The distressing mistreatment of people with dementia in some care homes is nothing if not a structural problem. Care Quality Commission reports reveal workers can’t respond to bells being rung and desperate shouts from bedrooms because they are overrun. Care homes can’t get the staff, with one in 10 jobs vacant and the rewards of working at a supermarket higher than the average care wage.
This is partly down to a means-tested system, in which councils are paid less than the full amount needed to look after a person, with care homes cross-subsiding by charging private payers more.
An average council fee may be £700 a week, which works out at just over £4 an hour for 24-hour care. Pay is low, training is limited and temporary agency staff are common, which is not ideal for people with dementia, who require consistent help with medical, emotional and social wellbeing.
The failings are also a result of repeated failures by the government to, as Boris Johnson promised in 2019, “fix social care”. The government’s plan to cap care costs and reduce means testing by increasing national insurance was canned by Rishi Sunak amid worsening public finances and the latest plan announced by the chancellor, Jeremy Hunt, to inject £7.5bn into the system over two years is only about half of what MPs (ironically led by Hunt when he was a backbencher) say is needed.
Current annual social care spending by the government stands at £27bn. They perhaps calculate that the electorate isn’t keen to think too hard about age and disability, despite a population the size of Milton Keynes – 260,000 people – already living with dementia in care homes in England.
The funding injections are anyway focused on delivering more care packages, rather than increasing standards. The aim is to tackle gridlock in NHS hospitals with thousands of people waiting to be discharged to social care slowing down elective surgery and worsening A&E waiting times.
Another root cause of the nastiness that can occur in a minority of dementia care homes is that in the UK treatment for cancer and other conditions is not means-tested but dementia care is, which can seem unfair. It is a policy that shapes the way people with dementia are cared for – in many cases by private companies prioritising profits, employing people with little if any specialist training and overseen only by a regulator that inspects mostly when serious concerns are raised.
