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14th September 2015 3

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Another one bites the dust

News and Comment from Roy Lilley

I've been to have a look at another care home. Another CQC 'failure'. It's nowhere near as bad as you might imagine. There are problems, sure, but it is far from a write off.

It's a homely place, in a quiet part of town. Tree lined and green. Brocade and pictures of the Queen. Cushions and comfy. It passed my sniff test. No smell of dinner or worse.

The owner and his wife invited me on the understanding I didn't identify them, other than they wanted me to tell you they are immigrants. They arrived here when Iddi Amin threw out Ugandan Asians. Britain opened its doors and its heart. These two lovely people have repaid that kindness over and over again.

They trained as nurses, that's how they met. They got fed up with the standards where they worked, sold their house, took out a loan and started their own care home. Massive risk, massive undertaking.

What's their problem? Money. Plain and simple, money. To try and overcome it, like many care homes, they run a two tiered system; social care packages and private care.

There is a huge differential between the prices. Social care funding is around a quarter of what the 'private' residents pay. Social funding rates have been cut and cut and are due to be cut again. Unless the Chancellor rescues social services in the Spending Review, it will spiral into hopelessness. Private payers subsidise social care packages.

The home is clean and tidy, with meaningful daytimes, thoughtful menus and happy residents. But, to be brutally honest, their offering is nowhere near worth the money they are charging the private residents. They know that.

The home, with its gravel drive, herbaceous borders and well cut lawns is smack in the middle of one of the most expensive places to live in England. Therein the problem.

The CQC's complaint is that the home is not well led. Just about the most demoralising, insulting, crippling criticism that could be levelled at this couple who have their life wrapped up in the home.

It is not well led because, to put it bluntly, the place survives on agency labour. Staff turnover is high and in consequence induction is a nightmare, familiarity a problem, training fragmented, continuity impossible. Quality suffers.

A succession of well-intended strangers are paraded each shift. Recruitment is absolutely horrendous. Two hours of conversation and half a gallon of builder's brought us no nearer to a solution.

High housing costs drive away young staff; the backbone of the caring sector. These two lovely people are working all day and sometimes all night. They are at the coal face seven days a week. They can't remember their last day off.

They admit; there is not enough staff and not enough money to do the job properly. The increases in the minimum wage, which they accept the justice of, will push the equation of income, employment costs and cuts in the money to run the business, over the edge.

Government policy will close this care home. Cuts to social care budgets and increased operating costs simply don't add up.

They are typical of the smaller, owner-run care home that provides the warmth and sense of community that the bigger homes can often lack.

'What is your advice, Mr Roy?' ... they asked; hoping I could conjure an idea that between them, during every waking hour, they hadn't been able to fathom for themselves.

I'd seen the books, the contracts, the CQC report...

I looked across the mahogany desk, past the silver frames of someone's mum and granny, in party hats, smiling into the camera, souvenirs of happier days, and out through the window, across the lawns.

The home sits in the middle of a residential area. Planning permission would be a doddle; six nice houses with double garages, good schools nearby, would yield enough to clear the bank and fund a pension.

'Sell up' I said...

They looked at me, drew themselves back in their seats; I watched as they mentally ran through the memories of their life's work.

Regulation had demolished their pride, funding destroyed their business and staffing pressures pulled the plug on the whole endeavour.

There was a long pause. I could hear the grandfather clock in the hallway, outside; tick... tock... the soft Westminster chime struck the half hour.

There was no discussion. 'You are right' he said...'the situation will only get worse...' His wife nodded.

Another one bites the dust.

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roy.lilley@nhsmanagers.net

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