SCOTLAND’S elderly face years of neglect and “horrid” care unless there are significant tax rises and people begin to save more for retirement, according to the country’s leading dementia expert.
Professor June Andrews, former director of the Dementia Services Development Centre at Stirling University, said unless the current system of funding changes, gaps in standards of care will begin to yawn, resulting in “fabulous care for the rich, decent care that strips your family wealth for the affluent middle, and something unpleasant for those at the mercy of the future state”.
Ms Andrews said neglect could manifest in low staff numbers, poor staff training, poor food or the “decaying fabric” of the care unit.
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“If there is no-one to top up [care costs] for you, and you have no capital, you are at the mercy of the council,” she said.
“Vast numbers of care home beds have no ensuite facilities, and even where they do, its just a toilet and not a shower room, making management of continence really hard.
“If you add to that low staffing, or poorly motivated, high-turnover, unsupported staff and it starts to get fairly horrid.”
While the cost of care is nationally negotiated, Scottish care homes are currently threatening to walk away from a national agreement, after being offered what they claim amounts to a one per cent increase in the face of an eight per cent rise in costs.
Ms Andrews said “You get what you pay for. We will have to start expecting depressing unsafe care if the cost paid by the state does not match the price required by the service providers.”
While many well-off families resent having to use savings or the sale of their home to pay for care, they need a reality check, Prof Andrews added, with Scotland likely to follow parts of England where families often have to top up the cost of care with cash.
“Other countries have laws obliging children to pay for their parents,” she said. “And while the current older generation often owns property, which can be used to fund care, fewer people who are young now will be in that position when they retire”.
She added: “What about the next generation, who might never afford to buy? What will they sell for care when their time comes?”
Prof Andrews said that as councils struggle to fund care for those who need it, and care home company finances are precarious, no one was to blame for the current situation, but there was a lack of realism from the public, as taxpayers, and politicians alike.
“There are no villains here,” she said. “Just the problem of us all assuming we’ll be cared for at someone else’s expense in future.”
Earlier this week, Donald MacAskill, chief executive of Scottish Care said austerity and public sector cuts meant nursing homes were only paid £3.85 an hour towards the care of vulnerable residents, many of whom were at the end of life. He called for the Scottish Government to intervene to address underfunding in the sector. “For me this isn’t so much about finance but about the price we are prepared to pay for preserving the dignity of our older Scots and enabling them to exercise choice and control over their options for high quality care provision,” he said.
A poll by BMG for The Herald found that when asked to choose between the state or the individual, 72 per cent of people aged 65 plus say that the state should pay for social care not the individual, even if it means significantly increasing taxes. The figure for 16-34 year olds was lower with only 57 per cent expecting that the state would pay.
However only 60 per cent of those aged 65 or over believed they could actually rely on the state to pay for their care, with 11 per cent saying they were likely to rely on family and friends. Just eight per cent of over 65s said they would pay for care by selling their home or assets.
A spokesman for Age Scotland said the charity was concerned about levels of funding for care services and - ahead of local government election - would be calling for councils to invest in personalised, dignified and high-quality social care; ensure the cost of free personal and nursing care was paid promptly for those who need it. Local authorities should also collaborate to ensure social care charges are fair and consistent, he said.
A Scottish Government spokesperson said: “Everyone should receive quality care and support appropriate to their needs. We have seen the number of care services found to be providing good, very good or excellent care rise, and the on-going review of National Care Standards will ensure those using care services experience even better quality of care and support across health and social care services.
“National Care Home Contract negotiations are between COSLA and care providers, however we believe that the offer being made by COSLA is a reasonable and fair one. The Scottish Government has already provided significant investment of £250 million, alongside a further £100 million next year, to support social care and ensure adult care workers receive the Living Wage.”