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Frail elderly " Failed by care deserts. "

The system for looking after frail older people in England is falling apart, with what are being dubbed " Care deserts " emerging, a charity says.



An analysis carried out for Age UK indicates about 30% of areas now have no residential care beds.

The situation is even worse for nursing homes - needed for the most frail - with more than 60% having no places.

Recruiting staff and keeping services running were proving a real challenge some areas, the charity said.

Age UK believes the situation is now so bad that about 1.4 million older people are not getting the care they need - nearly one in seven of the over-65 population.

Ruthe Isden, from Age UK, said: "The system is failing people - and that is having catastrophic consequences."

The government has promised plans to reform the care system will be put forward soon.

The " Care deserts "

1.4 MILLION
older people not getting the care they need

7,500
postcode districts in England analysed

30% have no residential care beds

62% have no nursing home beds

Source : Age UK


Age UK asked analysts at Incisive Health to look at the state of the care market for older people needing help with daily tasks such as washing and dressing.

This covers round-the-clock support in care homes and nursing homes and daily help in individuals' homes.

The research said services were being cut, with some areas having no or very little care available, calling these "care deserts".

To given an idea of the scale of this, the research looked at how many local areas did not have any residential care or nursing home beds.

It found out of the 7,500 postcode districts in England, about 2,200 had no residential care beds and 4,600 had no nursing ones with the north-east, south-west and east of England particularly badly hit.

It is not clear cut though

Postcode districts - certainly in urban areas - are pretty small, essentially covering neighbourhoods.

So, it may be the case that residents in a district with no care home do not have to travel far to find a care home if a neighbouring district has one.

What is more, some districts will be largely rural areas, such as a national park, where you would not necessarily need a home.

Nonetheless, Age UK believes it is a good proxy for illustrating the problem.

Access to help at home was harder to quantify - but Age UK said it was undoubtedly a problem, with the number of hours of care being provided falling.

Why is this happening ?

Age UK said the system was severely underfunded - spending by councils had fallen by 9% per person in real terms since 2010.

One result of this had been an increasing reliance on self-funders - those who paid the entire cost of care themselves.

But even that had not been enough, with reports of services struggling to stay open and recruit enough staff.

In Hull, for example, a third of nursing home beds had closed in the past three years.

Overall, about 8% of posts in the care sector were vacant, Age UK said.

And nursing jobs were the worst hit, with more than 12% of posts unfilled.

What needs to be done ?


The government has set aside extra money for the social care system in recent years to help relieve some of the pressures.

In the long term, it has promised a Green Paper to reform the entire system.

This has been promised since the 2017 election but has been repeatedly delayed.

The Department of Health and Social Care said it would be published soon.

Kieran Lucia, from Incisive Health, who carried out the research for Age UK, said it could not come "soon enough".

"The system is broken," he added.
Better article from The Guardian :

One in four English postcode areas have no care provision – study.

Age UK says " Care deserts " are evidence of how chaotic and broken the system has become.



More than a million people over 65 live in areas in England where there are no care home beds, a charity has said.

A study commissioned by Age UK found that large swathes of the country were “care deserts” lacking residential care or nursing homes.

Caroline Abrahams, the charity’s director, said the research showed how “chaotic and broken” the market for care had become after years of underfunding. “If the awful situation set out in this report does not persuade our government to finally get a grip and take action, I don’t know what will,” Abrahams said.
Damian Green suggests modelling social care provision on state pension
Read more

The study, conducted by Incisive Health, an independent health consultancy firm, found that more than one in four postcode areas in England – 2,200 out of around 7,500 – had no residential care provision. Two-thirds (5,300) had no nursing homes, for people with more acute problems.

The report said more than 1.3 million over-65s lived in these areas and risked being unable to get support if they needed it.

The study found that a big driver of the problem was a lack of staff. Vacancy rates for nurses in social care rose to 12.3% in 2017/18. The report said staffing was a particular problem in the south-east, and that high numbers of EU staff in the sector, many of whom have left or are planning to leave, could mean extra disruption from Brexit.

Abrahams said: “The report shows what an impossible position local authorities are in. They are supposed to manage their local care market, but they lack the levers to do so, and the big drivers of the problems in the care industry are way beyond their control.

“Meanwhile, they are desperately short of money to purchase care home places for older people in need, so more and more of the financial burden is being shifted on to those older people who fund their own care, who are paying through the nose to keep the system afloat. This is deeply unfair.”

Age UK estimates that public spending on social care has declined by £160m in the last five years despite rising demand.

The government has repeatedly delayed publishing a green paper on a new long-term funding model. The paper will build on an additional £2bn the government has provided to meet social care needs and reduce pressures on the NHS.

The Department for Health and Social Care has been approached for comment.
I hope this means that the term "bed blockers" is banned!?

Are we heading back to the long term geriatric wards which I remember, rows of elderly people in a ward with no privacy, desperate to go home but unable to do so due to lack of care?
Why did the government ever close the Cottage Hospitals which were in every community, where elderly people could get the nursing care they needed in their own communities, where friends and family could visit without a long trek?
I had several ops in our small local hospital , only 2 miles away. The ward had about 28 beds, so not much privacy, but I knew some of the staff as their children were at the same school as my son, and some of the people visiting other patients, so it was quite a sociable experience.
Mum had her varicose veins done there, dad had blood transfusions when he had cancer, mum in law had a skin graft etc. etc. None of these things needed a high tech hospital at all.
I understand that some large hospitals have "Economies of Scale" but surely the needs of elderly patients, especially those who will never "get better" because they are approaching the end of their natural life, should be taken into consideration?
Especially now the post war "Baby Boomers" like me are now pensioners!
Care capacity in Norfolk " Thinly spread " across county, report claims.

People requiring residential care in some areas of Norfolk are only left with services rated as " Inadequate " , a report claims.


A study commissioned by Age UK found large areas of the country were "care deserts" where sufficient social care services are unavailable.

Norfolk was one of five areas in the country examined as part of the analysis, conducted by Incisive Health, an independent health consultancy firm.

The report said while care home capacity was more evenly distributed in our county than other parts of England, it was still "thinly spread".

It claimed this could result in a lack of choice, with residents unlikely to have more than one or two providers to chose from in their area.

Furthermore it claimed some areas in Norfolk were only left with services rated as "inadequate".

Caroline Abrahams, charity director at Age UK said: "This new report shows how chaotic and broken the market for care has become after years of underfunding and the absence of determined government action to ensure the right workforce is in place.

"The end result is laid bare by the authors - the emergence of care deserts and a deeply worrying lack of nursing home places, in particular, leaving some of our most vulnerable older people high and dry."

The report said there were large gaps in provision of care home beds with nursing across Norfolk, with the number declining "precipitously".

"This suggests, at least to some extent, that providers have been focussed on care home capacity, rather than nursing beds that are harder to staff and maintain," the report added.

The study found that more than one in four postcode areas in England - 2,200 out of around 7,500 - had no residential care provision.

Two thirds (5,300) had no nursing homes, for people with more acute problems.

The study said a lack of staff, particularly nurses, was severely limiting the care providers are able to offer.

A spokesman for Norfolk County Council - which does not run the county's homes but does have a social care responsibility - said: "We are committed to supporting sustainable growth in the care market and that end we are investing an additional £11.2m in fees from April this year. We also backed the national Every Day is Different campaign to encourage people to consider a career in adult social care.

"While we work very closely with homes under special measures to ensure the wellbeing and safety of residents it is ultimately the responsibility of the home owner to ensure that the needs of residents are met. Where the council is not assured that residents receive good quality care we will take proportionate steps to identify alternative care arrangements."
So much for escaping to the country in retirement years. Or at the other end of scale, depressed areas. Economic market forces at play.