James Mumford

How to reform the care home system

The care home residents had been left on the landing in wheelchairs. That was the sight that greeted me as I walked up the stairs of the nursing home I was visiting in Wembley, north London. From above, sawdust fell as builders blithely went about their business, fixing the roof. Apart from the drilling there was no noise. No one cried for help. No one complained. It was as if no one expected anything different.

The abandonment of the elderly in residential care was driven home recently by revelations of the full extent of failing homes. This year, forty per cent – yes, forty per cent – were found wanting by the regulator, the Care Quality Commission (CQC). Of a whopping sample of 5,300, 2,000 care homes were found inadequate or in need of improvement. Inspectors discovered the all-too familiar stories we wish we could consign to a Dickensian past. Men and women left soiled or locked in windowless rooms. Scenes from films and newscast nobody wants to watch.

The awful findings chime with the chilling things I saw during a two-year review of social care I led at The Centre for Social Justice think tank. Even in the past ten years, care home residents have radically changed in profile. Indistinguishable now from nursing home residents, the demographic shift has meant the people you see are more like patients than residents – frailer, older residents, with shorter lengths of stay. People suffering from many illnesses at once. A higher proportion than ever with dementia. In the past a care home was somewhere you went to forestall the decline to dependency. Now you go there when you are ill. And your future looks bleak.

Our immediate reaction is to leap to the Funding Question.

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Written by
James Mumford
James Mumford is a London-based writer and fellow at the University of Virginia's Institute for Advanced Studies in Culture. His most recent book, Vexed: Ethics Beyond Political Tribes, is out with Bloomsbury Continuum.

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