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Archive for February, 2011

‘Intolerable’ bed-blocking crisis threatens NHS

The Daily Telegraph reported this today:

The NHS faces an “intolerable” bed-blocking crisis as funding cuts lead to half of its wards being filled by elderly people who should be in care homes, a report warns today.

 A lack of care home places means the problem of ‘bed-blocking’ in hospitals will get progressively worse, warns Bupa Photo: GETTY

The “chronic under-funding” of care homes, a growing shortage of places and a rapidly ageing population will mean that more vulnerable people have nowhere to go but hospital for the care they need.

If current trends continue, almost 100,000 of 170,000 NHS beds will end up being filled by elderly people who are well enough to be in residential care.

This will cost the health service millions of pounds and throw its day-to-day operations into chaos, says the report by Bupa, the health insurance and care provider. It blames the looming crisis on a “17-year legacy of under-funding in the care home sector”.

The next few years will see the problem getting progressively worse, the report’s authors predict, despite a Coalition pledge that local authorities will have an extra £2 billion to spend on adult social care over the next four years.

As this money is not ring-fenced, councils are likely to use some of this extra funding to pay for other services, the report warns. The Department of Health said it was important that councils were free to decide how they spent the money.

The study, entitled Who Cares? Funding Adult Social Care Over the Next Decade, says the number of care home beds that will be lost per year will rise from 5,190 in 2011 to 8,500 by 2015, and will stay at that level until 2020.

This will lead to more pensioners resorting to accident and emergency departments and ending up spending weeks in hospital when their needs would be better served in the community. This would also limit hospital space for other patients.

Bed-blocking is classed as when elderly people are well enough to leave hospital, but cannot – either because there is no care home place for them, or because they do not have enough support to return home.

Mark Ellerby, managing director of Bupa Care Services, said that up to 81,000 care home beds could be lost by 2020 due to funding restrictions, while the ageing population would mean that another 18,000 elderly people a year would need care home places. The number of over-85s in the population is projected to double in the next 25 years.

Mr Ellerby said: “Tens of thousands of older people who need specialist help will, as a consequence, be unable to access care home places. The danger is that, given the dependency of these people and the practical difficulties of providing care to them in their own homes, many would end up having to be admitted to NHS hospitals.”

He said the health service faced “hundreds of millions of pounds in extra costs over the next decade, caused by having to cope with up to 100,000 more frail elderly people in NHS hospitals”.

He continued: “Even if, optimistically, just half of these people were admitted to hospital, it would put an intolerable strain on the already-stressed 170,000 NHS beds in the UK. It would stretch the NHS far beyond the pressure imposed by events such as seasonal flu outbreaks.”

Last month there were 4,640 “delayed discharges”, where a patient cannot be discharged due to a lack of a care home bed or sufficient support at home, across the NHS. They accounted for 113,304 “delayed days” — those spent in hospital by people who should have been cared for elsewhere.

Oliver Thomas, director of Bupa UK Care Homes, said the only way to avoid the situation worsening was if councils, which fund six in 10 care home places, were made to ring-fence the money they have for adult social care. He accused the Coalition of passing the buck by letting councils decide how to spend it.

He said: “I think the Government needs to put pressure on the local authorities to make sure the resources they say have been made available, actually are available for looking after elderly people. If these beds are not around, then these people will be left when they are in difficulty with only one resort: and that’s to go into the acute sector through A&E.”

In 1993, local authorities were given the power to set the prices they paid care homes. Bupa’s report said that, since then, these had tended to be below “fair price” levels. Consequently, the number of beds had dropped from 514,300 in 1999 to 455,700 in 2009.

Last April, two-thirds of local authorities froze the amount they paid per place, while the average increase throughout Britain was just 0.8 per cent. While the industry put the real cost of a care home bed at almost £700 per week, this year funding from councils and the NHS would leave a weekly shortfall of £94.

Baroness Greengross, chair of the All-Party Parliamentary Group on Dementia, said council leaders “must make a public pledge to pass on in full the £2? billion”.

David Rogers of the Local Government Association said ring-fencing was not feasible and “councils still face a multi-billion-pound shortfall in the adult social care budget”.

A Department of Health spokesman said: “The report bases its figures partly on an assumption that the demand for care homes is increasing when in fact, the opposite is true.

“Most older people want to stay supported in their own homes for as long as possible and the extra £2billion we have allocated to councils will help them care for older people in an environment that’s best for them; not necessarily in a care home.

“We are determined to protect the most vulnerable members of our society and the extra investment in social care will act as a bridge towards a sustainable long term solution to the reform and funding adult social care.

“As recognised in the report, we have already set in train the steps to reform the care system with the establishment of the independent Commission which will report in July. We will bring forward plans for reforms in a White Paper by the end of this year.”

Our comment:

Our experience in Devon confirms there are real issues with discharges from hospital to care homes. Not so much because there are no care home vacancies, but beacuse the assessment process can take weeks to complete. We have seen a number of cases where people have decided they want to move into a particular care home but the process does not move quickly enough. Discharge pressures then means this person is discharged into the ‘default’ care home, typically a ‘Social Services’ care home. The other problem is that many people can no longer afford to go into good homes, as the State funding is shamefully inadequate. A two-tier care home system is the sad and inevitable consequence.

Ground floor room available at Rose Lodge from 1 April



Ground floor room with door onto the gardens

We will have a recently redecorated ground floor room with direct access to the garden available from 1 April for respite or long term care. Please call us if you may be interested in joining us at Rose Lodge. You can contact Peter or Karen on 01395 227071. 

A Packed programme for people with dementia

(as reported by Exmouth Journal 17 February 2011)

An exciting programme of community events are planned by Rose Lodge, East Devon’s dementia care specialists. To pick just a few of the many events on offer in the next few months:

In March, some of the residents will be on stage at the Blackmore Theatre, performing for family and friends under the guidance of Mazlen George of the First Stage Drama School, who runs a popular weekly drama club at Rose Lodge. At Easter, residents and staff will do a sponsored 5 mile run along the beach front.

In June Rose Lodge will host it’s very popular garden party and open day, and throughout the season children from the Beacon School will be growing vegetables with the residents at Rose Lodge. The very successful Artist In Residence week and art exhibition will also be held again this year.

“Being engaged with our community is a really important part of our work at Rose Lodge. Not only do our residents really enjoy these events but we also think it is important that we work to reduce some of the misconceptions associated with dementia” says Karen Bousher, manager at Rose Lodge.

It’s a dog’s life…

Brenda (one of our carers) and her husband brought in their very well behaved dog Danni to show the residents.


In the background is our new TV which was kindly donated by Ian the Builder. It is much bigger than the old one and so easier to watch for the residents.

Getting ready for spring

Spring is coming!

At GreenfingersGarden Centre in Exmouth
OK it was a little chilly outside. Still, the sight of snowdrops in our garden made us want to take a trip to Greenfingers garden centre to select some vegetables and bedding plants for the veg garden and the raised beds on our terrace. The gentlemen took care of the veggies while the ladies selected the pretties. All followed by a nice pot of tea and some fruit cakes in their excellent cafe…