At the beginning of December, the care minister Norman Lamb announced a consultation into improved financial regulation of English care homes, criticising the current processes that are in place.
The new consultation has been put into motion as a direct result of the collapse of care home provider Southern Cross in July 2011.
But what do this mean for those of us who have direct, day-to-day experience of care homes? Age UK’s care policy expert Stephen Lowe explains…
A change in the type of care home patients
More and more people with social care needs are helped to stay in their own homes. This means that those who move into care homes are increasingly those with the very highest needs. Many will have some form of dementia, and all are likely to have multiple long-term conditions.
Impact of care home closures on patients
The impact of a home closing can be devastating. It’s very difficult to show whether people die as a result of home closures because care home residents often have a low life expectancy anyway.
It is, however, obvious that the shock of losing familiar faces and surroundings is likely to have a dramatic impact on people’s lives.
Will the new proposed measures lead to care home closures?
Most residential care is now provided by private organisations that are subject to market pressures, so closures would seem to be inevitable.
However local authorities and the government should be doing everything possible to ensure that homes are able to provide older people with the stability and continuity that they need.
The need for action was demonstrated last year when the then largest care home chain, Southern Cross, went out of business.
In the event, the government, local authorities and the care home sector pulled together to ensure that the homes were taken over or, in a minority of cases, residents safely moved.
Obviously, though, it would have been preferable if Southern Cross had not been allowed to reach crisis point.
What about the CQC? Doesn’t it already do this job?
The Care Quality Commission (CQC) regulates the level and quality of social care – what Norman Lamb is suggesting is more challenging.
Large care home chains can have complex business structures and their ownership, even if it can be definitively established, may not lie within the UK.
This is a job, therefore, which requires specialised business and economic skills which are likely to be beyond the skills of the CQC. The most appropriate body to take on this role might be the NHS financial regulator, Monitor.
What happens if care homes do close?
If homes do close, it’s vital that alternative care and support is found for all residents.
The new consultation proposes a duty on local authorities to assist all residents who are in this position, regardless of whether they are clients of the local authority or paying for their own care.
So are these new proposals a good thing or a bad thing?
The proposals are unsatisfactory in one respect, because the risks to residents of their home closing is the same, regardless of the size of the business running the home.
Financial regulation of small care home providers is also needed. However these smaller businesses are unlikely to have such complex structures, so ensuring that they are financially viable might be a role that the existing regulator, the CQC, could take on.
Alternatively local authorities could be expected to ensure that their contracts with homes require evidence of future viability.
Further reading on care homes
Download our information guide on care homes (PDF 645 KB)
Read our factsheet on choice of accommodation (PDF 691 KB)
