Taxpayers have spent close to half a billion pounds buying beds in the worst care homes in England in the last four years, driving profits for private investors while residents suffer unsafe treatment, a Guardian investigation has revealed.
In what one affected family branded “a robbery of taxpayers’ money” and Labour said was “scandalous”, about £480m is estimated to have been spent on “inadequate” care homes – many rated unsafe and in special measures, meaning they are threatened with closure. They are often staffed by untrained agency workers, ignore residents’ needs and fail to provide proper nutrition and medicines in dirty and dangerous properties.
Billions more in public cash has been spent on homes rated “requires improvement”, many operated by chains providing large returns for overseas shareholders and creditors.
In all, councils have spent an estimated £7.5bn to put people in poor quality care homes since 2019, Guardian analysis of tens of thousands of public contracts and inspection records reveals.
The findings expose “a broken care system”, said Sarah McClinton, president of the Association of Directors of Adult Social Services, whose members commission council-funded care.
The Relatives and Residents Association said state payments to the worst homes were “propping up substandard care” and “failing the taxpayer”.
In 2022 one pound in every five spent by English local authorities buying residential elderly care was estimated to have been spent on paying for homes that were in the poorest categories. In the east Midlands that rose to almost a third of all public money spent last year – more than £200m.
The findings will pile pressure on the government for wholesale reform to “fix social care”, as promised when Boris Johnson became prime minister. The 2019 Conservative manifesto promised to “urgently” seek cross-party consensus to legislate for long-term reform, but Rishi Sunak’s government in October postponed an overhaul of charging until 2025.
Labour’s Liz Kendall, a shadow care minister, said: “These scandalous figures reveal the shocking exposure of taxpayer funds to inadequate care thanks to 13 years of Tory failure to reform social care. Labour will not tolerate poor-quality providers that put private profit before quality care.”
In the UK, 380,000 people live in care homes, with over a third of those places funded by the taxpayer. That number is projected to rise by 30,000 by the end of the decade, and care homes face increasingly complex demands as dementia affects more people.
The Guardian estimates are based on council contracts with care home providers in England, provided by Oxygen Finance, cross-referenced with numbers of residents in homes rated “inadequate” or “requires improvement” in recent CQC inspections.
The investigation found that last year:
Liverpool city council paid £1.5m for places at an “inadequate” home where stains encrusted furniture, walls and floors, fire doors were defective and addictive controlled drugs were not signed out properly. Care Quality Commission inspectors found it was “not safe” with “significant staff shortages”.
Derbyshire county council spent £1m with a home where assaults were not investigated, doses of medicines were missed and there were not enough trained staff, the CQC found.
A care home where undertrained care workers were seen yanking people out of their seats by their waistbands, one resident was “frightened to look at staff” and care was “humiliating” received £1.3m from Portsmouth city council.
“Decades of chronic underfunding have meant that thousands of older people are forced to ‘make do’ with poor quality care, falling well below the standards we would expect for our loved ones,” said McClinton.
Poor people who lack the funds to pay their own way suffer most, with 71% of residents in “inadequate” homes council-funded, official data shows.
Helen Wildbore, director of the RRA, said the system was “failing the people it exists to support, putting their dignity and safety at risk”.
“It is failing their families who face an uphill battle to ensure basic needs are met,” she said. “It is failing the workers, expected to provide care without adequate training. We demand a better system – tomorrow any one of us could need it.”
While councils try to avoid placing people in care homes rated “inadequate”, “because of the lack of capacity that isn’t always possible”, McClinton said. They are also reluctant to move people out of the worst homes in case if it results in the provider collapsing, worsening a capacity crisis that is currently causing congestion on hospital wards.
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Government grants do not allow them to pay providers enough to increase wages above the current average of £9.50 an hour and attract more staff to fill at least 165,000 vacancies, they say.
Ministers are poised to unveil a plan to boost the sector’s beleaguered workforce, but are not expected to promise the billions in extra funding experts such as the economist Sir Andrew Dilnot, thinktanks such as the Health Foundation and MPs on the health and social care select committee say is urgently needed.
The Local Government Association has forecast a £13bn annual shortfall in funding to meet rising care costs and increasing demand from an ageing population. The most recent settlement from the chancellor, Jeremy Hunt, was an additional £7.5bn over two years. When Hunt chaired the commons health select committee he said at least £7bn a year more was needed “as a starting point”.
A spokesperson for the Department of Health and Social Care said: “Nobody should receive substandard care and we expect local authorities and the CQC to hold failing providers to account.” It said councils should spend the latest funding increase “to ensure everybody who needs it is able to receive the highest quality care in their community”.
The problem also affects NHS-funded social care. One woman, whose grandfather is in a “requires improvement” care home in the north-east costing £1,000 a week, said: “I don’t know what the money is going on because it is not the residents.
“His room was dirty, smelled of pee, the bedding and towels were dirty and ragged,” she said. “One member of staff was sacked for the way that they treated my grandad, they dragged him out of bed and wouldn’t listen when he said no. He was assaulted by another resident with Alzheimer’s who had been left to wander the corridors. It has been devastating to watch his life end this way. I’m heartbroken.”
Some councils will not place people in “inadequate” homes, but have to deal with quality collapsing when people are already installed.
A spokesperson for Derbyshire county council said it managed concerns about care “robustly” and made plans for affected care homes to “urgently” respond. It can suspend new placements until improvements are made, but “often there is nowhere locally that is a suitable alternative or that has vacancies”.
Matthew Winnington, the cabinet member for health, wellbeing and social care at Portsmouth city council, said: “We do not place in care homes rated as inadequate, but we do see ratings change. In these cases we always try to work with providers, in cooperation with the regulator, to support improvements, alongside an active assessment of risk to individuals.”
Liverpool city council said it did place people in “inadequate” homes where there had been “improvement since inspection and serious issues are being addressed by the provider”. “Some parts of its market are presently not supplying the quality of services we would like to see,” a spokesperson said.
