ITV News Correspondent Sarah Corker reports on the growing crisis in social care
When 87-year-old Christopher Wilson from Chichester had a serious chest infection, he genuinely believed he was dying.
Struggling to breathe, an ambulance took him to hospital, but a shortage of beds and corridors filled with patients on trollies meant he was turned away despite being in significant pain. “I was absolutely shocked. I’d seen that sort on thing on the TV, but I was actually in the middle of it experiencing it and that really brought it home,” Mr Wilson said. “The NHS is basically broken. I just want to stay at home for as long as I can go on, but I am losing my independence,” he added.
Mr Wilson has early onset dementia and lives alone. Neither his GP nor the local council could organise a care package for him, and so in desperation, his nephew David Carling booked him into a home for a month of respite care.
“Most people didn’t even have time to see him as they were fully booked, the ones that did have time (to assess him) focused only on money, his finances, and they wanted him to be checked financially to see his bank records to know that he could afford care,” said Mr Carling. Eventually after months of searching, the family discovered Home Instead, a national home care company, who now provide Mr Wilson with daily care visits in his own home. “I think his life would be a lot shorter if he didn’t have help, there’s no doubt about that, I don’t think he’d be able to look after himself properly and would slowly go downhill, worse and worse.”
Mr Wilson wants to stay in his own home for as long as possible, while his nephew David fears his uncle's health would deteriorate rapidly if he didn't have help
Care providers have warned that the social care system is at crisis point – underfunded and understaffed - and it’s sending a ripple effect through the entire NHS.
Every day an estimated 13,000 patients who are medically fit to be discharged from hospital are stuck on wards because there’s no care available for them at home or in the community. That’s putting unsustainable pressure on NHS beds and ultimately leads to ambulances backing up outside A&E.
Exclusive research for ITV News by one of the UK’s biggest social care providers reveals the scale of this crisis; Home Instead found that 27% of their network, which represents 13,000 carers, are facing record demand from hospital discharges, some have seen a 1,000% increase compared to a year ago.
64% of respondents to their survey said there’s been a rise in requests from families directly trying to arrange care, the majority referencing hospital discharge as the main reason.
When it comes to length of home visits, the industry standard is an hour of care, but almost a third of respondents said more councils are requesting call outs of just 15 minutes.
The sector currently has 165,000 vacancies with record numbers leaving the profession because they can often earn more in hospitality or retail.
ITV News has also learned that people with complex needs, including end-of-life care, are being moved to providers willing to accept the cheapest rates from £15 an hour.
The Homecare Association which represents providers has warned that these rates "come nowhere near covering costs" and "the negative impact on individuals and their families is substantial."
Councils with squeezed budgets are purchasing homecare by the minute at - in many cases - very low fee rates, Homecare Association CEO Jane Townson explains
But the hourly fee rate has to cover the care worker's wages, employment costs such as National Insurance, as well as contribute to the other costs of running a care agency
She said: "We're miles away from there being enough funding in the system to be able to invest in our workforce which we need to do because we know that if we pay them well and recognise their skills and train and support them they will stay - and then we can grow the workforce to meet the needs of the population."
Chief Executive Jane Townson warned that decisions about care were being taken not based on the welfare of patients - but driven by cost-cutting. She is calling for an hourly fee rate of at least £28.44.
The average across the UK at the moment is £19 an hour, she said.
Paula Glass of Home Instead Stockport & Tameside estimates that 13% of hospital beds are taken up by patients who can be at home if they have the correct care in place
At Harrogate and District NHS Foundation Trust, while flu season and Covid testing have made discharges more challenging, the biggest factor is the delays in finding suitable care packages in the community or nursing homes.
“On any given day we have up to 60 patients who aren’t needing the care of the hospital,” the Trust’s Deputy Chief Operating Officer Dr Matt Shepherd said.
“That’s triple the number from pre-Covid times. We have just over 300 beds, so a sizeable portion of our bed base is taken up by people who don’t need to be there.”
Winter is always challenging, but due to issues around discharges - that busy winter period is effectively extending across most of the year Dr Matt Shepherd, Deputy Chief Operating Officer said Harrogate and District NHS Foundation Trust says
He worries about the impact it has on staff and their wellbeing
“The busy winter period is effectively extending across most of the year and that’s hard to sustain being on that level of highest alert on a day-to-day basis. It’s difficult for staff. How long can you sustain that level?” he added.
Simon McGee, founder of Home Instead Chichester & Bognor Regis: "Budgets are shrinking and the elderly population is growing. This is not something you can solve without serious changes."
It’s estimated that more than half a million people are stuck on waiting lists for support or even just waiting for their needs to be assessed.
A situation that’s threatening the welfare of some of the country’s most vulnerable people.
A Department of Health and Social Care spokesperson said: “We have made up to £7.5 billion available over the next two years to support care services – the biggest funding increase in history – and we are working to bolster the workforce through our domestic and international recruitment campaigns."
Want a quick and expert briefing on the biggest news stories? Listen to our latest podcasts to find out What You Need To Know...