I have published annual reports analysing openings and closures in Care Homes for older people during 2015, 2016 and 2017. As 2018 is going to be a pivotal year for social care, especially care homes that look after people aged 65 and over – I thought I would increase the frequency of my reports, and can now show the results of my analysis of the first quarter of 2018.
What is obvious, is that there are major regional and local variances in both openings and closures of homes.
Only 23, or 1 in 7 local authorities could boast a single care home opening, with only 38 new care homes adding 1,700 beds. 74% of new beds came from just 10 of them.
Residential or nursing dementia registrations accounted for 87% of all new beds. But there was a surprising shift (but a much needed one as this editorial goes on to show) towards residential dementia, which accounted for nearly half of new beds, whilst it only accounts for about a third of beds in the total market.
Regionally, the best performance for openings was in the South West, accounting for 18% of openings, against their 14% share of all homes. The worst performer, London, did not have a single opening. When one considers that the eight Local Authorities with the lowest supply levels across England are in London, this is not good news at all.
61 homes closed their doors, losing slightly over 2,000 beds, with a total net loss of 322 beds during the quarter.
Out of those 2,000 beds lost through closures, around 1,400, or 70%, were registered as dementia.
I alluded above that there was a much-needed shift towards extra residential dementia beds from first quarter openings, but around 60% of lost beds were from that sector So the net effect was a loss of 164 beds – or half of the net loss. The only sector to show a net increase was nursing dementia.
Out of around 150 Local Authorities only 39 suffered any closures, and in fact 50% of lost beds were down to just 10 of them.
One would expect poor inspection ratings to affect a home’s ability to survive, and this was in fact the case with around 43% of closures having an INADEQUATE rating.
However, there were as many closures of GOOD homes as those who were deemed to REQUIRE IMPROVEMENT.
Regionally the North West came of worse with a net loss of 313 beds, followed by a loss of 165 in London, not helped by zero openings. West Midlands showed the best net increase at 164, followed by the South East with 118.
A net loss of 322 beds may not seem a big deal out of around 395,000 available beds – but it comes at a time when supply is not keeping up with the extra demand created by an increasing elderly population.
Finally, I look at the net “winners” and “losers” at Local Authority level, but first the “no shows”.
Ninety-nine, or about two thirds of Local Authorities did not have any openings or closures.
Only 20 showed an increase in beds, headed by Surrey, followed by Leeds and then Sefton. This is despite all three Local Authorities already having higher than average supply levels.
Lancashire was the worst performing Local Authority losing 226 beds, but this must have something to do with the fact that they ended 2017 with about 23% over supply. Essex were the second biggest losers, and St Helens in third – even though they both began the year with below average supply levels.
CSI has repeatedly reported on the massive variances in supply levels across the country. Unfortunately, those variances are occurring with openings and closures as well, but we are not necessarily seeing growth in areas with low supply levels (citing London as an example) or reduction with higher supply levels such as Surrey Leeds and Sefton.
WHERE care is provided is as important as HOW and needs to be quickly remedied to give everyone a good choice of care on a local basis, and providers a chance of sensible occupancy levels.
Average supply is based on the number of care home beds for older people for every one thousand people over the age of 75, which is around 84 in England – but varies between 50% and 150% of this across the Local Authorities.