Does the UK’s Social Care system sufficiently provide for care in older age?

Introduction

In the past 5 years, the real time spending of local authorities on care for older people has fallen by approximately 11 percent (Press Association). There is a growing disparity between those older people who are wealthy and capable of receiving care, and others who do not have access to such funds and have to fall back on family and relatives to give them care.

The need of older people to care may be related to health and medical needs, or simply about receiving help with washing, walking and meeting other daily requirements.

This essay examines how the social care system responds to the needs for care of older people. The essay argues that the social system is failing to provide the care for older people as required.

Social Care System and Older Age

The UK has a significant growing population and the population is ageing because people are living longer. In the period between 2005/06 to 2014/15, the number of people aged 65 or over has witnessed a substantial increase, with almost a fifth increase and the number aged 85 and over rose by approaching a third, and this is increase in elderly people is projected to accelerate (Mortimer and Green 4). What is of more concern in the context of this essay, is that the age group of people aged 85 and over has shown the most increase of almost 29.3 per cent in the period between 2006 to 2015 (Mortimer and Green).

Despite the increase in the older people population, there is no increase in the social care system expenditure. On the other hand, there is a decrease on social care budget. Therefore, in the past five years, the level of care received by older Britons has depended more on their economic capacity and not on the level of their needs (Press Association). Therefore, if an older person is rich, he is better able to obtain care.

The last ten years have seen a lot of social care budget cuts by the central government. In fact, £1.95 billion has come out of social care budgets in the last five years and social care budgets were reduced by £472 million (Mortimer and Green). In 2005/06 15.3 per cent of people aged 65 and over received support with social care. This dropped to 9.2 per cent in 2013/14 (Mortimer and Green).

Added to the ageing population and the decreasing social care budget is the fact that there are a significant number of older people who have at least one unmet need for social care. This population is increasing as shown in a report which found that there are now 1 million older people with at least one unmet need, as compared to 800,000 in 2010 (Mortimer and Green). Therefore, in 5 years there is an increase in older people needing care, without a corresponding increase in the social care budget. On the contrary, there is a decrease in the budget. This leaves a significant number of people outside the social care system, and puts them on the mercy on the help that they may receive from family, neighbours or friends. Due to the budget cuts, the local authority will not be able to help a number of these people. At the same time, as these older people may have restricted incomes or savings, they may not be able to receive this help from family or friends. The situation is even more dismal for those older people with one or more unmet care, who live alone.

It is noteworthy that the local authority is now helping people with serious and critical needs. As one study points out access to care had been tightened considerably over the past decade, so that by 2010 90 per cent of local authorities were limiting help only to those with ‘substantial’ or ‘critical’ needs (Humphries, Thorlby and Holder 41). This ignores the problems of those elderly people who may not have critical and acute needs but still have daily needs or at least one unmet need who are unfortunately outside of the social care system. Recent assessment of official statistics and the English Longitudinal Study of Ageing for Age UK suggests that the number of people with unmet needs has now grown. This includes the more than a million people who need help with the basic activities of daily living and unfortunately get little or no support for the same (Humphries, Thorlby and Holder 41). Then there are people with multiple health conditions who do not get the access to care that they need.

One report finds that there is a reduction of at least 26 per cent in the numbers of people receiving publicly funded services over the past five years (Humphries, Thorlby and Holder 41). Added to that, the increasing number of older people with multiple health conditions and more acute levels of need is increasing and it is also indicative of the fact that the number of older people who should ideally be getting social care, has increased and not become lesser.

Access to care has come within the central government’s concerns of areas that need to be made subject to budget cuts. In fact, by 2010, local authorities were helping only 90 per cent of those people who had substantial or critical needs (Humphries, Thorlby and Holder 41).

One matter of considerable concern recently is the fact of self-funding of care by the elderly where such people have resources that exceed £23,250. This is also true for such older people who have critical or urgent needs and should have been eligible for public funding. A report suggests that 41 per cent of care home funding is privately funded (self) and 12 per cent is privately funded (third parties), these third parties being relatives who may offer to add to the fees paid by local authorities so that the elderly individual may have better living conditions and amenities (Humphries, Thorlby and Holder 42).

Another important aspect of social care, is the quality of services that older people receive in care homes. With older people who are dependent on the social care system, this becomes critical because these are publicly funded services. A study pointed out that the inspection of nursing homes in May 2015 revealed that only 10 percent of the homes inspected were rated as inadequate, and 46 percent were rated good or outstanding (Humphries, Thorlby and Holder 43). This leaves us with a considerable proportion of homes of about 34 percent that failed to get a good rating, although they did not get an inadequate rating as well. Again, smaller homes of all kinds were found to provide better care than larger ones (Humphries, Thorlby and Holder 43). These are some of the indicators of the kind of services that are offered by the social care system and the quality of these services. As a large proportion of care homes failed to get a good rating, this puts a significant proportion of elderly people in care homes that are not well maintained or that do not offer good services. At the same time, it is noteworthy that study also shows that older people who get publicly funded social care, have shown a 90 per cent satisfaction with the care and support they receive (Humphries, Thorlby and Holder 42).

The above mentioned is also related to the dignity of the old people because positive health outcomes and social outcomes only result from situations where people feel valued and respected; where people are in control of their care decisions; and where people are able to maintain for themselves a positive self-regard (Tadd and Calnan). This becomes even more essential for older people as their circumstances requiring care for basic daily needs makes them vulnerable to lower self-regard, or a feeling of helplessness (Tadd and Calnan). In such a situation, if older people have to fend for themselves or rely upon unpaid informal carers, usually family members, where such family members do not want to take care of such dependent older people, puts such older people at a risk for compromise on their dignity.

The number of unpaid informal carers has increased over time, rising from “16.6 per cent of the population in 2011, peaking at 18.9 per cent in 2013, before falling slightly to 17.6 per cent by 2014. In 2014, 30.6 per cent of people providing care did so for 20 or more hours a week” (Humphries, Thorlby and Holder).

Conclusion

Clearly, the social care system is unable to take care of the needs of a significant number of older people who are in need of such care. The budget cuts have forced local authorities to provide care only in the most critical and urgent cases, leaving a major portion of the population outside of social care and dependent on self-funding (if they have such money) or at the mercy of unpaid informal carers, when they cannot afford paid care.

Works Cited

• Humphries, Richard, et al. Social care for older people: Home truths. London: Kingsfund.org, 2016. 07 January 2017.
• https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Social_care_older_people_Kings_Fund_Sep_2016.pdf
• Mortimer, Jill and Marcus Green. “Briefing: The Health and Care of Older People in England 2015.” 2015.
• Press Association. “Elderly Britons bearing brunt of cuts to social care.” 15 September 2016. theguardian.com. 07 January 2017.
• Press Association. “Elderly Britons bearing brunt of cuts to social care.” 15 September 2016. theguardian.com. 07 January 2017.
• https://www.theguardian.com/society/2016/sep/15/elderly-people-social-care-cuts-kings-fund-nuffield-trust-repor
• Tadd, Win and Michael Calnan. “Care for Older People: Why Dignity Matters? The European Experience.” Nordenfelt, Lennart. Dignity in Care for Older People . Chichestor: John Wiley and Sons, 2009. 119-149.