked after her well

I work in a care home. We have 70 residents and about 50 full-time staff. Everyone has to undertake lots of training and updates for which we are paid. We The building lcost about £12 million. There are endless insurance requirements regarding building, professional indemnity, public liability and business insurance. Residents die and income stream stops after 3 days. Those receiving council support pay about half what self funders do hence those with money subsidise them. Add heating, food, water, maintenance. Yes, long term they make money. A live in carer can be as cheap as £500 a week if you employ direct and include board and keep.

Thats the choice of the home though. It’s a bit like hotels they will sell off the rooms cheaper to have greater occupancy. The one my great uncle was in was really upfront about only accepting self funders. After three years if funds ran out then they could stay on LA rate but be moved to a cheaper room round the back ( he was paying a lot for a fancy room with a sea view). He was expected to die within 6 months ( and did) so wasn’t an issue for him. I do think it’s a good conversation to have when considering a home.

If a nursery place costs £2k pm and is open 10 hours a day, it stands to reason that a care home would cost more than double that. The buildings will be bigger so more utility bills, they will need more staff such as ones with medical knowledge and more cleaners etc too.

Care homes, nurseries, it's all the same - the first priority isn't the kids or vulnerable people they look after. It's profit, what with them being businesses, not charities.

https://www.theguardian.com/money/2024/mar/12/private-nursery-chains-profits-england

That's the motivation of the owners but fortunately in my mum's home the residents were the staff's priority.

I don’t think anyone who has a relative in a care home begrudges the care staff a penny of their wages, and most people probably think they should be paid far more.

It’s the vast profits that these places make which is the issue. I understand perfectly that they are businesses not charities, but owning a care home or 10 is basically a licence to print money.

The Herald newspaper has a series of articles on social care at the moment, this is from today's:

"Echoing the other care workers The Herald spoke to, Tamara said the pay - £12.60 an hour from this year - did not match the responsibility of the job.
She said: "What sane person would want to take on the responsibility you’ve got in a care home, where you’ve got people’s lives in your hands, for £12.60 an hour when you could go to Aldi and get paid almost £15?"

Staff get paid buttons for a really hard job.