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Throwing more money at care homes will not help the elderly

The real solution is that care should be what it claims to be – namely caring

By on Friday, 3 June 2011

The hands of an elderly resident at a nursing home (John Stillwell/PA Wire)

The hands of an elderly resident at a nursing home (John Stillwell/PA Wire)

The Daily Telegraph carries a wise and well-informed article about the current crisis in the care home industry by Lady Bakewell. About the current crisis sparked off by the near bankruptcy of the care group Southern Cross, she has this to say:

But this is only a symptom of what is wrong with the entire care system in this country. The whole sector is operating at too low a level. Money is scarce on all fronts, and what little money there is is being cut. The state is obliged, under the 1948 National Assistance Act, to care for the old, but this has always been on a mean-tested basis. Now that local authorities are being squeezed, the availability of care packages which once went to those with “moderate” needs is being restricted to those with “critical” needs.

Private care homes have their own budget-related problem. Given similar spending concerns, they often pay low wages and have a high turnover of poorly trained carers. Many of the homes are dependent on immigrants to provide this labour and the Government’s projected targets for reducing visas will bear heavily on services which rely on such workers.

I am not sure I agree with her implied solution, namely that we need to spend a lot more money. Money is only part of the solution. The real solution is that care should be what it claims to be – namely caring.

I myself have some experience of care homes for the elderly. Many, sadly, are places that you associate with the word “neglect”. The bad care homes I have encountered have all been privately owned – that is to say, run for profit. By contrast, the best ones I have seen have been ones not run for profit – namely those run by local authorities and those run by nun.

The local authority homes tend to be purpose-built, which is a huge advantage – no subdivided rooms, no shabby patterned carpets, no rabbit warren-like corridors – but rather light and airy and well adapted to their purpose, with proper bathrooms and easily cleanable floors.

As for the ones run by nuns, these are places inspired by love of neighbour and where the paid staff take their cue from the Sisters. When I go into a religious-run care home I immediately sense a serene and happy atmosphere.

If a care home is not up to standard, these are the giveaway signs. The first and most obvious is the smell of stale urine. A nurse once told me that there is absolutely no excuse for this. So if a place smells, that is a sign that the staff are simply not up to their job of keeping the place clean, or that they do not care that it is dirty. And there are other indications, too: the blaring television on all day that no one watches; the arrangement of chairs around the walls of the room, making interaction between residents difficult, if not impossible; the infantilisation of residents in the way they are addressed by staff; and, I think, most heartbreaking of all, the complete lack of activities. True, some oldsters are happy on their own, but many are capable of and greatly enjoy group activities that can easily be organised by staff, if they have enough time and the inclination to do so.

Some of our care homes are heartening places, others the exact opposite. Lady Bakewell is right about the need for training of carers, but the fundamental training all carers need is moral. This is not meant to be a business; rather it is a vocation; that’s why nuns do it so well.

  • Anonymous

    The primary point I want to make is that there is now a pressing need for unannounced inspections in care homes which should be pushed through by the government asap.

    However, it is interesting to note that in a distant time in history, long before the creation of the welfare state much of the hospital & mental health care was dealt with by the Church with nuns running such institutions. The Church shone the way in terms of charity and morality. Of course, with civilisation becoming more “socialist” these roles were taken out of the hands of the Church.

    It is absolutely true that what is needed in these care homes is a grounding in morals, and not another useless  government run tick box training course.

  • RJ

    Perhaps this highlights the need for a return to the traditional family, where the old are cared for at home by their relatives and only have to go to a care home if that is no longer possible.

    There are a number of cultural factors militating against this happening: the younger generation moving away from their older relatives; or seeing it as the job of the state to take care of them; and the lack of children due to contraception and abortion.

  • ms catholic state

    If families are not caring for their elderly…..then families are not fulfilling their primary function.  Caring other is the central role of a family…..nothing else can do it quite so well.  But our society seems to view people only in terms of their contribution to the economy…..and nothing else.  That’s why mothers and stay at home wives are viewed as insignificant….yet they could be fulfilling the most important need….of providing love and care for all the family. 

    You can’t put a price on that.

  • ms catholic state

    I mean…..caring for others is the central role of the family.

  • Ratbag

    I totally agree.  Unannounced inspections should be compulsory, not just for elderly care homes but, having watched BBC’s Panorama, residential homes for the vulnerable too.

    One fine example of elderly care is by the Little Sisters of the Poor. They are dedicated in their care of the elderly and exemplary on all counts. There’s love, dignity, patience and joy and have been commended and approved for their care.

    I’ll never forget being put on a placement in a private care home as a trainee clerk in the office many years ago. It was a heartbreaking and excruciating experience. You could have cut the atmosphere with a chainsaw, the smell of wee, the elderly residents were apathetic, there was a worryingly large turnover of staff, the ‘boss’ was so slimy you’d want to shoot him with a good dose of Flash and the owner drove a Porsche. The ‘boy racer’ used to go up to the counter at the bank and look around over his shoulder like a demented owl at those in the queue.

    I left after a week. I could not stick it any longer.

    One afternoon, a few months later, I went to the bank and – lo and behold – there was the familiar owner of the care home. I was the only one waiting to be served and he did his demented owl impression again. I stared him out and kept him within my sights until he eventually looked away. Oh, how I cheered when I saw the whole place was converted into a pub! Please God, the residents found a better place to live than that godawful place.

    It is sad that, years later, profit is still being made out of the elderly and the vulnerable. Then again, families should take responsibility for their vulnerable and elderly instead of dumping them like they are an inconvenience, a burden and nothing of value. Respite care should be made available for both the carer and those being cared for to give each other a break from time to time.

    The thing is, carers quietly get on with it and are largely hidden from view.