Social Care: the haves and the have nots

Dear Editor,

With the recent announcement that there is to be a review of social care, headed by Louise Casey and due to report in 2028, I was moved to consider the current sorry mess from a personal point of view. Until my retirement in 2001, I was in a relatively senior managerial role in social care with Norfolk County Council and have retained an interest in it ever since through work in the voluntary sector and through my trade union, Unison.

The ‘Rolls Royce’ treatment

I also have power of attorney for my very aged aunt who, when she was in her late nineties, began to show growing signs of dementia and eventually had to go to a specialist establishment who could deal with older people suffering dementia.

Back in October 2023, she was accepted as a resident in a very expensive care home, managed by a national private sector organisation. Luckily, my aunt has substantial means and can afford the weekly cost which is approaching £1,600. The care she receives is excellent. She has a very nice room, she is warm, the food is very good and the activities programme is extensive. There are staff everywhere and it is clear that she is treated with respect and affection.

As the Head of Care told us “We all love her” and it shows. My wife and I, as joint powers of attorney, are informed of every fall, every change of medication and every potential difficult incident that she is involved with. When we had a party for her 100th birthday, the home brought her to the venue and provided a member of staff to be with her at no additional cost. They then had another party at the home. Although she says “I don’t live here”, my aunt is clearly well settled and as happy as it is possible for her to be.

The other side of the coin

Contrast this with the experience of the sister of a friend of mine (let’s call her Jane) who has serious dementia at a relatively young age, in her 70s. She has no money other than her state pension and is entirely reliant on state provision. Norfolk is perhaps unique in having a number of care homes in its ownership via its arms-length company, NORSE Care. Some of them are registered for dementia care but none, other than one a long way away on the North Norfolk coast, was offered to her. The family were given a number of options to look at, none of which were appealing and in the end they had to accept a placement in a market town some 20 miles from Norwich, but with good transport links.

My friend reports that the care is poor and the food neither plentiful nor nutritious. Fish pie, for example, seems to have lots of potato and precious little fish. Jane was in a poorly heated room to start with whilst “assessment” took place. When my friend visited she often found Jane soaking in urine and often worse. She has now got a better room but the standard of care does not seem to have improved.

The family was assured that social work assessment was taking place but only ever saw one social worker, who left soon after. There are telephone discussions but they seem to be with social workers, some of whom are not based in the county and clearly know nothing of the local services. To the best of their knowledge, no social worker has visited the home. Given that it is costing somewhere in the region of £1,000 per week, perhaps taxpayers might think that quality checks just might be a good idea?

What happened to quality control?

The other sting in this tail is that both of these homes have a Care Quality Commission rating of “Requires Improvement”. Given that one provides Rolls Royce care and the other is distinctly poor, what credence can one give to CQC ratings?

A major question for the Casey Review must be about achieving parity of care so that Jane can receive the same quality of care as my aunt, even if she has no money.

James Porter
Norfolk