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Care Homes are all over the place. Literally.


CareWorkersCareWorkersFor a number of years, I have been going on about how we should be looking closely at where care is being provided, as much as how it is. The 2014 Care Act’s main aim was to put people at the centre of their care and be able to offer those needing a care home bed, a reasonable selection of homes for older people, on a local basis, throughout the country.

But across England there are massive variances in supply levels, ranging from much too little up to too much.

Too little local supply and people will not be offered a choice of locations, as they will be few, probably full, and this could result in having families having to look outside their local area.

Too much supply will bring low occupancy rates but more importantly will put a strain on local employment and the ability to obtain and retain enough care workers and RNs.

In the postcode sector adjacent to mine in Worthing, BN11 4, has more care home beds than any other postcode sector in England. Now Sunny Worthing has been a favourite retirement destination for decades, and around 11% of its population is 75 or over, against 8% nationally, but achieving viable occupancy levels is still a challenge.

But the even greater challenge is finding sufficient number of care workers and RNs. The photograph shows just 3 examples of where Worthing care groups are using hoardings outside their homes to try and get more staff. One group has a regular Friday afternoon “drop in” to try an convince people to work for them.

In previous reports I have tried to show how local supply varies greatly across the country, and for this, my latest illustration, I have gone back two and a half years to the start of 2016 to show what has happened to supply levels through openings and closures during that time.

I measure supply and demand levels on the number of beds available per thousand population aged 75 and over. According to research undertaken by Bupa and the Personal Social Services Research Unit (PSSRU) in 2011 around 90% of all care home residents come from this age group, and only 10% between 65 and 74.

In England in 2016 there roughly 89 beds per ‘000, and this has shrunk to 85 in July 2018 due to a 4% increase within the key age group, and little or no growth in the number of beds.

Topline highlights (or lowlights) are as follows:

• 42 local authorities who started 2016 relatively over supplied had a net increase in beds since then. Of these 35 were Unitary Authorities and only 7 were County Councils.

• 34 local authorities who started 2016 relatively under supplied had a net loss of beds since then. Of these 32 were Unitary Authorities and only 2 were County Councils.

• Therefore, most of the Local Authorities that are “going in the wrong direction” with regards to supply and demand levels, are Unitary Authorities.

• 42 local authorities who were under supplied at the start of 2016 have seen an increase in beds since then, but only 22 of them by a percentage equal or above the 75 plus population increase during that same time.

• 71, or nearly half of the 150 local authorities, have lost more beds through closures than new beds from openings.

• 28 local authorities have not had a single care home opened since January 2016.

The chart displays supply levels across the regions, showing the index for the lowest local authority, the highest, and for the region overall. What is evident is not only massive variances within each region, but also the supply levels of the regions themselves.

Whilst we have identified major variances in supply at regional and at local authority levels, we are still only looking at the total number of beds. People will require different types of care, be that nursing, residential and of course dementia care, so having a residential bed for someone needing nursing care, this will not meet requirements.

It is so important that local authority social services departments have a clear understanding of where they have supply issues, finding ways of incentivising developments within low supply areas, and also working closely with their planning departments when it comes new applications, by fast tracking those where there is a need, and seriously considering applications in areas that are already over supplied.

There is market intelligence available, such as the data held by CSI, and it should be harnessed and utilised to support the robust future planning of care homes for older people,

Mike Short

28th September 2018



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