The Social Care Property and Investment Crisis?
June 12, 2011
The current news leads on Social Care including the on-going future of Southern Cross and the distressing pictures of the NHS Learning Disability Hospital as covered by the BBC Panorama highlight wider systemic fault lines with the delivery of Social Care services in England and Wales.
For years the growth of the private market in the provision of registered care has been well documented including the practice of land purchase and lease back as portrayed within the Southern Cross model of delivery, incidentally funded by two of our part state owned banks Lloyd’s and RBS. At the same time the continued use of NHS hospitals to provide support and care and protection to some of the most vulnerable service users with a learning disability highlights a model of service delivery which is outdated and no longer sustainable. Indeed following the various hospital scandals of the 1970s and 1980s the advent of Community Care in the 1990s was supposed to have seen an end of hospital provision for people with a mental health or learning disability.
The link for the 31,000 residents within Southern Cross Care homes and all the thousands of people still retained within a hospital environment requiring specialist care is an inadequate model of property and building investments. On the one hand the purchase and lease back model seen in the private residential sector as a business model is now placing at risk the security and safety of some of the most vulnerable older people who live in these homes; whilst why as a Society have we not invested in greater housing options for people with a learning disability to end the need for hospital provision?
The property and financial investment requirements for the longer term support for vulnerable people especially in need of registered and regulated housing and support models must be one positive outcome promoted from these two unrelated but extremely serious events. Democraphic trends confirm the rapid increase of both our older and learning disability populations over the next 30 years. If we are to avoid so called ‘warehousing’ models of care then Government Policy must promote and invest in greater funding for new housing and care models. One consequence of the credit crunch has been the radical reduction in funding in new build developments by the Housing Association Sector who traditionally have been a major provider of extra care and supported housing schemes.
The 2000 Community Care Act which set well defined building standards for Care Homes has never been fully implemented as the majority of today’s care homes would failure the standards of single en-suite rooms along with ratio’s of floor space and communal space. Yes, new standards are applied to new build but it highlights the critical under investment in public and private property investment for older people at preciously the point that demand will double and triple over the immediate next few years.
I was fortunate to lead the development of one of the country’s first set of dementia designed neighbourhood resource centres for the London Borough of Greenwich which opened some 10 years ago. The three buildings replaced the Council’s former older peoples homes and offered state of the art homes for some 160 people. I remember on day one relatives and residents moving in some in tears because they could not believe how lovely the new builds were. Yes, it was done under PFI itself a controversial model of finance but at least were investing in the future of older people. What ever we say about the old institutions built by our Victorian ancestors at least they invested money!
A demand crisis for specialist care now places Social Care at a crossroads – politicians, policy planners, and regulators must come up with a blue print for the provision of secure housing and regulated care which will address the immediate pressures of the ‘baby boom’ generation and confirms the safety of the most vulnerable people in our society.
If nothing else we must all take a long hard look at these two unrelated events and consider what type of care system do we want for the future? Major investment is needed.