tag:blogger.com,1999:blog-1189064357283855936.post5635568146824685389..comments2024-02-01T09:25:16.606+00:00Comments on Bubb's Blog: Catherine the Great and Health!Sir Stephen Bubbhttp://www.blogger.com/profile/13575202213305419556noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-1189064357283855936.post-75517319950028252452012-02-22T22:54:58.898+00:002012-02-22T22:54:58.898+00:00High quality residential homes. What a good idea. ...High quality residential homes. What a good idea. I was for several years chairman of trustees of a charity that had supplemented a set of almshouses (read, sheltered housing) with a home for frail elderly (not, note, a nursing home), with the original intent of housing almshouse residents who could no longer live on their own but open to direct admissions too.<br /><br />The care given for residents, mostly not very mobile but able to spend their days in a well appointed day room if they chose to leave their own rooms (or were not bed-bound) was good. The food was good and there were superb gardens adjacent to the day room. <br /><br />Arguably the trustees made an error (the home was opened before I became a trustee) in not going for economies of scale as a care home is labour-intensive and labour in inner London is not cheap, especially if, by choice, you do not pay the rock-bottom wages paid in the private sector, nor the higher ones paid in the local authority sector, but in between.<br /><br />What became apparent in recent years was the sheer market forces of bad care driving out good, and cost-driven considerations driving out care-quality considerations. Put simply, the local authority who for the most part were increasingly the purchasers of our places chose to first fill their own homes - middling in quality, frankly - to keep them viable, despite the weekly cost per resident being a couple of hundred pounds a week higher. Then they shopped around in the private sector for the cheapest weekly cost, often well away from the borough in places where nobody familiar would visit the resident. Only if they could not find a place thus did they turn to us, even though the quality of care was recognisably better than that in either their own homes or the private sector's (at least at the market end we were covering - no doubt somewhere there were very high quality private sector homes at over £1,000 a week), though a leading councillor's mother was found a place. Faced with an absence of placements from the council, the charity for a period accepted pure private sector residents whose absence of poverty or anything approaching it sat uneasily with our charitable terms of reference. Eventually the trustees, after I retired from their number, decided the financial risks and subsidy could not be justified and closed the home, and are now converting the premises into further almshouse accommodation with minimal staff presence. <br /><br />So there goes another place where those who should not be in hospital, but are too frail to live alone in their own homes, could have gone. By the time the authorities wake up, there will be no voluntary sector presence in London - and possibly increasingly more of southern England - for this type of resident, and even the for-profit sector frankly finds it too hairy given the quirks and roller-coaster policies of placement purchasers.Dan Filsonhttps://www.blogger.com/profile/08090743893438968769noreply@blogger.com