Throwing more money at care homes will not help the elderly

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.