Care home crisis: Edinburgh short of places and is one of the most expensive areas

The crucial ability to look after patients is in danger of collapse
The crucial ability to look after patients is in danger of collapse
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THE extent of the Capital’s care home crisis has been laid bare after stark new figures revealed that places in the city’s facilities are among the most expensive and under-pressure in Scotland.

As part of a nationwide care home census, it emerged that 93 per cent of places for the elderly were occupied in the city – the second highest rate of the country’s 32 local authority areas.

The number of older care home residents with dementia is also on the rise, having almost doubled over the past decade to 53 per cent, as the average price of a room rose to £789 per week, with only the remote Shetland and Orkney Islands proving more expensive.

The worrying statistics revealed the number of care homes for older people in the city had fallen from 84 in 2000 to 64 this year, with the number of registered places also falling from more that 3400 to 2936.

Of the city’s long-stay care home residents, 63 per cent require nursing care compared with 57 per cent ten years ago, while those with medically diagnosed dementia increased from 27 per cent a decade ago to 53 per cent.

On the back of the figures, the city’s health leader, Ricky Henderson, admitted that the council and NHS faced increasing challenges in dealing with mounting pressure over care home places and said he hoped funding would be allocated to build a new home in the Capital in the forthcoming council budget.

He said: “The aging population and how we cope with that as a society is definitely top of our agenda. These figures do reflect the fact that we have a huge challenge in Edinburgh. Our focus is on trying to care for people more in their own homes and allowing them to be as independent as possible. But people are living longer and there are ever-increasing levels of care needs, and some people do reach a stage that they can’t stay at home. It does look like demand is going to continue to increase and put pressure on resources.”

It is anticipated that 184 new care home beds will be available in three new homes run by the private sector in the Capital next year, although fears have been raised that patients with more severe conditions may be denied private beds, as the operators “cherry-pick” less challenging and more lucrative residents.

Self-funding residents, paying on average £789 a week, are often preferred to those who rely on state-funding, with a nationally-set rate of £550 paid by local authorities to private companies.

Cllr Henderson said his department was “actively considering” building a new care home. “If the capital funding is available it’s something we would very much like to do,” he said.

But speaking at a meeting of the NHS Lothian board, Peter Gabbitas, the city’s director of health and social care, said that creating more care home capacity was “not necessarily a good thing” and that he wanted more people to be cared for at home. He said: “We want to increase care at home capacity.”

The Scottish Government has announced plans to integrate health and social care, meaning that NHS boards and councils will be asked to work more closely together to improve the experience and health of older people.

A shadow health and social care partnership, which includes seven NHS Lothian and seven council representatives, has already been set up to oversee the steps towards integration in Edinburgh.

Doug Anthoney, communication and campaigns officer for Age Scotland, said the charity is in support of the policy, but that it would not solve the “imminent funding crisis” that faced social care services.

He said: “Age Scotland is generally supportive of the government’s proposals for joining up health and social care services in Scotland, which should enable more older people to live fulfilling and independent lives in their communities.

“However these plans don’t solve the imminent funding crisis in social care, or the issue of charging for care services in the home and charging for residential accommodation. We would like to see our politicians give consideration to the debate in England, where the Dilnot Commission has proposed measures including a £35,000 cap on individual care payments.”

Tory health spokesman Jackson Carlaw said the census has shown that dementia had become an increasing challenge in the Capital’s care homes, as well as its hospitals, and called for more training for nursing and care home staff to deal with the condition.

He said: “We should never lose sight of just how difficult an illness this is, not to mention hugely upsetting for loved ones.

“Around one in five patients at the ERI has dementia, something nurses there are not automatically trained to deal with.

“That is why it is so critical that those people who work with dementia sufferers are equipped to do so, whether that be in a care home or hospital setting.With such a rapidly ageing population across the Lothians, it is essential we are prepared for this dementia timebomb, which is only going to increase as time goes on.”

It is estimated that the number of over-65s living with dementia in Edinburgh is currently 7142, with the figure expected to increase to 8745 in ten years and 11,548 by 2032.

It was announced yesterday NHS Lothian had appointed a dedicated dementia expert who will aim to drive up standards and improve the quality of life for people with dementia, as part of a joint initiative between the government and Alzheimer Scotland.

Professor Alex McMahon, NHS Lothian’s director of strategic planning, said that improvements had been made in home care packages and the services which are provided in communities.

He added: “Within Edinburgh, we expect to see a significant increase in the number of care home places available over the next six months. We also hope to improve the balance between capacity and demand across home care, care homes and NHS beds, through more integrated working across GPs, acute hospitals and community care.”

Pressure builds up in hospitals

PRESSURE over care home beds in Edinburgh is one of the key reasons behind “bed blocking” in Lothian hospitals.

Bed blocking patients are those well enough to leave hospital but become stranded there because they have nowhere appropriate – such as a care home – to which they can be discharged. NHS Lothian made progress to tackle the problem in recent years but recently, numbers of bed blockers – also referred to as delayed discharges – have been on the rise again.

We revealed last month that Lothian health chiefs had been urged to take action after it emerged that 325 patients had become stuck in hospital in August – which was a four-year high.

At least 17 of the patients had been stranded in hospital for six or more weeks and at least 35 had been waiting for a minimum of four weeks, with many of them waiting for Capital care home beds. The average excess stay for delayed discharge patients was 22 days.

Tory deputy leader and health spokesperson Jackson Carlaw said: “We know bed blocking is a significant issue across the Lothians, and one of the reasons for that is the lack of care home places.”