Large sums of money are being continually squeezed from the care home sector in Britain, with services such as Avery Healthcare and HC-One, Britain’s largest care provider, found in terrible condition, rated one-star for hygiene. Avery Healthcare cashed in on earnings of £8.9m in 2021, with John Stowbridge, the CEO, securing £567,000 in 2020. James Tugendhat, HC-One’s CEO, pocketed £592,000 in 2021. HC-One, despite its net losses of £83m in 2022, paid out £1.8m in dividends to its shareholders in that year. The average resident is paying around £41,000 annually with many being assisted by the state. Care is owned by multiple asset management companies such as Safanad and Court Cavendish, whose sole goal is to milk the cash cow that is the care business. Further commodification of care means disaster for those in need.
At the beginning of March 2023, the Chief Executive of Care England stated that the care sector is being ‘significantly underfunded by local authorities and requires significant investment by central government’. Care England’s Fair Cost of Care Analysis exposed the huge underfunding in elderly residential and nursing care homes: over £2bn in the year 2020/21. This figuredoes not account for the inflation that peaked late 2022 at over 11%. Essentially, many local councils are paying hundreds of pounds less every week for residents.The funding shortfall primarily affects those whose care or nursing home bills are either partly or completely paid for by the state, those with less than £23,250 in personal assets.
The situation is made more urgent by the ever-growing need for care in Britain. There are currently more than 400,000 people who rely on residential care,with an additional 800,000 receiving some type of care within their homes. Britain has more than 17,000 private residential homes;it is an industry worth £7.7bn per annum.A vast majority of care homes are now under the control of for-profit providers, such as Farrington Homes, a chain of 11 care homes which has paid £14.7m in dividends, loans and expenses to its owners Paren and Kiran Nathwani over the last two years. A man suffering with diabetes died in Farrington’s Lyme Regis Nursing Homeafter staff failed to check his sugar levels. It charges £1,200 per week.The Care Quality Commission CQC) has rated hundreds of care homes as ‘inadequate’. Hazardous conditions for residents, poverty pay, and chronic understaffing are but some of the symptoms of a dilapidated sector. Relatives had relied on the CQC’s positive ratings forLyme Regis home; it transpired that the CQC were already aware the home was performing poorly. Currently one in ten care home posts are vacant, with understaffing being one of the main causes of poor care delivery.
Reform or ruin
The long-standing crisis within social care predates the pandemic, as at the time, staffing shortfalls of 122,000 and severely low pay plagued the sector. Cuts to local authority spending totalled over £8bn in the 10-year period to June 2020. Approximately 1.4 million elderly people were receiving either insufficient or entirely inadequate care during this time. Things are getting worse. Care is very labour-intensive, so increasing productivity within the sector is extremely difficult. Hence the private owners of this highly commodified industry have to constantly slash workers’ wages and conditions to make a profit. Social care workers are still amongst the lowest paid in Britain with average hourly wages of £9.60. 60% of both frontline domiciliary care workers and domiciliary nurses are on zero-hour contracts; they are mainly women, black and Asian people and migrant workers.
It comes as no surprise that the Tory government now plans to cut back on extra adult social care spending announced in December 2021. The Health Service Journal (HSJ) says at least £550m will be slashed from the ‘adult social care workforce, reform and integration’ plans. The December 2012 plans were for a total pot of £1.7bn ‘to improve social care in England, including at least £500m investment in the workforce’, on top of £3.6bn to introduce a cap on care costs, extend means testing, and move towards a ‘fair cost of care’. The £3.6bn has already been cut, with the 2022 spending review saying those measures would be delayed and the money redirected ‘to allow local authorities to provide more care packages’. The £500m new investment in the workforce is to be halved. NHS Confederation policy director Layla McCay said: ‘Leaders have been calling for extra investment in social care, particularly around pay, to drive recruitment and retention in a system that has at least 165,000 vacancies. We know that this would be one of the best and most effective actions that could be taken to reduce pressure on the NHS and fill vacant positions.’
Care in the hands of the capitalist is bleak. It cannot ensure the wellbeing of users of an expanding sector the safety and dignity that they need.
Alex Scurr
